Background <p>Nurse-patient conflict acts as a common stressor for nursing interns during clinical training. Existing research fails to empirically verify the synergistic buffering pathways of two-way social support and psychological resilience on interns’ situational emotional responses in Chinese clinical settings. This study aimed to describe interns’ emotional response status under nurse-patient conflicts and explore relevant associated factors.</p> Methods <p>A cross-sectional correlational design was adopted. A total of 423 eligible nursing interns with conflict experience were recruited from six Henan hospitals via convenience sampling between August and October 2025. Three validated scales (ERES, Brief Two-Way Social Support Scale, CD-RISC) were adopted for data collection, with Pearson correlation, multiple linear regression and SEM used for statistical analysis.</p> Results <p>The average situational emotional response score was 124.49 ± 21.73; situational emotional perception obtained the lowest subscore. Two-way social support (<i>r</i> = 0.682, <i>p</i> &lt; 0.01) and psychological resilience (<i>r</i> = 0.512, <i>p</i> &lt; 0.01) were positively correlated with emotional response. Conflict frequency, two-way social support and psychological resilience served as independent associated predictors, and the SEM confirmed their positive associative pathways.</p> Conclusion <p>Nursing interns showed moderately high situational emotional response but weak emotional perception. Frequent nurse-patient conflicts were negatively correlated with emotional functioning, whereas two-way social support and psychological resilience served as protective correlates. Based on cross-sectional data, we recommend targeted emotion perception training and regular mutual support channels for interns; systematic intervention schemes need subsequent verification.</p> Clinical trial <p>Not applicable.</p>