Tara Rynders, a registered nurse, creates dance workshops for nurses and other medical workers. “We help workers reflect on their brilliance, resilience and creativity.”
Burnout and stress have caused approximately 100,000 nurses to leave the workforce since the start of the COVID-19 pandemic. This comes as no surprise to Tara Rynders, a Colorado-based registered nurse who has created a series of workshops for medical staff to address the sorrow and the joy of caring for others. The workshops—which combine movement, writing, play and debriefing—also focus on how workers can provide what she calls “courageous care” to themselves.
The programs have won accolades for Rynders, who has been on the receiving end of a slew of awards. The Colorado Business of the Arts, for one, named her a Next Wave Leader, and she has been dubbed a Fulbright specialist and a Nightingale Luminary.
Now a nursing educator rather than a floor nurse, Rynders’ latest workshops will focus on the needs of nurses working for Kaiser Permanente in northern California.
Rynders spoke to Ms. reporter Eleanor J. Bader about the healing power of performance and the ongoing need to reframe how U.S. medical care is delivered.
Eleanor J. Bader: Tell me about your discovery of dance as a form of personal healing.
Tara Rynders: I had a tumultuous upbringing in Reno, Nevada. My parents married and divorced three times and my home life was really unstable. But when I was in first grade, I was in a musical production. The instructor had just opened a dance studio and she reached out to me, apparently recognizing that I was a kid in need, and suggested I take classes with her.
I felt seen and knew that I felt good when I danced. My grandfather agreed to pay for my first month of lessons and after that, my mother somehow found a way for me to stay enrolled.
In 2011, I got my Master of Fine Arts degree in dance from the University of Colorado. Since childhood, movement has been a constant in my life.
I was a kid in need … I felt seen and knew that I felt good when I danced.
Tara Rynders
Bader: You also became a registered nurse. Why did you feel drawn to this field?
Rynders: I was one of four kids. My brother died at the age of 30. He’d been born with spina bifida and later developed schizophrenia and suffered from other mental health issues. At the time of his death, he was incarcerated and had refused medical treatment.
He was also scorned. I recognized that he’d been treated as unworthy of care by many of the institutions he’d interacted with. They let him refuse treatment. He died in 2019 but his passing made the health disparities in this country obvious to me. The system had failed him.
My mom also died young. She passed away in 2006 at the age of 49. She had a rare form of cancer in her small intestine and her condition, and my brother’s spina bifida, meant that I spent a lot of my childhood in hospitals. They’d become comfortable places for me, a sort of second home. This was true even though my brother did not get the care he deserved.
Several other brushes with illness also drew me in. My sister had developed Acute Disseminated Encephalomyelitis, ADEM, in 2012. It appeared abruptly. ADEM damages the myelin that covers nerves and helps with electrical signaling; it can also cause inflammation of the spinal cord and brain. My sister was 26 when she got sick, had an 8-year-old child, and suddenly could not move or speak. I was already living in Colorado, but I flew to Reno, where she lived, after she was hospitalized. There was nothing I could do to reverse the disease but every evening, I’d dance around her room. It made her laugh, howl and cry and even though she couldn’t talk, it seemed to help her find some freedom in her body. She remains a quadriplegic today but can now use an iPad to communicate.
I, myself, had a health emergency—an ectopic pregnancy—in 2016. I’d had twins six months earlier and did not know I was pregnant again, but after a fallopian tube ruptured, I ended up in the emergency room.
This was my first time as a patient and I remember thinking that I might die. I was alone because my husband was with the twins but there was a nurse who held my hand and told me I’d be okay. At first, when she touched me, I wanted to pull away. Like many nurses, it was alien for me to accept being cared for. It felt jarring but I also thought I might be dying so I remember saying, “Tara, will you let someone care for you?” I softened and received her tenderness. That’s always the tricky part, to let ourselves receive care.
That experience changed my life both as a human and as a caregiver. I recognized that allowing myself to be attended to forced something in me to shift. Later, I determined that this was something every patient should feel. Once I was well, I began to study best practices for the delivery of compassionate and courageous care.
There was nothing I could do to reverse the disease but every evening, I’d dance around her room. It made her laugh, howl and cry and even though she couldn’t talk, it seemed to help her find some freedom in her body.
Tara Rynders
Bader: How did that lead into the creation of workshops for nurses and other medical workers?
Rynders: Burnout is pervasive in every medical setting and in 2017 no one was talking about it. After my ectopic pregnancy, I found myself on a quest and spoke to the chief nursing officer at the Rose Medical Center in Denver, where I worked. She saw my passion and said that I could do a 45-minute talk for a group of nurses. I made it up as I went along, but the program included slow walking and drawing and gave us a way to connect to one another.
I later co-developed an immersive theater piece with Lia Bonfilio, Jadd Tank and Edith Weiss called First Do No Harm. It put the perspectives of nurses front-and-center. The play gave us a way to express our grief over patient deaths, something we’d never done before. This was six years ago. Among other things, we talked about unrelenting grief, losing children and then having to go home to our families. It was deeply impactful.
The performance introduced me to Dr. Clare Hammoor, who has a Ph.D. in applied theater and play. For me, dance and movement are play. Clare and I created a program together that gives nurses a way to debrief and process their feelings.
Bader: And then COVID-19 hit.
