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Nurses perform in Tara Rynders's First, Do No Harm in 2018, to bring awareness to compassion fatigue and nursing burnout.EXPAND
Nurses perform in Tara Rynders's First, Do No Harm in 2018, to bring awareness to compassion fatigue and nursing burnout.
DW Burnett

Denver Nurse Tara Rynders Uses Art to Heal the Healers

Tara Rynders, an artist and nurse at Rose Medical Center, is bringing together musicians, theater artists and choreographers from around the world to reflect on the challenges of being a health-care worker during the COVID-19 pandemic.

On Thursday, July 2, from 1 to 2 p.m., Rynders is hosting a virtual event called Resiliency Moments to support and acknowledge the challenging work that medical professionals do every day. It’s part of the virtual worldwide festival Reimagine: Life, Loss and Love, a series of community-driven events exploring death and celebrating life in response to COVID-19.

Reimagine, A Blade of Grass and The Clinic are co-hosting the event, which will is free to the public.

The Clinic, founded by Rynders, combines arts, dance, music, movement and science to create immersive experiences for health-care professionals. A nurse for thirteen years, she's used art and performance to talk about and support health-care workers' experiences with compassion fatigue, burnout and secondary traumatic stress throughout her career; she's also worked to provide grief recovery to health-care workers.

“In many ways, my relationships with my nurses have now become the relationships that I once had with my patients,” Rynders says. “Giving my nurses a voice and empowering them to care for themselves goes even deeper and allows them to better care for their patients.”

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Rynders began using art to express compassion fatigue and burnout after after she was a patient herself, and almost died from an ectopic pregnancy in 2015. “During that time, I really got to see our health-care system from the inside,” she says. “And I think what that did to me was open my eyes to many things I had grown accustomed to.”

After researching patient outcomes and experiences, she says, she'd realized that everything in the system relates back to the nurse and the bedside; she began to fully recognize the magnitude of responsibility that nurses have to care for the hurt and vulnerable. As a patient experiencing a life-threatening emergency, however, she felt for the first time that there were many missed opportunities for nurses to provide that care. She blames this on the system in which nurses work and the need for more conversations around burnout.

“I don’t think we really understand how important our role is as nurses,” she says. “We’re burned out. We’re tired."

One of her recent attempts to raise awareness about compassion fatigue was the immersive theater production First, Do No Harm, which took place at Rose Medical Center in October 2018. The purpose of that event was to de-stigmatize fatigue, burnout and mental health issues for health-care workers, says Rynders, who brought a cast of sixteen dancers, artists and musicians into the hospital, where they acted out the story of a wife whose husband was dying, from the nurse’s perspective.

That same month, she expanded her scope to compassion-fatigue workshops with nurses at Rose Medical Center and the Medical Center of Aurora. Her hope was that after the nurses went through the workshops and reflected on their own burnout, they would take the experience back to their jobs and to day-to-day interactions with patients. And a study done after the primary workshops found that they not only decreased burnout, she says, but also increased empathy. Although she has only worked with nurses, she eventually wants to open up workshops to all medical providers.

For these workshops, Rynders collaborated with Clare Hammoor, with whom she is also working on Resiliency Moments. Together, they created sessions based in theater and movement, in which nurses would role-play, pretending to be everything from secret agents to hospital patients. “They would show up and immediately be part of this play that they knew nothing about,” Rynders explains. “And then they would start building their chosen characters.”

The unusual type of role-play disrupted their normal thinking and the hierarchy that they were used to, allowing them to be more honest, comfortable and reflective about the hardest parts of their jobs, Rynders says. For the first half of the workshop, each nurse was paired with an artist, and they all practiced creative expression in a large room, dancing and talking about important issues in a playful way. The second half of the workshop involved mindful practices like yoga. At the end, there was a discussion about how to bring mindful practices back into the hospital setting.

Grief stories were also a big part of these workshops, Rynders says. Nurses would write down experiences where they had lost someone or experienced grief in the hospital, then circle the words that stood out to them from their written stories. Then they would create movements to the words.

“When everyone was moving together, it helped create a sense of collective care,” she says.

Rynders is now trying to foster that same sense of collective care during the pandemic by partnering with the Northwell Health Staten Island University Hospital to offer resilience and strength to the hospice nurses who work there. Over the past month, she has brought her own experience with compassion workshops and role-play to help them process and talk about their grief. Staten Island nurses have virtually planted flowers, sung, danced and written reflections.

Artists Jadd Tank, Lia Bonfilio and Hammoor are partners on the project; they have been working on the concept since late March.

Jadd Tank, who is based in Lebanon, created a “mourning dance” with the nurses in New York. He worked with them to help them talk and think about someone they lost or were grieving; then they put movement to those stories. Rynders describes it as “very interactive, and it’s a space for nurses to feel seen and heard and cared for.”

Lia Bonfilio, who's based in New York City, did a performance event with nurses, reading a poem and inviting them to share what emotions and experiences they want to release. Then together they planted a flower bulb. Bonfilio took pictures and sent them to nurses every week. Bonifilio says those who participated dedicated the growth of the flower to someone of their choosing, usually a patient or a patient’s family member.

“It’s about giving them something that has some wonder or imagination in it,” Bonfilio says about her moment with the nurses. “I really believe in those types of things having transformative power.”

Denver-based Hammoor led a playful invitation for health-care workers to dance, breathe, listen and practice healing themselves. He says it was a silent dance between himself and the health-care workers. “I hope that the moment I am able to share with health-care workers is a time for them to be cared for...a balm amidst this especially difficult journey they are leading us all through right now,” he says.

Musician Abby Ahmad wrote a song with nurses. The health-care worker she was meeting with could choose an instrument, song, tempo and feeling, and then Ahmad worked to put it all together.

And Mary Lynn Lewerk, who is also based in Denver, told nurses to laugh, throw a tantrum and then fake cry, but Rynders says many ended up actually crying for a few minutes. Lewerk talked to the nurses about what they felt they needed, and had them write it down and put it in an envelope. Then she mailed it to them so they would remember.

Through the Clinic, nurses are now meeting once a month to write down grief experiences and share COVID-19 stories. They put movements to words from written testimonies. Rynders says this story sharing will continue even after the event is over.

The event on July 2 will be a live discussion between the nurses and artists who participated in the program over the past month; nurses will share what their experiences were like with the artists. Then the audience members will discuss Resiliency Moments themselves.

The event is an invitation for a larger conversation about how to incorporate support for nurses into hospitals. “I see Resiliency Moments as an opportunity for health-care systems to step up and start implementing these moments into their daily experiences,” says Rynders.

She points to the hospice director at Staten Island University Hospital, Paula McAvoy, as an individual who is leading these practices. Rynders said McAvoy sat down with her and helped brainstorm a way to incorporate resiliency moments into the nurses’ schedules, and is now looking to expand them to all of her medical workers.

“This is a hospital that is actively pursuing the health of their nurses, social workers and caregivers,” Rynders says.

For now, Rynders provides mindfulness practices to health-care workers at Rose Medical Center. She says she spends a lot of time listening, but they also draw, read poems and meditate. They sometimes even have dance parties in the middle of the nursing unit.

“It’s a reminder to them amid all of this struggle and hardship and loss and sadness and fear, to just be able to take a moment to breathe and check in with themselves,” Rynders says.

Resiliency Moments, 1 to 2 p.m. Thursday, July 2. To register, visit Reimagine's website.

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