The First Time I Froze

I don't think I actually froze.

At least, not in the way we usually imagine it.

I didn't stand motionless in the middle of a resuscitation. I didn't forget everything I had learned. I didn't suddenly become incapable of performing the clinical skills I had spent years developing.

But I remember standing in a resuscitation room, struggling to draw up medications.

I remember struggling to open vials.

And I remember the frightening realisation that my clinical skills, the things I had done hundreds of times before, suddenly felt like they had disappeared.

I had worked in emergency nursing for around twelve years at that point.

I had seen sick patients before. I had been involved in resuscitations. I had worked in paediatric emergencies and trauma. I knew what the clinical environment demanded of me.

But this was different.

This was the first time I had found myself genuinely struggling to think clearly in a clinical situation.

And the reason wasn't that I didn't know what to do.

The reason was that I cared too much about what was happening.

The moment things changed

Paediatric trauma has always been difficult.

There is something about caring for a seriously unwell or injured child that can make even the most experienced clinicians feel the weight of the situation differently.

But becoming a parent changed the way I experienced some of those cases.

Before becoming a parent, I could still understand the fear and devastation of a family. I could empathise with them. I could imagine, intellectually, what it might be like to have your child critically unwell.

But after becoming a parent, that distance became much harder to maintain.

Suddenly, the child in front of me could be the same age as one of my own children.

The parent standing at the bedside could be me.

And in one particular case, that is exactly what happened.

I knew the clinical situation was serious.

I knew what the likely outcome was.

I understood the seriousness of what we were dealing with.

But then I saw the father's face.

It was the genuine fear that stayed with me.

And something shifted.

I stopped seeing the situation only as a clinician.

I started seeing it as a parent.

I placed myself in his position.

I imagined what it would be like to be standing there, watching your child in that situation, surrounded by clinicians, machines and urgency, with no control over what was happening.

And suddenly, I wasn't just managing a clinical emergency.

I was experiencing the emotional reality of the parent standing in front of me.

That was the problem.

Not because empathy is a problem.

Not because caring is a problem.

But because, in that moment, my emotions began to interfere with my ability to think systematically.

When experience disappears

The resuscitation continued.

Around me, the team was working.

People were communicating. Medications were being prepared. Decisions were being made.

And I was trying to do my job.

But I could feel myself becoming overwhelmed.

I remember trying to draw up medications and struggling to open the vials.

Something I had done countless times before suddenly felt difficult.

I remember thinking that I should be able to do this.

I had been an emergency nurse for twelve years.

I knew how to draw up medications.

I knew how to work in a resuscitation.

I knew how to function in a high-pressure environment.

But suddenly, those skills felt like they had evaporated.

The more I tried to maintain my composure, the more difficult it became.

And there is something particularly difficult about becoming emotionally overwhelmed in a room full of clinicians.

You are aware of everyone around you.

You are aware that you are supposed to be the experienced person.

You are aware of the expectation that you should be calm.

You are aware that other people may be looking to you for confidence.

And you are aware that you are struggling.

The natural instinct is to try to hide it.

To push through.

To tell yourself that you are experienced enough to manage it.

To keep going because you don't want to be the person who needs to step away.

But I eventually recognised that I was not functioning at my usual level.

So I changed roles.

I moved away from the more complex tasks and focused on simpler ones.

I did what I could to remain useful to the team.

But eventually, I realised that I needed to step away completely.

I told another nurse that I needed to leave for a while and refocus.

And then I walked out of the resuscitation room.

I sat outside in the cold air.

The decision to step away

I had worked in emergency nursing for twelve years.

And this was the first time I had done that.

The first time I had recognised that I was too emotionally affected by a situation to continue functioning at my usual clinical level.

The first time I had stepped away from a resuscitation because I knew that I was no longer the best person to be doing the job I had been doing.

And, honestly, that was difficult to accept.

There is a culture in healthcare that often celebrates the person who pushes through.

The person who stays late.

The person who keeps going.

The person who remains calm in every situation.

The person who can deal with anything.

Experience is often associated with an ability to withstand more.

More stress.

More trauma.

More responsibility.

More emotional pressure.

But I think there is a difference between being resilient and pretending that you are unaffected.

There is a difference between being able to manage difficult situations and believing that you should be immune to them.

And there is a difference between being experienced and being so determined to prove your experience that you ignore the signs that you are no longer functioning effectively.

In that moment, stepping away wasn't a failure.

It was a clinical decision.

I recognised that my emotional response was beginning to affect my ability to think clearly.

I recognised that I was struggling to perform tasks that I would normally perform without difficulty.

And I recognised that someone else was better placed to continue.

That is not weakness.

That is clinical judgement.

We all bring something into the room

One of the things I have come to understand more clearly throughout my career is that no two clinicians experience the same patient in exactly the same way.