Rynders: At the start of COVID-19, the CEO of the Rose Medical Center asked me how the hospital could improve how it cared for caregivers. We developed a program that incorporated dance parties with a chance for folks to talk about what they were seeing. There was so much anxiety and fear. Staff were terrified that they would carry the virus home or get sick themselves. It was clear that everyone needed a safe space to reflect; they also needed joy.
I call what we created (Re)brilliancy since we helped workers reflect on their brilliance, resilience and creativity. Instead of asking them to do more, we focused on taking care of each other and discussed what courageous patient care looks like. We emphasized our worth and talked about leaving unhealthy work relationships.
In addition, we determined that our entire healthcare system is steeped in white supremacy, with white men in charge and few if any Black or brown people in leadership.
We questioned why this was so.
Many of us concluded that we need to burn the house down and start again and stop doing things that are not only bad for us personally but bad for patients. We shared stories. I remember one registered nurse talking about a patient who she knew was dying from COVID-19. She’d arranged to let the patient Facetime with relatives so that they could say goodbye. She later realized that she was so busy charting everything that she did not hold the patient’s hand as she died. This nurse was holding in so much sadness and guilt. No one had prepared her for the fact that she would have to stand in for family as a patient died. She felt as if she’d incurred a moral injury.
Many of us concluded that we need to burn the house down and start again and stop doing things that are not only bad for us personally but bad for patients.
Tara Rynders
Bader: I can’t imagine how painful this must have been. Meanwhile, people were banging on pots, calling nurses heroes, and lauding them for their work. Did that help?
Rynders: At first, it felt good to be seen and recognized, but in the end, it felt as if our humanity was taken from us. There was a facade that we were appreciated. At the same time, we were set apart as if we could do extraordinary things. It resulted in many of us bottling up our feelings in order to get through each day.
We now need to find space to acknowledge that it was a mistake to treat us as if we needed nothing because we were superheroes.
Bader: Is this why there’s been a mass exodus from the field?
Rynders: Yes. Nurses and other medical workers need to be able to stand up to power and celebrate themselves, not for being self-sacrificing, but for being able to set boundaries, say no, and not comply with every request. We have to be able to talk about how we’re feeling, even if what we’re feeling is exhaustion, anger or frustration. We need spaces that honor our humanity, that recognize that we may need to take time for ourselves. We need to be able to take a vacation, or even a lunch hour. When we are able to recharge we benefit and our patients benefit as well.
Bader: It’s obvious that job satisfaction plummets when this doesn’t happen. How can addressing emotional needs and the need for respite be woven into the workday?
Rynders: We need time and space during the day to debrief and share our humanity, the emotions that come up after we experience trauma.
Trauma happens in all kinds of ways. One nurse told us that she fell apart when she realized a 2-year-old she was resuscitating had the same shoes as her toddler. Sometimes caring for someone who has had a miscarriage will be triggering for a nurse who has also lost a pregnancy. Basically, there are times when the parallels are so close, when a coincidence of losses or experiences aligns so completely, that we’re touched deeply. We have to be able to acknowledge and name that.
In our workshops, movement releases the reactions that our bodies have been holding in. Movement allows us to feel. I learned this as a child. When I danced as a kid, my feelings found a way out. I couldn’t express my sadness that my parents were fighting or that my mom and brother were sick, but when I danced it allowed me to grieve and feel pleasure.
We need to be able to take time out during the day—a few minutes can do the trick—to sit with our feelings and process what we’ve been through.
Bader: You worked in emergency rooms for a long time. What drew you to that environment?
Rynders: An ER is a place where a CEO can be seated next to a homeless person. Both are united by their vulnerability. This is not seen in many other places. I loved caring for people during some of their most difficult times. This felt sacred and I felt honored to support them.
Bader: Tell me about the workshops you’re doing at Kaiser Permanente.
Rynders: Kaiser is paying up to 600 workers to attend one of six all-day workshops. Dr. Hammoor, along with Maria Schimpf, a music therapist, and Ashley Cornelius, a talk therapist/poet and I are collaborating.
There were two workshops in April and four more are scheduled for June and September. Among other things, the workshops address the invisible forces of COVID-19 and help staff talk about the impact of having patients die while we’re being hailed as heroes. We do a lot of playing, dancing and journaling to help us tell the truth about what we’re feeling. We’re declaring what we need to continue doing this work. We talk about being cared for and address our collective needs.
There was a facade that we were appreciated. At the same time, we were set apart as if we could do extraordinary things. It resulted in many of us bottling up our feelings in order to get through each day.
Tara Rynders
Bader: Most nursing training focuses on the rudiments of patient care. How can curricula better incorporate the needs of practitioners?
Rynders: Classes need to address the mental health of nurses and other medical workers and offer interactive ways to cope with the things they’ll experience. Training needs to include the arts to help practitioners understand that we heal in relationships, that remaining isolated hurts suffering individuals as well as patients. It also prevents the profession as a whole from thriving.
Bader: How do you keep from burning out?
Rynders: Self-care is so important, but I find collective care the most healing. When I can be in collaboration with others, it is sustaining for me. I find that telling the truth about what I am feeling helps a lot. So does asking for what I need to do my work. Dancing is key and I’ve found that travel is also essential. Going to new places has always been a way for me to take care of myself. When I can combine work and travel, it’s especially wonderful.
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