Background <p>Clinical leadership is crucial for healthcare quality, but its predictors among nurses in China are not well understood. This study investigated the independent predictive power of emotional labor, psychological detachment, and perceived organizational support on clinical nurse leadership, guided by Conservation of Resources theory.</p> Method <p>Using a convenience sampling method, 212 registered nurses from three tertiary hospitals in Tianjin were recruited for a cross-sectional survey. Data were collected using a set of standardized questionnaires, which assessed demographic characteristics, emotional labor, psychological detachment, perceived organizational support, and clinical leadership. Descriptive statistics and linear regression analysis were employed to analyze the data.</p> Results <p>The average leadership score of the clinical nurses was 4.53 ± 0.54 points. Clinical leadership was positively correlated with emotional labor (<i>r</i> = 0.432, <i>p</i> &lt; 0.01) and perceived organizational support (<i>r</i> = 0.538, <i>p</i> &lt; 0.01). Clinical leadership is negatively correlated with psychological detachment (<i>r</i>=-0.186, <i>p</i> &lt; 0.01). However, in the hierarchical regression model controlling for demographic variables, only emotional labor (<i>β</i> = 0.304, <i>p</i> &lt; 0.001) and perceived organizational support (<i>β</i> = 0.439, <i>p</i> &lt; 0.001) remained significant predictors, collectively explaining 44.5% of the variance in leadership scores (adjusted <i>R²</i>=0.445). The initially observed association with psychological detachment became non-significant in the final model (<i>p</i> = 0.063).</p> Conclusion <p>Emotional labor and Perceived Organizational Support are critical, modifiable factors that significantly predict clinical nurse leadership. Healthcare organizations should prioritize fostering a supportive environment and providing emotion regulation training to cultivate nursing leadership.</p>