We all bring our own history into the room.

Our experiences.

Our families.

Our relationships.

Our previous patients.

Our own trauma.

The things we have seen.

The things we have lost.

The things we fear.

The things we understand personally.

A patient may affect one clinician deeply while another is able to remain relatively detached.

Neither response is necessarily wrong.

The same patient may affect the same clinician differently at different points in their life.

Before becoming a parent, I may have experienced that situation differently.

After becoming a parent, I didn't.

And that is important to recognise.

Because sometimes we assume that emotional responses are a measure of clinical experience.

That the more experienced you are, the less you should feel.

But I don't think that is true.

Sometimes experience simply gives you a better understanding of what you are feeling.

And sometimes, life experience changes the way you see the patient in front of you.

A junior nurse may be affected by something that an experienced nurse is not.

An experienced nurse may be deeply affected by something that a junior nurse is able to manage more easily.

One person may have a personal connection to the situation that nobody else in the room understands.

We cannot always know what someone else is carrying.

That is why clinical teams matter.

Emergency nursing is a team sport

Emergency nursing is a team sport.

That isn't just a nice phrase.

It is a clinical reality.

We rely on each other for knowledge, skills, decision-making and support.

But we also need to rely on each other emotionally.

Sometimes that means recognising that a colleague needs help.

Sometimes it means taking over a task without making someone feel like they have failed.

Sometimes it means asking someone to step away.

And sometimes it means giving someone permission to do it themselves.

I think we often talk about speaking up for patient safety as though it only applies to clinical deterioration or potential errors.

But recognising that your own emotional state is affecting your clinical judgement is also a patient safety issue.

If I had continued trying to perform tasks that I was struggling to perform, simply because I felt that I should be able to continue, that would not have been good clinical practice.

The safest thing I could do was recognise the problem.

Change roles.

Ask for help.

And eventually step away.

The same principle applies to any member of the team.

We need to create environments where people can say:

“I'm not okay to do this right now.”

Without being labelled as weak.

Without being judged.

Without feeling that they have failed.

Because sometimes the most experienced person in the room is the person who recognises that someone else is better placed to take over.

Caring makes you vulnerable

I think one of the most uncomfortable things about nursing is that the qualities that make us good at our jobs can also make us vulnerable.

Caring makes you vulnerable.

Empathy makes you vulnerable.

Connection makes you vulnerable.

The more you understand what a patient or family is experiencing, the more difficult it can sometimes be to maintain emotional distance.

And I don't think the answer is to care less.

We should be careful about the message we send to nurses when we suggest that becoming emotionally affected by patients is something that must always be overcome.

Because caring is not a weakness.

Emotion is not a failure of professionalism.

Being affected by something does not make you a bad nurse.

In many ways, caring is one of the reasons we become nurses in the first place.

The goal isn't to eliminate emotion.

The goal is to understand it.

To recognise when it is beginning to affect our ability to think clearly.

To recognise when we need support.

To recognise when someone else may be better placed to take over.

And to have the confidence to act on that recognition.

That is not a lack of resilience.

That is part of being a safe clinician.

The first time I froze

So, perhaps I did freeze.

Not completely.

Not in the way I had imagined freezing would look.

But I froze enough to realise that my usual clinical skills were no longer readily available to me.

I froze enough to struggle with tasks I had performed hundreds of times.

I froze enough to realise that my emotions had become stronger than my ability to think systematically.

And I froze enough to understand something I had never really considered before:

Sometimes the most important clinical decision you can make is to recognise that you are no longer the best person to continue.

For twelve years, I had worked in emergency nursing.

I had built experience.

I had developed skills.

I had learned how to function under pressure.

But that experience did not make me immune to emotion.

Becoming a parent changed the way I experienced certain patients.

And that was not a weakness.

It was part of being human.

What mattered was recognising what was happening.

What mattered was knowing when my emotional response was beginning to affect my clinical judgement.

What mattered was having a team that allowed me to change roles and step away.

And what mattered was understanding that doing so was not abandoning the patient.

It was the opposite.

It was recognising what was safest.

We often tell nurses that they need to be resilient.

Perhaps we should also teach them that resilience does not mean never being affected.

It does not mean always being the strongest person in the room.

It does not mean pushing through every difficult moment.

Sometimes resilience is recognising that you are struggling.

Sometimes it is asking for help.

Sometimes it is stepping away into the cold air outside the resuscitation room, taking a breath, and allowing someone else to do the job you are temporarily unable to do.

And then, when you are ready, finding your way back.

Because caring makes you a better nurse.

And with caring comes emotion.

The skill is not learning how to stop feeling.

The skill is learning how to recognise when those feelings are affecting your ability to provide safe care.

And having the courage to do something about it.