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Join us as we sit down with Tara Rynders, a nurse, dancer, and choreographer, as she shares her journey of healing and resilience in the face of trauma. From her experiences in nursing to her innovative workshops combining nursing and dance, Tara provides insight into the importance of softening rather than hardening in the caregiving profession. Learn how dance became her pathway to healing and how she’s creating spaces for nurses to process their grief and trauma in a supportive and uplifting environment.

Tara Rynders is a nurse, dancer, and choreographer.

She discusses the KevinMD article, “America’s nurses have PTSD: Will anyone listen to them?”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast, get CME for this episode by clicking on the CME link in the show notes. Today we welcome Tara Rynders. She’s a nurse, dancer, and choreographer. Today’s KevinMD article is “America’s nurses have PTSD: Will anyone listen to them?” Tara, welcome to the show.

Tara Rynders: Thank you, Kevin. It’s so great to be here.

Kevin Pho: So let’s start by briefly sharing your story and journey.

Tara Rynders: Yeah. I am a nurse, I’ve been a nurse for over 25 years, and I’m also a dancer. I grew up dancing and I have my master’s in dance.

And when I think back on my career, there’s really three main moments that stand out to me, and those moments are the intersection of when my dance and my nursing came together, and also surrounded around some traumatic events. The first one being when my mother passed away and I decided to go back to school. I’d been nursing full-time and I went and got my master’s in dance. And then my sister got very sick, and I used dance as a way of bringing laughter and joy to her. And then lastly, I almost died and was a patient for the first time, from an ectopic pregnancy, and had a really big realization of the need to care for our health care teams, and to use dance and movement and the arts as a means to do that.

Kevin Pho: All right. And today, tell us about that intersection between what you do as a nurse and dancer. How does that influence your professional career today?

Tara Rynders: Yeah. So I am the CEO and founder of the Art and Heart of Healthcare Institute, and I bring together nurses, providers, health care teams, and create a space for them to share what it is that they’ve been holding.

And we do that by using the arts as a structure. We play, we use movement, we journal, we have an incredible poet laureate who’s on our team who comes in, another team member has his PhD in theater and play. And so our team really creates this beautiful space for people to come in and feel cared for, to create trust with one another, and to lay down a lot of the PTSD, the stories that have been living in their bodies for so long.

Kevin Pho: All right. Your KevinMD article is titled “America’s nurses have PTSD: Will anyone listen to them?” For those who didn’t get a chance to read that article, tell us what it’s about.

Tara Rynders: So as I’ve gotten deeper into this work, I have also looked at how nurses are experiencing PTSD, and all the things that we’re holding. But also it begins looking to the root. It begins as nursing students and as medical students, that we’re exposed to a lot of experiences and people in trauma that we really don’t have support to come around those moments.

And so I was journaling and thinking of some of those moments for myself, and this story that I had forgotten about came to me. When I was working as a nursing student, I happened to have a patient who was dying of cancer and who was Spanish speaking only. And the doctor said, there was nobody around who spoke Spanish. And I said, I do. Not really knowing what that would mean.

And at that time, this was over 20 years ago, there wasn’t interpretive services available as readily as they are now. And so they asked me to go interpret and let this beautiful man know that he was dying of cancer and that he had less than six months left to live.

And so I went in, being eager to please as a nursing student, wanting to do my very best, went in and shared that news. And I just remember, I had no idea that that story would impact me so deeply, and how hard that would be. And telling this man and his wife, with the children present, that he didn’t have much time left. And just experiencing the pain of him trying to stay strong, his wife trying to stay strong, and then watching everyone slowly start to break down. And I just remember saying, lo siento, lo siento, lo siento, and I didn’t know what else to do.

And I think back on that and I wonder, was I the right person to do that? And is there a right person? And I think maybe I was, because I still had a lot of empathy, I still was coming alongside them and holding them. And I wonder if there’s ways that we can continue to care and have that same empathy, if we had more support for each other.

So that story was in my body and I was just remembering it. And later my mother would pass away from cancer on that same floor, and so that family came to my mind multiple times as well during that time, which was in 2006.

Kevin Pho: So tell us about how this story changed you. How did you use this story going forward to overcome some of that trauma? So tell us some of the lessons that you learned from that story.

Tara Rynders: You know, the biggest lesson is just to share our stories, to have spaces to tell the truth about what happened, and to be with other people specifically who get it.

So when I do these workshops for health care providers, the biggest thing that they say is, wow, I didn’t realize how impactful it was to be in a room of people who understood what I’m going through. I could go home and tell my partner, I can tell my therapist, but when other people around me are like, oh yeah, that happened to me too, I get that, that was hard, and I remember when I had something similar, you’re not alone, the shame is released. You realize we’re in this together. So I think that was one thing that I learned, is telling our stories.

