Objective To explore an effective method for cultivating prescribing competence of specialist nurse and to provide clinical experience for the implementation of nurse prescribing. Methods A "three-ladder" training was implemented for specialist nurses based on physician-nurse joint clinic, including physician assistant position training, practice in physician-nurse joint clinic, and practice in nurse-led clinic based on physician-nurse collaborative prescribing. Results A total of 342 cases of nurse prescribing were extracted for analysis. The rate of correct diagnosis of symptom/nursing problem by specialist nurses was 97.66%, appropriate test prescribing was 95.91%, appropriate treatment selection was 93.27%, and accurate interpretation of specialty test results was 99.12%. Conclusion The "three-ladder" training model based on physician-nurse joint clinic can enhance prescribing competence of specialist nurse.