A Real-Time Tool

What Now

For healthcare workers of color or culture facing identity-based harm at work.

Use this when something happens on shift. Figure out what just happened. Decide what to do next. Keep going.

Move through what you need. Skip what you don’t.

Your entries stay on this page. This version has no account, analytics, cookies, database, or local storage. What you type is not sent or saved by the tool. Closing or refreshing the page clears it. Keep patient health information and other identifying details out.
Step 1 of 10Name What Happened

Name What Happened

You don’t need certainty to name it. Select all that apply.
Why this list
Identity-based harm is often ordinary-looking: credentials questioned, a loaded comment, being talked over, being assigned a disproportionate load, or being treated as if you do not belong. You do not need perfect certainty before noticing what happened.
What fits this moment? Select all that apply.
Do not enter patient names, room numbers, medical record numbers, or identifying clinical details.

Open only what you need. You can return to any step.

Notice Your Body

More than one can be true. If you’re not sure, pick the closest one.
About these states
These are common words people use for automatic stress-response patterns. More than one can be true, people may move among them, and not everyone experiences them the same way. The labels are descriptive, not diagnostic. Tap a state to see examples.
FightHigher-energy protective response

In the body

Heat in the chest or face. Jaw tight. Hands tense. Heart faster. Breath higher.

At work, this may look like

Wanting to push back hard, correcting immediately, snapping, standing taller, or feeling ready to confront.

The body may be preparing to protect dignity, safety, or belonging. Anger can carry information.
FlightHigher-energy protective response

In the body

Restless legs. Scanning. Stomach tight. Shallow breath. An urge to move.

At work, this may look like

Wanting to leave the room, avoid the unit, call out, change assignments, or mentally plan an exit.

Leaving, creating distance, or buying time can be protective choices. Context matters.
FreezePause / inhibited action

In the body

Held breath. Stillness with tension underneath. Mind blank. Words gone. Time may feel slower.

At work, this may look like

Not finding words until later, going quiet, moving on autopilot, replaying it afterward.

Not responding immediately does not mean you agreed with what happened. A pause can be a protective response.
FawnAccommodation / appeasement

In the body

Forced smile. Voice softer. Shoulders drawn in. Apology rising quickly.

At work, this may look like

Smoothing it over, reassuring the person who caused harm, laughing it off, over-explaining, or over-performing.

Accommodation and code-switching can be learned strategies for navigating power. Noticing the strategy gives you more choice about when to use it.
ShutdownLower-energy / disconnected response

In the body

Heavy, distant, numb, slowed, foggy, or far away from yourself.

At work, this may look like

Going through the motions, flat voice, difficulty tracking, feeling detached, needing more time to come back.

Sometimes the system reduces energy and connection when a moment feels like too much. Return can be gradual; forcing it is not required.

Open only what you need. You can return to any step.

Weigh What To Do

Pause for a moment before you respond.
Why this is here
The fear of speaking up can be rational. The cost of swallowing something can also be real. You get to weigh safety, power, energy, patient care, timing, and what matters most to you.

What could make this harder right now

  • Risk of being labeled difficult
  • Risk of patient complaint
  • Energy I don’t have right now
  • Possible retaliation
  • Becoming “the one who always brings this up”

What could help right now

  • Slowing down just enough
  • Choosing one clear action
  • Letting it be incomplete for now
  • Telling one trusted person
  • Keeping a clear record if needed
This can be safety, patient care, getting through the next task, being heard, protecting your energy, or something else.

Open only what you need. You can return to any step.

Choose Your Move

You don’t have to do everything. Start with one.
Choose one or more moves.
Get a witnessBring someone in
Keep PHI out. Use roles, not names. Reference the assignment or interaction, not patient health information. This tool is not part of a medical record.
Document itBuild a clear record
Use the right record. Patient care belongs in the EHR. Workplace harm belongs in the reporting or documentation route your organization, union, ombuds office, or legal adviser identifies. Do not put PHI into this tool or a personal note.

Open only what you need. You can return to any step.

Say Something

Start with words you can actually use.

You don’t need perfect words, and you don’t owe a full explanation. Open any situation for a starting line.

When a patient or family asks for a different provider
“I’m the provider assigned to your care today.”
When credentials are questioned
“I’m your [role]. I’ll be taking care of you.”
When a colleague talks over you
“I was in the middle of a thought. Let me finish.”
To redirect in front of a patient
“Let’s keep this focused on the patient.”
To buy yourself time
“I want to respond clearly, not quickly. Give me a minute.”
To name what happened, when it is safe to
“That comment didn’t sit right with me. I want to come back to it.”
To set a limit with a hostile patient or family
“I’m here to take care of you. I’m not available for that kind of language.”
To ask for backup without explaining yourself
“I need someone else in this room with me.”

