Treating Burnout, Trauma, and Grief with Dance

Treating Burnout, Trauma, and Grief with Dance

Tara Rynders, RN, MFA, BSN, BA, admits she hasnt had the easiest life. From when she was a child, though, she would heal from it through dance. In fact, she wanted to be a professional dancer before she thought about being a nurse.

My earliest memory is of holding a neighborhood performance in my backyard—and its a lifeline that Ive held on to through all of lifes highs and lows,” Rynders explains.

So Rynders graduated high school and headed to Hollywood. But she soon realized that the business was more focused on outward appearance rather than the inward healing dance provided.

After my time in Hollywood, I realized that I wanted to be able to offer both emotional and physical healing. Nursing allowed me the entry point into that space. Its a profession that offers flexibility to keep connected to my lifeline—dancing,” she says.

treating-burnout-trauma-and-grief-with-dance

Trauma Hits Home 

Rynders came to embrace dance and bring it into the world of nursing after her tough times. She cared for her mother until she passed. Rynders says that losing her mother made her entire world fall apart. At the time, she was working as a nurse but decided to reach out again to what had always helped—dance. So, she cut down her nursing hours

to earn a masters degree in dance.

Her sister became ill during that time and went into a coma for months. Rynders took off a semester and went to live with her in rehab until she was transferred from California to Colorado, where Rynders was living.

In my sisters hospital room, my dance and nursing worlds began to collide,” recalls Rynders. Every night, I would dance to Miley Cyruss ‘Party in the USA.’ And I discovered that although my sister couldnt speak, she could laugh. That became my goal—to make her laugh.”

When Rynders returned to school, she created an immersive theater performance called You & Me that was connected to her experience as her sisters caretaker and her work as a charge nurse in the ER.

The show You & Me traveled nationally and internationally to more than five countries.

What I realized when I cared for my sister was the gift that comes from having one-on-one intimate moments with another human being—to bathe her, feed her, and help be her voice,” says Rynders. During the day, I would hold the suffering and loss with my sister, and at night we would hold the joy as I danced. It felt like I had both my joy and my grief coupled together in all that I did.”

One more scary experience brought Rynders to where she is today. When her twins were six months old, she learned she was pregnant again. But this time, it was an ectopic pregnancy.

When I arrived at the hospital, things moved quickly. I remember the ER tech rolling me on the bed with too much force to start my IV; the ER physician and his caring face took extra time to see and listen to me. I remember feeling his compassion for my situation. I remember being transferred to a room when my fallopian tube burst and my abdomen began to distend with blood,” says Rynders.

They called a code yellow—the code they call before a code blue when your heart stops. My room was full of people,” she says. I passed out, but I could still hear everything being said. I felt my nurse grab my hand. She leaned into my ear and said, I am here, and you will be okay.’ I remember thanking her for remembering me because I was so scared and couldnt speak.”

This experience caused Rynders to have an epiphany.  “I realized that nurses are everything to their patients–their voices, their advocates, their support, their healing hands. I experienced this firsthand as a patient and realized how many opportunities I was missing as a nurse to connect and see my patients authentically. I became passionate about this in my practice as a nurse and began researching authentic connection in nursing,” she says. Everything pointed to one thing: our nurses are tired, overworked, and our healthcare systems are not set up for them to thrive and successfully care for patients.”

Rynders decided she was going to change that.

Bringing Dance to the Nurses

Pre-COVID, Rynders says that nursing leadership was downplaying nurses burnout. And in 2017, nurses werent ready to talk about it openly.

But the CNO and CEO where she worked approved her creating a two-hour immersive theater experience at the hospital to raise awareness of compassion fatigue and burnout. She created the performance with artists Jadd Tank and Lia Bonfilio and worked with playwright Edith Weiss.

The 2-hour performance took place in the hospital and was open to the general public. The nurses, doctors, and other healthcare personnel testimonials were breathtaking. Most along the lines of Thank you for giving us a language to understand the unrelenting grief and trauma we have been carrying with us,’” says Rynders.

After raising awareness about burnout, Rynders co-created, with Dr. Clare Hammoor, a six-week grief and trauma workshop series. The nurses connected with it so much that they began having monthly meetings post-workshop, which continued until COVID.

At the height of COVID, my CEO asked me if I would come off the floor and focus on caring for our nurses as they cared for our COVID patients. This told me he also saw that our staff would need ongoing support,” says Rynders. The position was temporary, though; she would eventually work as a clinical nurse educator at another health care system.

Today, Rynders is also an advanced grief recovery specialist and a RESTORE (Resiliency and Equity Support and Training for Organizational Renewal) peer responder who is on call for health care personnel when they need immediate support.

I help teach resilience, equity, and anti-racism courses for our entire system. I do this alongside my position as executive director of The Clinic Performance. I see both of these roles mutually honoring each other as I bring my whole self into all my experiences,” she says. We dance in the hospital at our meetings, and having a pulse on nursing in the hospital setting is vital to creating workshops that tend to our nurses—meeting them where they are emotionally.”

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Tara Rynders in her dance workshop

Dance Workshops

Rynders workshops touched many people and were so effective that Kaiser Permanente asked her to bring them to nurses across California. These six eight-hour workshops with up to 600 nurses began in April and will run through September.

Our workshops are now titled (Re)Brilliancy, a play on the word resiliency. I was tired of hearing everyone tell us to be more resilient during the pandemic. Nurses are some of the most resilient humans I know. We need resilient systems that reflect the brilliant and resilient humans we already are. (Re)Brilliancy workshops help us reflect on and honor the brilliant and resilient humans we already are,” says Rynders.