I think the other is telling the truth about what it feels like. I don’t remember telling anybody how hard that was for me, to be the person to say that. I don’t remember sharing that and receiving care around that specifically. And it would be great if people could ask and pull that out, but I also wonder if there’s a space where I don’t hide my feelings, where I come home from work and instead of swallowing my tears and saying everything was fine, I actually say, no, today was a really hard day, I need you to make dinner tonight, I need to go for a walk. Or really say what it is that I need. I have a hard time doing that.

Kevin Pho: So outside of your workshops, do you think that nurses in general today are getting that space where they can share these stories with their peers?

Tara Rynders: I think that we’re on the edge of exploring it. I think we have peer support systems in hospitals, which are huge, for these peer-to-peer coming together to hear and use, like, psychological first aid, to care for somebody in the moment when they’re going through something traumatic. I think that that’s huge. I know there’s Debriefing the Front Lines, would be another organization who’s using spaces to debrief and come in to debrief after hard situations or traumatic situations occur, sentinel events, things like that.

But in general, I don’t think so. I think we’re still running from room to room, space to space. We aren’t even necessarily aware of what we’re holding, because we don’t have time to feel it.

Kevin Pho: I hear that nurses all the time, especially during the pandemic or after the pandemic, they are tremendously short staffed and the patient to nurse ratios are getting unacceptably high. What kind of stories are you hearing from the nurses who come to your workshops about what it’s really like practicing on the front lines today?

Tara Rynders: Yeah, I think 100 percent there’s not enough nurses, there’s a shortage. And I think one of the biggest things that I’m hearing is there’s a lack of seeing nurses for who they are.

So during the pandemic I was so frustrated at everyone asking us all in health care to stay resilient, we have to stay strong, we have to do it. And I just, like, that’s putting the onus on us when there’s a larger issue here.

And so I remember creating a word, rebrilliancy, instead of resiliency. Because what I want, and what I’m hearing nurses say, is they want spaces that are reflecting back who they are, who are nourishing them, who are nurturing them, who are caring for them. And that’s what rebrilliancy is, reflecting back and remembering the brilliant and resilient we already are.

If that’s our starting place, then what we’re doing is, we’re tilling the soil for them, we’re being mindful about the places we’re planting them in, and we’re watering them, we’re feeding them, and that’s how we grow. Instead of this version of resiliency where we’re the one flower that blooms through this cracked concrete, and we’re honoring and praising that individual overcoming.

What I’m seeing is that when we can come together and care for each other and create spaces that honor each other, we can take on a lot of hard things. It’s not that nurses are scared of hard things. We can be short staffed, we can do it, but we need to be in it together, and we need to have a supportive environment that honors us simultaneously.

Kevin Pho: Well, tell us a story where a nurse had that breakthrough moment, where that kind of thing really helped her through that proverbial PTSD that he or she may have experienced from the health care setting. It could be from your workshops, it could be from a story that you heard outside your workshops. But give me an example of a breakthrough a nurse had just by being able to share with their peers.

Tara Rynders: Yeah, there’s so many beautiful moments and stories of people breaking through. I can share one of a male nurse who came into the workshop thinking, like, I wonder if they’re going to ask me about this one story, because I don’t really want to talk about it, so I’m just going to already make the choice that I’m not going to talk about it.

And we talk about our grief stories in our workshops, but first we play. Before we even get to that deeper part, we play together, we experience joy together, we laugh together, and so we create this space of trust. And then we ask them to write their grief stories, and we start with this prompt, I remember when, after that I, in the future I hope.

And so, like I said, he was like, I’m not going to tell that story, and he actually wrote a completely different story. And then when we got into groups and began to share, he said everyone was sharing so vulnerably about these stories that had been living in their bodies that they don’t really get the chance to share. And he started crying and he told his true story. He said, I wasn’t going to tell this story, but I’m going to tell it, because thank you to everyone else for laying that out.

And he told the story of how he lost someone during the pandemic in the same hospital that he worked in, and how difficult it was for him to come back to work every day and to take care of patients, because it constantly reminded him of his loss. And so this zippering of our personal lives and our personal losses alongside our patients’ losses, and the secondary traumatic and post-traumatic stress that’s involved in that.

And you could just see the relief as he was telling the story that he hadn’t shared with anyone. And we do this thing where we come around and we put a hand on people, so there’s maybe six people in a group, and so he’s standing in the middle and we’re all putting hands on him, and watching just the tears fall, and watching him be cared for in it.

