Background <p>Nurses working with state patients face several challenges such as physical aggression and verbal threats while rendering care. State patients are individuals who have been charged with crimes but are deemed unable to face trial because of infirmity. This study explored and described the experiences of nurses caring for state patients in North West Province of South Africa.</p> Methods <p>A qualitative exploratory-descriptive and contextual research design was adopted to gather the experiences of nurses caring for state patients. Thirteen nurses caring for state patients were purposively sampled from one selected public mental healthcare facility. Face-to-face in-depth semi-structured individual interviews were used to generate data. The interviews were recorded and transcribed verbatim, and the data were analysed separately by the researcher and co-coder using thematic analysis.</p> Findings <p>Four themes emerged from data analyses: (1) psychological experiences of nurses caring for state patients, (2) consistently setting limits and maintaining boundaries, (3) receiving positive feedback from patients and families, and (4) suggestions for improving care and support.</p> Conclusions <p>Effective care delivery, adequate training, emotional support, and resources should be provided in mental health care settings to ensure proper care to state patients. Mental health care institutions should implement proactive and holistic support systems for nurses to perform effectively. This study suggests that improving patient care depends on enhancing the working conditions and emotional resilience of nurses through empathetic leadership.</p> Clinical trial number <p>Clinical trial number not applicable.</p>