Artists such as actors and puppeteers in health care face emotional challenges in their work. This article investigates the interpersonal competencies and emotional skills of the artist who uses puppets in their practice in health-care contexts and settings. We present initial findings from phase B of a wider longitudinal study. Phase A focused on actors in hospitals and drama trainees; Phase B uses qualitative research methods with actors, puppeteers and therapists as participants. Content analysis of data reveals that the main competencies the artist needs to deal with emotional incidents in health care are empathy, self- and social awareness, self-care, self-reflection, emotional resilience and active listening. These skills are needed alongside acting and puppetry skills to develop competent and professional artists in healthcare. The study offers evidence to further develop strategies of receiving, processing and communicating emotions safely and effectively within the protection of the artform. This study therefore diverts our attention from traditional training courses that are mainly about learning artistic skills to a cross-disciplinary pedagogical framework that aims to enable artists to observe, reflect and process emotions before, during and after a performance with patients as theatre ‘audience’-participants.