Open only what you need. You can return to any step.

“Caring for myself is not self-indulgence. It is self-preservation.”
Audre Lorde, A Burst of Light (1988)

Quick Reset

One thing for your body before the next room.

Pick one. If a practice makes you feel worse, dizzy, unsafe, or more activated, stop and choose something else.

Cool-Ah BreathInhale and notice where you sense coolness. Exhale and notice where you sense warmth. No forced breath-hold.
Bilateral TapIf it feels comfortable, cross your arms and alternate gentle taps on your shoulders or upper arms.
Cool waterTry cool water on your hands or wrists. Skip extremes if you have a medical reason to avoid temperature changes.
Grounding pressPress both feet into the floor or your palms into a steady surface. Notice pressure and release.
OrientingLet your eyes move around the room. Name three neutral things you see. Turn your head only as far as is comfortable.
Shake or moveIf movement feels good, gently shake out your hands or shoulders, stretch, or take a short walk.

Open only what you need. You can return to any step.

What Stays With Me

Before the moment defines you, come back to yourself.
Why this is here
A harmful moment can narrow attention to what just happened. This section is a way to remember what was already yours before the moment: training, people, culture, practice, instincts, care, humor, boundaries, and more.
Pick one or two. There is no wrong answer.

Open only what you need. You can return to any step.

After the Moment

Before you go home, choose what matters now.
Keep this de-identified. These fields are for thinking, not formal documentation. Nothing entered here is stored by the app, but it may appear if you print or save a PDF.

Open only what you need. You can return to any step.

If This Keeps Happening

One incident can be minimized. A pattern is information.

If this is becoming a pattern, the pattern itself is information. You may want a clear chronology for yourself or for a formal process.

Before keeping a personal workplace record: know your employer’s policy and consider union, ombuds, HR, or legal guidance when the stakes are high. Keep PHI and confidential patient information out. Personal notes may be subject to disclosure in some disputes. This tool does not give legal advice.

Workplace and escalation resources

Open only what you need. You can return to any step.

Close the Loop

You don’t have to solve everything right now. Choose one for now.
Where are you landing right now?

Open only what you need. You can return to any step.

Next: Resources
Resources

Printing can include anything you typed. The page itself does not save your entries.

Resources

When you need someone other than yourself

Support, professional organizations, and workplace routes worth knowing before you need them. Use what you need.

Urgent safety: If you are in immediate physical danger, use your workplace emergency procedures or local emergency services. For emotional crisis support in the United States, call or text 988 or use the 988 Lifeline chat.

Crisis and immediate peer support

988 Suicide & Crisis Lifeline

U.S. crisis support by call, text, or chat.

988 Lifeline

Crisis Text Line

Text HOME or HOLA to 741741 for free, confidential crisis support in the U.S.

Crisis Text Line

Call BlackLine

Peer support centering people impacted by systemic oppression.

Call BlackLine

Trans Lifeline

Trans-led peer support and community resources.

Trans Lifeline

StrongHearts Native Helpline

Domestic and sexual violence support for Native Americans and Alaska Natives.

StrongHearts

Professional and workplace routes

ABNAO

Community, professional enrichment, education, and advocacy for Black nurses in Oregon.

Alliance of Black Nurses Association of Oregon

National Black Nurses Association

NBNA

Trauma Informed Oregon

TIO resources

Your workplace

Depending on your setting: charge/lead, supervisor, ombuds office, union representative, HR, professional association, employee assistance program, or formal incident-reporting system.

U.S. EEOC

Federal employment discrimination and harassment information and charge-filing process.

EEOC filing information

Oregon BOLI

Oregon workplace discrimination, harassment, retaliation, and complaint information.

BOLI complaint information
About

Built for the moment after something happens

What Now is for the space between rooms, after the meeting, in the car, or before going home, when you need enough room to decide what comes next.

What this tool is for

It supports healthcare workers of color or culture navigating identity-based harm, workplace stress, and the decisions that follow. It does not grade your response, diagnose your nervous system, replace mental health care, replace workplace reporting, or decide whether conduct meets a legal definition.

How the body-state language is used

Fight, flight, freeze, accommodation/fawn, and shutdown are used as plain-language descriptions of stress-response patterns people may recognize. Responses can overlap, change quickly, and look different across people and situations. They are not presented here as diagnoses or a fixed biological sequence.

The collaboration

Alliance of Black Nurses Association of Oregon × Trauma Informed Oregon.

Developed by: Steffannie Roaché, LPC, LMHC; Erica Bailey, MS, RN, BC-NC; and Violet Larry, BSN, RN.

Privacy: This version uses no account, analytics, cookies, database, or browser local storage. Refreshing or closing the page clears what you entered.