This piece forms part of Praxis, a regular reflective series from The Christie Institute of Cancer Education exploring equity, inclusion, wellbeing and the lived experiences that shape healthcare education and practice.
There is something incredibly powerful about being in a room with healthcare professionals who, perhaps for the first time in a long time, are given space to speak. Not to be taught, not to be assessed, not to be “fixed.” To talk about what their work feels like.
Over recent weeks, I’ve had the privilege of facilitating wellbeing sessions with clinical staff, including nurses working here at The Christie, people who, day in and day out, balance operational pressure with profound emotional labour.
What has stayed with me is not just what was said, but what happened when we stopped trying to structure the conversation and allowed space. When space is held well, something shifts.
The intervention is the space
In healthcare, we often feel the need to formalise support. To build frameworks. To package reflection into models or structured wellbeing interventions.
These can be valuable, but over time, they can become sanitised: another thing to attend to, another format to follow, another expectation to meet. What we saw in these sessions was something much simpler, and arguably much more powerful; when people are given genuine permission to speak openly about the emotional realities of their work, that space is therapeutic.
The problem with “resilience”
There is a persistent narrative in healthcare about resilience. We talk about it as though it is the answer, the skill that will enable us to withstand the pressures of the system.
But increasingly, this framing feels uncomfortable. Not because resilience is inherently wrong, but because of how it is used.
Too often, resilience becomes a subtle suggestion of individual deficit, a way of locating the problem within the person rather than within the system, and an expectation that people should continue to absorb more, cope better and endure longer.
And in doing so, we risk asking people to tolerate what is, at times, intolerable.
There are experiences, such as grief, trauma and sustained overload, that people should not simply be expected to be "resilient” to. There are limits to human capacity, and those limits matter.
Perhaps what we need is not more resilience training, but a shift in language and focus, from resilience to capacity, boundaries and survival.
What really causes the strain
One of the most striking insights from these sessions was that, despite the routine exposure to grief, fear and life-altering diagnoses in a cancer hospital, patients are not the primary source of emotional distress; many nurses describe those interactions as meaningful, even when they are difficult.
Greater strain stems from the emotional weight of supporting colleagues, holding each other through distress, and navigating blurred boundaries between professional, personal and friendship roles. Without adequate outlets, this creates a kind of emotional congestion in which feelings circulate but are never properly processed.
The nurse as a sponge
One image that emerged during these conversations was that of the nurse as a sponge. Absorbing patient distress, systemic pressure and colleagues' emotions, but unable to release it.
And over time, that sponge becomes tightly wrapped in threads. Layers of responsibility, expectation and unspoken tension. Still absorbing, but with less capacity to expand. More constrained. More compressed.
Eventually, something has to give.
The myth of separation
Healthcare professionals are often trained implicitly or explicitly to separate their personal and professional selves. To “put on the uniform,” to play the role, to leave their own experiences at the door, and for a while, perhaps that works.
But we are the same person at home, and our experiences don’t neatly compartmentalise at work. They accumulate, intersect, overlap and eventually leak. There is a need to be honest about that. To support people not only in maintaining professional boundaries, but in recognising when those boundaries are under strain.
And at the same time, for some people, work is the place where they feel most contained and in control. Even in inherently distressing environments, like cancer care, work can offer a sense of purpose, clarity and stability that might not exist elsewhere in their lives.
There is no single experience, and that is precisely the point.
Moral injury and the limits of control
Many of the most difficult moments shared in these sessions were not about clinical complexity, but about moral conflict.
A nurse described finishing a 12-hour shift, only to stay an additional three hours due to an operational delay. By the time she returned home, her children were asleep.
She spoke not of tiredness, but of guilt. Of feeling like a “bad mother.”
Another described taking a call from a patient whose treatment had been delayed. The patient cried on the phone, desperate to move forward with her care, to be able to continue supporting her family.
The nurse said: “I didn’t know what to do. I couldn’t fix it.”
But this is where a subtle, important reframing is needed. Not everything can be fixed. But much can be held.
Being present. Listening. Allowing someone to express distress without interruption or a solution is not “doing nothing”; in many cases, it is the most meaningful thing we can offer. To be the container, rather than the fixer.
Why our interventions fall short
Healthcare systems are not unaware of these challenges. There are numerous initiatives designed to support staff wellbeing, such as walks, shared breaks and signposting to services.
These are well-intentioned. But they often sit at the edges of the problem(s) because the most significant drivers of distress, operational inefficiencies, communication breakdowns, lack of agency, and chronic overload, are embedded within the system itself and without addressing these, wellbeing initiatives often feel disconnected from people's lived reality.
Education as a radical space
Where, then, is the space for something different?
Increasingly, it feels as though education occupies a unique position, not as a place for delivering more content or instruction, but as a space in between clinical work and organisational structure, between individual experience and collective understanding.
It is here that people can come together, not just to learn, but to reflect, to speak and to be heard.
Perhaps more importantly, to begin translating their experiences into something else: into advocacy, into a shared voice, into change.
As Audre Lorde reminds us, “the master’s tools will never dismantle the master’s house.” (Lorde, 1984, p.111).
Systems rarely transform themselves from within. But people, when brought together in honest conversation, can begin to imagine and create something different.
Towards compassionate boundaries
If there is one shift that feels both necessary and possible, it is this: A move away from performative care, where kindness and excellence equate to ‘going over and above’, and towards compassionate boundaries.
Because over-giving is not sustainable, it places pressure on others to do the same and doesn’t recognise that capacity fluctuates. In fact, modelling boundaries may be one of the most compassionate acts within a team. It permits others to recognise their own limits.
Reflection
What these sessions have reinforced is something both simple and profound.
When we stop trying to control the narrative, stop telling people what they should feel or how they should cope, and instead create space for them to speak openly, something important happens.
People do not need to be fixed.
They need to be heard.
They need to be held.
And sometimes, they need a place where they are allowed to put things down.
Praxis is a regular reflective series from The Christie Institute for Cancer Education. We invite you to engage with the series, share your reflections and be part of the conversation as it grows.
Written by Leone Alexander
Equity, Diversity, Inclusion and Involvement Education Lead
References
Lorde, A. (2007). The master's tools will never dismantle the master's house. In Sister Outsider: Essays and Speeches, pp. 110-114. Crossing Press (original work published 1984)