Objective To understand the level and influencing factors of medical narrative ability among nurses working in 3A hospitals in Tianjin, and to provide basis for the implementation of targeted training aiming at improving of medical narrative ability of nurses. Methods A total of 350 nurses from 3A hospitals in Tianjin were investigated by using the Narrative Engageability Scale. Results The nurses scored (154.20±17.07) points in medical narrative ability, with the scores of each dimension in descending order being listening attentively, understanding and giving response, and reflection and reminiscence. Such factors as place of growing up, professional titles, familiarity with narrative nursing, working years, and satisfaction with nursing work contributed to a variation level of 27.7% of medical narrative ability (P＜0.05，P＜0.01). Conclusion Nursing managers should pay special attention to nurses who grow up in cities, have low professional titles, do not know narrative nursing at all, have fewer working years and who have low satisfaction with nursing work, and provide targeted training to improve their medical narrative ability.