In this article we consider the impact of shock in hospital emergency departments where people seek urgent medical care and access hospital services. We define shock as an unexpected event or set of circumstances, for although emergency departments plan for uncertainty, shock moments are when protocols and procedures fail to meet operational demands. We reveal how, depending on the professional experience and personality of staff, shocks are experienced and defined in a variety of ways. On some occasions shocks result in critical departmental failure, while at other times they generate new working practices. Shocks can empower individuals through celebrating teamwork and a sense of belonging, to take personal responsibility at a range of 'shop-floor' scales. These emotional and embodied engagements contribute to the operational resilience of the department.