“We Are One of the Most Depressed Professionals”: Nurses' Experiences of Psychological Hazards in A District Hospital

AIM: This study explored the occupational hazards faced by nurses in a district hospital in Ghana, analysed their psychological outcomes, and examined how emotional labour mediates nurses' behaviour in patient care. DESIGN: A focused ethnographic study. METHODS: Over the course of 11 months, data were collected purposively from 31 general nurses and one key informant using in-depth interviews, participant observation, and informal dialogues. Data were analysed thematically using network analysis, supported by NVivo 12 Plus. Rigour was enhanced through prolonged engagement, triangulation, pilot testing, member checking, and peer debriefing. RESULTS: Two categories of psychological hazards emerged: default hazards (unavoidable), such as patient deaths, ubiquity of sickness, and unpleasant sights; and escapable hazards (somewhat avoidable), including work-related injuries and shift-work maladaptation. These hazards triggered grief, disgust, fear, anxiety, and fatigue, which nurses managed through emotional labour strategies: surface acting, deep acting, spiritual coping, peer support, and emotional detachment. While these strategies enabled professionalism, they often led to emotional dissonance, burnout, and strained relationships between nurses and patients. CONCLUSION: Occupational hazards in hospital wards carry significant psychological burdens that shape nurses' behaviour and professional conduct. Emotional labour mediates these responses, but reliance on individual coping strategies is unsustainable without institutional support. Comprehensive support systems, such as psychotherapeutic counselling during and after nursing school, are needed to mitigate the effects of these occupational hazards on healthcare providers. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.