ObjectiveTo investigate the nursing work environment, affective competence, and work engagement of outpatient and emergency department nurses, and the relationships among these three variables, to enhance the work engagement level of outpatient and emergency department nurses.MethodsFrom May to June 2022, a convenience sampling method was used to select 306 outpatient and emergency department nurses from five top tertiary hospitals in Wuhan, Hubei Province. The Nursing Work Environment Scale, the Nurse Affective Competence Scale, and the Utrecht Work Engagement Scale(UWES) were used for a questionnaire survey. Descriptive statistics, correlation analysis, and multilevel regression analysis were performed on the survey data to explore the mediating role of affective competence between the nursing work environment and work engagement.ResultsA total of 291 questionnaires were collected, with a valid recovery rate of 95.1%. The total scores for nursing work environment, affective competence, and work engagement of outpatient and emergency department nurses were (87.35 ± 13.24), (129.21 ± 6.35), and (20.25 ± 7.68) points, respectively, indicating an overall good status. The scores for nursing work environment showed a strong positive correlation with both affective competence scores and work engagement scores (r = 0.656, r = 0.735, both P < 0.01). Affective competence scores also showed a strong positive correlation with work engagement scores (r = 0.706, P < 0.01). Multilevel regression analysis results indicated that affective competence played a partial mediating role between the nursing work environment and work engagement, with the mediating effect accounting for 34.97% of the total effect.ConclusionsNursing managers can promote the work engagement of outpatient and emergency department nurses by optimizing the nursing work environment and cultivating nurses' affective competence, thereby improving the quality of outpatient and emergency nursing services and promoting the high-quality development of hospital service levels.