Nurses suppress grief, fear, and disgust to do their work
STUDY: Kodom PNB et al, Nursing Open 2026;13:e70597
STUDY TYPE: Qualitative study
FUNDING: BANGA-Africa Project Thesis Completion Grant
Background
Nurses face daily psychological hazards: patient deaths, graphic wounds, needle-stick injuries, and disruptive shift schedules. Most research on nurse burnout uses surveys that count symptoms but miss the lived experience. This study went inside a district hospital in Ghana for nearly a year to watch what actually happens, and records it in the nurses own words.
The Study
- 31 general nurses and one senior matron at a district hospital in Ghana; participants averaged 32 years old with 5 years of experience
- Data collected over 11 months through direct observation, in-depth interviews, and informal conversations
- Researchers identified two categories of hazards: unavoidable ones (patient deaths, constant exposure to illness, disturbing sights) and avoidable ones (needle-stick injuries, shift-work sleep disruption)
Results
Nurses described two emotional responses:.
- Surface acting: suppressing visible grief or disgust to appear professional. One nurse, after a patient died, snapped at a family member who asked a routine question. She knew why it happened.
- Deep acting: genuinely inducing empathy, sometimes buying insulin for an uninsured child out of her own pocket.
Over time, many nurses went numb. One said, “We are hardened, so death is no longer news.” Another said flatly: “We are one of the most depressed professionals you could ever find.”
Needle-stick injuries created fear of HIV that could last months. One pregnant nurse lived in anxiety through six months of repeat testing. After a prick from a patient who moved unexpectedly during an injection, one nurse refused to give injections altogether.
Night shifts compounded everything. Nurses working afternoon shifts arrived home after 11 p.m. and returned by 8 a.m. One nurse took sleeping pills just to rest. A nursing student was mugged at knifepoint waiting for a taxi after a late shift.
This study is set in Ghana, but the patterns run across every health system.
Practice Implications
- Emotional labor is invisible work, and without institutional support, it burns people out.
- Burnout in nurses isn’t a character flaw. It is a problem with our systems.
— Chris Aiken, MD
Director, Psych Partners
Editor in Chief, Carlat Psychiatry Report
