Objective To investigate the current status of occupational insecurity among ICU nurses in China, reveal its diversity and heterogeneity, and provide scientific evidence for improving nursing quality and promoting the professional development of nurses.

Methods In 2023, by a convenience sampling method, 1 500 ICU nurses from 24 provinces, municipalities, and autonomous regions in China were surveyed online using the Occupational Insecurity Scale, Psychological Ownership Scale, and Team Positive Emotion Climate Scale. Mplus 8.3 software was used to explore latent profiles of occupational insecurity; SPSS 24.0 software was used to construct multinomial logistic regression models to analyze the influencing factors of different types of occupational insecurity.

Results A total of 1 437 valid questionnaires were collected with an effective response rate of 95.8%. The median and 25th to 75th percentile M(P₂₅, P₇₅) of the total occupational insecurity score was 29.0 (18.0, 37.0) points, with quality job insecurity at 18.0 (10.0, 23.0) points and quantity job insecurity at 11.0 (6.0, 16.0) points. The psychological ownership score was 44.0 (39.0, 49.0) points, and the team positive emotion climate score was 34.0 (31.0, 40.0) points. Four latent profile types of occupational insecurity were identified, including the low (513 cases, 36.3%), the moderate (654 cases, 43.6%), the high (92 cases, 6.9%), and the mixed (178 cases, 13.3%). Logistic regression analysis showed that among nurses with low occupational insecurity: (1) for each 1-point increase in team positive emotion climate score, the occurrence risk of moderate, high, and mixed occupational insecurity decreased to 0.850, 0.926, and 0.862 times, respectively (P < 0.01); (2) for each 1-point increase in psychological ownership score, the occurrence risk of moderate occupational insecurity decreased to 0.958 times (P < 0.01); (3) compared to nurses aged ≤ 25, the nurses aged 36-45 or ≥ 46 w had 3.387 and 3.707 times higher risk of experiencing moderate occupational insecurity, respectively (P < 0.05); (4) compared to nurses with the title "Nurse, " those with the title"Nursing Team Leader" had 1.981 and 2.458 times higher risk of experiencing moderate or mixed occupational insecurity, respectively (P < 0.01); (5) compared to married nurses, divorced nurses had a 0.354 times lower risk of experiencing mixed occupational insecurity (P < 0.05); (6) compared to nurses with the title "Nurse, " those with the titles "Nurse Practitioner, " "Nurse-in-charge, " and "Associate Chief Nurse and above" had 0.370, 0.101, and 0.101 times lower risk of experiencing mixed occupational insecurity, respectively (P < 0.05).

Conclusions ICU nurses in China had high levels of occupational insecurity, influenced by multiple factors. Effective interventions and improvements should comprehensively cover individual, organizational, and social aspects.