In this chapter the author outlines his personal experience of setting up, operating and closing the Nightingale Hospital in London. This was the largest temporary intensive care unit in the Western World and was developed in the space of a few days in a large conference centre in East London to reduce pressure on intensive care units during the first wave of the Covid-19 pandemic. This is an experiential piece but highlights some important messages and learning points around managing resources in a national crisis, the teamwork required to deliver rapid change and the importance of having strategies for supporting staff in such a situation.