Until they experience the workshops, nurses often dont even realize that their stories or experiences have continued to both of them.

Rynders knows that her workshops are keeping nurses from leaving the profession. I have seen firsthand nurses ready to leave—completely burned out and done with the profession. [Theyve] attended our workshops on an ongoing basis and have a rekindled joy and fervor for caring for themselves and their patients,” she says.

But more needs to be done.

Nurses go into this field to make a difference in the lives of others. At some point, we begin sacrificing ourselves to do this. We dont have to sacrifice our mental well-being. These workshops help us disentangle our worth and identity as caregivers from being directly related to how much we can sacrifice our well-being. Our workshops help remind us what we love, what we are passionate about, and what we need to feel seen, heard, and cared for,” says Rynders. If healthcare systems want to retain their nurses, they need to start thinking creatively and bringing in non-traditional and innovative ways to care for their teams. Wellness must be embedded as a cornerstone that everything else builds upon.”

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The Worst Trauma I Experienced as a Nurse

The Worst Trauma I Experienced as a Nurse

She didn’t know her words would haunt me for years to come. It was a night like any other night. I stood at the bedside of a relatively stable patient, and I was dutifully giving him his meds. The floor was quiet, patients and nurses preparing for the night shift a few hours away.

Like a fire klaxon, a voice cut through the relative peace of the hospital floor. “My husband is dying! My husband is dying!”

Instinctively, I dropped the medicines and darted out of the room. In the middle of the hall, a middle-aged woman ran toward me, screaming about her husband in the room across the hall. “He’s dying,” she yelled into my face.

Mouth dry, heart pounding, I pushed past her and entered the patient’s room. Of course, he was unconscious, blue, and not breathing. I started CPR, but the craziness was not over.

I wasn’t exactly a new nurse. I had been through a few codes, and they all went rather smoothly. I never experienced the stomach-churning nausea of having a family member witness their loved one dying.

The patient wasn’t mine, but I knew about him. He had recently had coronary artery bypass grafting surgery and was due to be transferred to the ICU any minute because his heart rate and rhythm were abnormal. His doctor was on the floor, writing the paperwork for the transfer.

Others had heard the wife call out in anguish, and everyone came running, including the doctor. He burst into the room, shouting, “I need an intubation kit! Get me an intubation kit!”

I could hear the rumble of the crash cart coming down the hall, but it hadn’t quite reached the room yet. The doctor continued to yell at me, to point, to spit. His hands shook, but I had been here before. I yelled back, “Hold on a second! It’s coming!”

I realized then that the doctor was more afraid than I was. The cart arrived, the patient continued to code, and the doctor got his intubation equipment. Although we managed to get a sustainable rhythm on the patient, he soon died in the ICU.

Of all the codes I experienced over my years as a nurse, this one sticks out as the most horrible. When codes start, nurses become the ultimate professionals. No one runs. No one yells. Everyone works as a team.

As a relatively new nurse, I never experienced the terror that “normal” people experience when someone starts to die. For me, I knew how to handle it. A patient going south deserves my close care, but the emotion is usually not high during care involving advanced cardiovascular life support. Afterward, I would cry and shake, but not when I needed my faculties about me to do everything I could to save a life.

This code was different. In fact, I can live it over and over in my mind, and I still feel as scared now as I did then. The wife and the doctor were breaking the rules. They didn’t know how to deal with death, and I don’t really blame them. I just know their actions scarred me deeply.

Trauma is a real problem in nursing, and situations like these can cause a nurse to relive moments that didn’t go well. This is especially true of new nurses. New nurses make mistakes, and they haven’t developed the ability to be the calm professional yet. This means that the trauma of extraordinary events can stay with them forever.

I never dreamed that I would face a family member who was screaming that her husband was dying. I can only imagine the torment she was going through, the heartbreak of knowing that her loved one was slipping away before her eyes. She reached out for the only help she could.

And that help was me.

Her terror has stayed with me all of these years. In that moment, I became her. I empathized with her, as any good nurse will do. I felt her sorrow, and despite our best efforts, we couldn’t save her husband. I find myself imagining how she felt when he actually passed away.

I will admit that this situation scared me, and I have dwelt on it more than I should. Nurses, especially new nurses, have to develop a sense of detachment from the patient and family. But what about the human side of the equation? Too much distance leads to too little caring.

I am happy to say that I took part in codes after this one, and I did the best job I could. In fact, I was praised for my work in situations where a life was on the line. But I never forgot the distraught woman in the hallway, or the surreal feeling of dread that her words—”He’s dying!”—caused in me.

It remains a trauma that has impacted my life forever. Nurses need to realize that they experience traumas, too, and that it is okay to talk about them. It is okay to be afraid. It is okay to reflect on the situation and examine the emotions the trauma awakens. Without this reflection, the emotions become buried. Ignored emotions manifest as substance abuse, out-of-control feelings, and hatred of the job.

My trauma is just one example. Almost every nurse has a story of when she or he was scared and traumatized. Talk about it. Don’t pretend to be so strong that you don’t need to ask for help.

I wish I could have saved that man. I wish I could have wrapped that wife up in my arms and made it easier for her. I couldn’t, but it will stay with me forever as the trauma in my career that haunts me, because I couldn’t hide behind the façade of the calm professional.

I am the calm professional, but I am human, too.

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