Contained Chaos

 “Be kind, for everyone you meet is fighting a battle.” Plato

For anyone who has ever assisted in or performed an intubation, the intensity of those few moments is unforgettable. No matter how prepared you are: mentally, technically, emotionally there’s always an inner dialogue running: Is everything ready? What if this fails? You're praying silently, hoping everything goes as planned. Yet, despite meticulous preparation, some days just don’t cooperate. The laryngoscope light may fail at the worst possible moment, the blade might not fit right, or excessive bleeding may obstruct your view. In such high-stakes scenarios, clinical knowledge is vital but what often makes the difference is quick thinking, emotional regulation, and having a solid backup plan (A, B, C… sometimes even D). But here's the uncomfortable truth: these emotionally charged moments don't only test the skill of the intubating clinician they test the entire team and unfortunately, not everyone rises to the occasion with grace.

When Pressure Breeds Hostility

Instead of shared focus and calm, some situations devolve into finger-pointing, passive-aggressive comments, or open hostility eg greater risk of cross contamination. Colleagues may blame one another or the institution for missing equipment or poor outcomes. But when tools are available, and there has been a lapse in individual preparedness, the responsibility must be owned. It may be an unpopular opinion, but in any setting where resources are present, you are responsible for ensuring all necessary tools are functioning and ready before beginning any critical procedure. This is not about perfectionism it’s about patient safety.

A Culture of Safety Starts With You

Blame culture erodes trust and teamwork. According to the Agency for Healthcare Research and Quality (AHRQ), a true culture of safety relies on mutual respect, shared responsibility, and open communication. It's about preventing errors before they happen, not assigning blame after they do (AHRQ, 2019).

When emotional outbursts replace communication, or when anger clouds clinical reasoning, we don’t just create a toxic workplace we compromise the care we’re meant to deliver. That’s not just a personal failure; it’s a systemic risk.

Own Your Emotions  and Your Growth

We are human hence frustration is inevitable but how we manage that frustration especially in moments of high pressure determines whether we’re promoting a culture of safety or chipping away at it.

If you find yourself struggling with repeated irritability, misplaced blame, or emotional overload, it’s okay to seek help. Therapy, peer support, reflective practice, and even anger management are all valid tools for professional development. Emotional maturity is not optional in healthcare it’s part of our duty of care.

Reflection as a Clinical Skill

In those moments that haunt us or humble us we must ask:

What could I have done differently?

Did I lead with safety or react with ego?

What will I do next time to uphold care, not just competency?

Reflection is not indulgence it’s a clinical skill. It allows us to learn, improve, and safeguard both patients and colleagues. 

In conclusion, no shift will ever be perfect. equipment fails, situations escalate. emotions rise but how we show up for our team and patients when it matters most that’s what defines our professionalism.

So before you blame a colleague, raise your voice, or dismiss a mistake pause. Breathe. Reflect. Because contained chaos only leads to safe care when it’s met with clear minds, respectful communication, and a shared commitment to better.

Reference:

Agency for Healthcare Research and Quality. (2019). Culture of safety. Patient Safety Network. https://psnet.ahrq.gov/primer/culture-safety