The study investigated the relationship between emotional intelligence (EI) and nurses' clinical decision-making confidence (CDMC) among 1,126 nurses from 12 hospitals in China. The results showed that EI directly influences CDMC (27.16% of the total effect) and indirectly through creative self-efficacy (CSE) and self-directed learning (SDL), which together mediated 72.84% of the indirect effect. In high-stress environments, the EI → CSE → CDMC path was stronger, while in less stressful departments, mediation through SDL dominated, especially in pediatrics and gynecology. Nurses with less than 5 years of experience mainly used the sequential mediation of EI → CSE → SDL → CDMC, while more experienced nurses (more than 5 years) had a more pronounced direct effect of EI on CDMC and a reduced role of SDL. The study highlights the need to tailor emotional intelligence training and learning to nurses' stressful environments and experiences to improve clinical decision-making. Decision models should be context and experience specific.