It was two in the morning on a Tuesday, and I was kneeling on the floor of a resuscitation bay at Great Ormond Street Hospital, blowing bubbles from a tiny plastic wand to distract a three-year-old while my colleague cannulated his left hand. The boy was screaming. His mum was crying. The bubbles were landing on my scrubs and popping against the monitor cables. It was chaotic and exhausting and a little bit absurd, and I remember thinking, with absolute clarity: this is exactly where I am supposed to be.

That thought surprised me. Not because I didn’t love my job – I did, fiercely, by that point – but because twelve months earlier, I would have told you with total conviction that I was an emergency nurse, full stop. Adult emergency. Trauma, cardiac arrests, Friday night drunks, the works. Paediatrics was something other people did. Softer people, maybe, or people with more patience. I was wrong about all of that, obviously. But getting to that realisation required a career pivot I never planned and a willingness to let go of an identity I’d spent years building.

The Emergency Nurse I Was Before

Before Great Ormond Street, before London, before any of this, I was an ED nurse. I’d started my career at Daylesford, but after a few years in that small regional hospital I moved to a bigger emergency department in Ballarat, hungry for more acuity and faster pace. I got exactly what I wanted. Ballarat Base Hospital’s ED was busy, unpredictable, and the kind of environment where you learned to think on your feet or you didn’t last long. I loved it immediately.

Emergency nursing gave me an identity. I was the nurse who stayed calm when things went sideways. I thrived on the adrenaline, on the challenge of rapid assessment, on the satisfaction of stabilising a patient who arrived in crisis. There is a particular kind of camaraderie in emergency departments that is hard to explain to anyone who hasn’t experienced it – a bond forged by shared intensity, black humour, and the unspoken understanding that you’ve all seen things most people never will.

Why I Thought I’d Never Leave the ED

I was so certain that emergency nursing was my forever career that I built my entire professional development around it. I did my trauma nursing certification. I took extra shifts. I mentored graduate nurses and told them, with the evangelical enthusiasm of a true believer, that ED was the best speciality in nursing and they were lucky to be there.

The idea of leaving felt almost like a betrayal – of my colleagues, of my skills, of the version of myself I’d worked so hard to become. When people asked me if I’d ever considered other areas, I’d laugh it off. “Nah, I’m an ED nurse. It’s in my blood.” I meant it. And I think that’s exactly why the pivot, when it came, was so disorienting. I wasn’t just changing jobs. I was changing who I thought I was.

The Pivot I Didn’t Plan

When I decided to move to London, my plan was simple: get a position in a big adult emergency department – somewhere like King’s or the Royal London – soak up the experience, and come home a better emergency nurse. That was the entire strategy.

What actually happened was rather different. The recruitment agency I worked with told me there was an opening at Great Ormond Street Hospital in their paediatric emergency department. I hesitated. I had almost no paediatric experience beyond the occasional child who’d come through the Ballarat ED, and those cases had always made me nervous. Children are not small adults – every emergency nurse knows that phrase – and the prospect of an entire department full of them was daunting.

But the role was available, the hospital was world-class, and a small, stubborn voice in the back of my head said, “Why not? You came here for an adventure. This qualifies.” So I said yes, telling myself it would be a short-term detour before I found my way back to adult emergency medicine.

That was over a year ago. I have not found my way back. I have no intention of finding my way back.

The First Shift That Changed Everything

I wish I could point to one single, dramatic moment – a life-saving intervention, a Hollywood scene – but the truth is less cinematic than that. It was a collection of small moments across my first few shifts that rewired something in my brain.

There was the five-year-old with a suspected fracture who asked me, very seriously, whether the X-ray machine could also take a picture of his dinosaur. There was the teenager with an asthma exacerbation who was trying so hard to be brave that she was apologising between nebuliser breaths for “being annoying.” There was the mum who grabbed my hand in the corridor at four in the morning and said, “Thank you for talking to him like a person and not just a patient.”

