Background <p>To describe the overall level of self-assessed Traditional Chinese Medicine (TCM) nursing competency among clinical nurses, identify latent competency profiles, and examine demographic and training-related attitude factors associated with profile membership.</p> Methods <p>This cross-sectional study was conducted from January to October 2024 at a tertiary Grade A hospital in China. Eligible nurses were recruited voluntarily from multiple clinical departments in which TCM nursing services were routinely provided. A total of 457 valid questionnaires were analyzed. Data were collected using the Traditional Chinese Medicine Nursing Competency Questionnaire and a questionnaire assessing training-related attitudes and needs among TCM nursing staff. Latent profile analysis was used to identify competency profiles, and multinomial logistic regression was performed to examine factors associated with profile membership.</p> Results <p>The overall level of self-assessed TCM nursing competency was moderate. Scores were higher for TCM nursing techniques but lower for advanced clinical practice, indicating relatively limited advanced-practice and integrative application capacity. Latent profile analysis supported a three-profile solution (entropy = 0.846): low self-assessed competency (12.3%), moderate self-assessed competency (64.3%), and high self-assessed competency (23.4%) profiles. Profiles differed significantly in years of service, professional title, educational attainment, intention to participate in training, and perceived importance of training. In multinomial logistic regression, educational attainment, intention to participate in training, and perceived importance of training were consistently associated with membership in higher self-assessed competency profiles. Professional title was significant only in the high-profile contrast, whereas years of service was not independently associated with profile membership after adjustment.</p> Conclusions <p>Clinical nurses working in departments where TCM nursing services were routinely provided showed heterogeneous patterns of self-assessed TCM nursing competency, with most nurses classified into the moderate self-assessed competency profile and advanced clinical practice emerging as a relative weakness. Profile-informed, tiered training strategies focusing on contextualized practice and clinical application may be warranted. However, given the cross-sectional design and reliance on self-reported data, the identified profiles should be interpreted as patterns of perceived competency rather than developmental stages or evidence of progression over time. Longitudinal or intervention studies are needed to further verify these associations.</p> Clinical trial number <p>Not applicable.</p>