Objective To analyze the current situation of career decision-making difficulties among vocational college nursing students and influencing paths, and provide the theoretical references for promoting career decision-making among vocational college nursing students.

Methods A survey was conducted among 786 vocational college nursing students using the Perceived Social Support Scale (PSSS), Perceived Stress Scale (CPSS), Career Decision Self-Efficacy Scale (CDMSE) and Career Decision Difficulty Scale (CDDQ).

Results The scores of PSSS, CPSS, CDMSE and CDDQ of vocational college nursing students were (59.52 ± 16.16) points, (40.08 ± 9.35) points, (86.00 ± 18.20) points and (58.01 ± 11.70) points, respectively, and there was a significant correlation between any two (P ＜ 0.01). The CDMSE of vocational college nursing students played a partial mediating effect in PSSS and CDDQ. The mediating effect accounted for 83.76% of the total effect. PSSS and CPSS could significantly predict CDDQ (P ＜ 0.01), and the interaction effect between PSSS and CPSS was obvious (P ＜ 0.01). The simple slope graph showed that with the increasing of CPSS level, the positive effect of PSSS on CDMSE of vocational college nursing students weakened.

Conclusions The difficulty of career decision-making for vocational college nursing students is at a medium level. CPSS plays a negative moderating role in the first half of the mediating process of PSSS-CDMSE-CDDQ for vocational college nursing students.