Each of these moments cracked open something I hadn’t realised was closed. In adult emergency nursing, I’d become very good at clinical efficiency. I was quick, I was competent, and I got results. But somewhere along the way, I’d built a professional shell that kept the emotional dimension of nursing at arm’s length. Paediatric A&E didn’t allow that shell. Children demand your full presence – your creativity, your patience, your humanity – and in doing so, they gave me back a part of nursing I’d quietly lost.

What Makes Paediatric A&E a Different Beast

Clinically, paediatric emergency nursing is a fundamentally different discipline from adult emergency work, and I don’t think I appreciated the depth of that difference until I was living it.

Children – especially very young children – cannot tell you what’s wrong. A toddler with abdominal pain doesn’t say, “I’ve got a sharp, localised pain in my right iliac fossa.” A toddler with abdominal pain screams, or goes very quiet, or simply refuses to eat. Your assessment skills have to shift from relying heavily on patient history to reading a constellation of nonverbal cues: skin colour, breathing pattern, behaviour, tone of cry, interaction with parents. It is detective work of the most delicate kind.

Then there are the parents. In adult ED, your patient is usually your sole focus. In paediatric A&E, you are always treating two patients – the child and the family. A terrified parent can escalate a child’s distress in seconds. A calm, reassured parent can be your greatest clinical ally. Learning to manage that dynamic – to care for the parents’ fear while simultaneously assessing and treating their child – was a skill I had to build from scratch, and it is one of the most complex things I’ve ever learned in nursing.

The Emotional Weight (and the Joy)

I won’t pretend it’s easy. Sick children are heartbreaking in a way that stays with you differently from adult patients. There are shifts that follow me home. There are cases I think about at three in the morning, weeks later. The emotional weight of paediatric emergency work is real, and any nurse considering this path deserves to know that upfront.

But the joy is equally real, and it is unlike anything I experienced in adult ED. Children recover with a speed and resilience that borders on miraculous. A child who arrives limp and grey with sepsis can be sitting up eating toast and demanding cartoons twelve hours later. The turnarounds are extraordinary, and witnessing them never gets old.

There is also something profoundly grounding about working with children. They are honest in ways adults have forgotten how to be. They are not interested in your professional title or how many years you’ve been nursing. They want to know if you’re kind, if you’re funny, and whether you’ll take their pain seriously. Meeting those criteria requires you to be genuinely present, and I’ve come to believe that this presence is what makes paediatric nursing not just a speciality but a practice in its fullest sense.

Finding My True Calling – What That Actually Means

I used to find the phrase “true calling” a bit irritating, if I’m honest. It sounded like something you’d read on a motivational poster in a hospital corridor, right next to “Teamwork Makes the Dream Work.” But I’ve come to understand it differently now. A true calling isn’t a destination you arrive at with certainty. It’s a recognition – often gradual, often surprising – that the work you’re doing aligns with something deeper than competence or habit. It aligns with who you are.

Emergency nursing made me a skilled clinician. Paediatric A&E made me a more complete nurse. The pivot forced me to be a beginner again, to sit with discomfort, to let go of an identity I’d outgrown without realising it. And it gave me back the emotional connection to my work that years of high-pressure adult ED had slowly, imperceptibly worn down.

If you’re a nurse reading this and feeling restless – if you love your speciality but something feels like it’s missing, or if you’re curious about a different path but scared of losing what you’ve built – I’d encourage you to take the leap. You are not betraying your past by evolving. You are not less of a nurse for changing direction. You might be more of one.

I came to London to be a better emergency nurse. I became a paediatric one instead. And that three-year-old, the one with the bubbles and the cannula and the screaming at two in the morning – he fell asleep ten minutes later, clutching his mum’s finger, breathing easy. I cleaned the bubble solution off the monitor, wrote up my notes, and walked into the next bay.

It is, without question, the best work I have ever done.