And so that moment is sacred, right? Like, that priceless moment of being able to share your heart, tell the truth, show your true emotions, and have your colleagues come around you and hold you. Like that, to me, is how we heal. And I love this quote by bell hooks: rarely do we heal in isolation, it’s when we commune together with one another that healing takes place. And so that to me was an example of, OK, this is healing. This is what it looks like to have trauma, to share it, and to be supported.

Kevin Pho: So in your workshops, when you open it up by having people more comfortable around each other by activities that simulate play, what are examples of that?

Tara Rynders: So one of our colleagues, Dr. Clare Hammoor, like I said, has his PhD in play and theater, and he leads us in this really beautiful play. So it’s really silly. He comes up with a storyline. This last one was, we were astronauts, and NASA called everyone here because we were on this adventure together. And everyone’s like, OK, I’m in, and nobody really knows what they’re in for, but we’re all like, let’s do it, why not?

And so we eventually turn off the lights and create beautiful blue lights and these flashing lights, and we create astronaut costumes. And so all of a sudden we’re basically in kindergarten again together, finding boxes, wrapping tape around us, helping each other. And we’re not even thinking twice about it, we’re just creating these outfits to go to space, and nobody knows why. And it just brings out the childlike heart and the silliness, because there’s nothing at stake here.

So as providers and nurses and clinicians, there’s so much always at stake, and we’re in life or death mode, fight or flight mode. And in this mode we just get to play and be together, and it’s very low stakes. And it can be hard for people, but everyone for the most part jumps in and is in it 100 percent.

And then we go to space and we have a dance off, and people are dancing and some people are doing the worm. Like, the craziest things happen in this space, in outer space. And it just creates a real deep sense of joy, like deep laughter. And some of the participants have said, this is the hardest I’ve laughed in years, I don’t ever remember laughing this hard.

And I think that when we let ourselves feel the depths of our joy, we also allow ourselves to feel the depths of our grief, and vice versa, allows us to feel. And I say that in the article, that once I realized I was hardening my heart and desensitizing myself, I couldn’t turn it on or off. I became desensitized to everything.

Kevin Pho: Now, what kind of message do you have to your fellow nurses who may be listening to you now, who may not have the benefit of attending your workshop? What can they do to overcome some of the trauma that they’ve felt or seen at work?

Tara Rynders: I think the first thing to think through, and I’m still learning this, is redefining resiliency for yourself. To take away that silly individual flower in the concrete, and think of the underground union that Ross Gay talks about in his book Inciting Joy, and this underground embrace that happens with aspen trees, what that looks like. The softening that we have to do to tell the truth, versus the hardening and bouncing back.

I also, when I look to nature, I invite people to fire ants, because there’s this really beautiful thing that fire ants do when the floods come. So, when the hard times come, what they do is they hold on to each other with everything they’ve got, and they create this really beautiful boat that can only be created because they’re holding each other, and everyone’s holding on for dear life. And then when they get to a reed they can climb up and have a moment, and then when the waters come they go back into the boat.

So I wonder, to my fellow nurses and for myself, what does it look like to hold on to each other as though our lives depended on it, and caring for each other in that way? Because I really think that at the end of the day our lives truly do depend on it.

Kevin Pho: And what’s your message to health care institutions, so that the onus of overcoming the stress isn’t solely on the health care workers themselves? What’s your message to the institutions themselves?

Tara Rynders: They need to implement peer response programs, debriefing programs, and they need spaces like the workshops that we do outside of work, for people to come together for eight hours and to lay down their grief, to mine these stories that have been in their bodies and in their bones, and do it with one another. And so that those pockets that they create from mining can be refilled with joy, so that they can come back refreshed and ready to hold more.

Because that’s the ask every day, right, for us to hold and to continue to hold more and more. And at a certain point we can’t hold anymore unless we release and care for ourselves. And so it’s asking the systems to not just put self-care on us, but to create spaces of collective care, where we’re caring for ourselves but also caring for each other simultaneously, and paying us to go to them.

Kevin Pho: We’re talking to Tara Rynders. She’s a nurse, dancer, and choreographer. Today’s KevinMD article is “America’s nurses have PTSD: Will anyone listen to them?” Tara, we’ll end with some of your take-home messages to the KevinMD audience.

Tara Rynders: My take-home messages. I think it’s the softening, how to find spaces to soften. Who are we grabbing on to? Who are our fire ants that we can hold tight to in the midst, when hard things come?

And the dance of giving and receiving, that it’s really hard to receive, but to really think of ways that you can open yourselves up to receive more, as you’re constantly giving and giving.

And that the systems, like health care systems, are created of people, and that we can be the change in the systems, the more that we allow ourselves to receive and create these spaces of healing for one another.

Kevin Pho: Tara, thank you so much for sharing your perspective and insight, and thanks again for coming on the show.

Tara Rynders: Thank you so much.