Who Cares for the Caregivers? Raising Awareness About Burnout in the Nursing Profession Through Immersive Theater

This week’s Arts in Society blog post was written by the Denver-based choreographer, dancer and producer, Tara Rynders, whose newest project, “First, Do No Harm”, debuted last fall in Denver, after having received an Arts in Society grant in 2018. Here she shares her reflections on the process of creating a community-driven, immersive theater performance that instills a deep understanding and empathy for caregivers in its audience. Rynders is intimately familiar with the ups and downs of caregiving as a career; she has worked as a registered nurse for 11 years at Rose Medical Center in Denver and 14 years total in the nursing profession. What inspired Rynders’ new production, however, was her own unexpected turn as a patient, after a near death experience, due to an ectopic pregancy. The incredibly difficult experience she endured is what ultimately inspired her to develop the narrative of “First, Do No Harm”, a narrative exploring love, personal loss, life and death, through the eyes of nurses.

Read more below about “First, Do No Harm” here, and the upcoming workshops that Rynders and her team are planning to launch later this year at Rose Medical Center.


Our goal was to utilize the arts to bring awareness to compassion fatigue and nursing burnout through a scripted, two-hour immersive theater performance, First, Do No Harm, that took place in Rose Medical Center and was open to the general public.  By telling the story from the nurses’ perspective, we are bringing awareness to the incredible and difficult work that nurses do on a daily basis.
— Tara Rynders

For two weeks in October 2018, The Clinic debuted an immersive performance titled “First, Do No Harm” at Rose Medical Center in Denver, Colorado. Created by Tara Rynders, in collaboration with writer Edith Weiss and co-directors Lia Bonfilio and Jadd Tank, “First, Do No Harm” is an intimate journey of personal loss, love, life and death. Throughout the tender span of 120 minutes, an array of dancers, actors and musicians guide you throughout the hospital, where these themes are explored through the eyes of the caregivers and the cared for.

 

One in three nurses experience burnout

“First, Do No Harm” is based on sobering statistics that tell us that 1 in 3 nurses experience burnout, a startling trend that has a ripple effect. According to Web + Ed Web Solutions, a company that helps healthcare industry determine employee well-being, “burnout goes beyond feeling tired or experiencing a bad day at work. It is defined as emotional, mental, and physical exhaustion caused by excessive and prolonged stress. It impacts the personal lives of caregives, the patients they take care of, and the organizations they work for.” Audiences who participate in “First, Do No Harm”, are able to connect with the immense challenges of nursing on an emotional level, in real time. The project meets a vital need for raising healthcare and public awareness about the epidemic of burnout in nursing, shedding light on the need for prevention, intervention, and wellness resources for nurses.  

Nursing wellness is also directly related to patient safety. If our nurses feel seen, heard, and cared for, then so will our patients. Through the arts, “First, Do No Harm”, helps others step into the shoes of nurses and see firsthand, some of the difficult choices nurses have to make every day. Audiences are given a window into understanding the space of caring that nurses have to hold for others, as well as the exhaustion and stress results when these tasks are repeated over and over, without proper support and resources. Burnout negatively impacts the health and well being of nurses, as well as their families, patients, and the nursing profession as a whole.

 
 

Sharing the Inner World of Nurses, Exploring Our Capacities for Grief and Joy

To create “First, Do No Harm”, I brought together a group of nurses, artists, dancers, musicians, and a script writer. From there, we researched and created a script that explores issues of compassion fatigue and burn-out, from the nursing perspective.  Our team rehearsed weekly at Rose Medical Center for six months to create this production. With the support of Rose Medical Center CEO Ryan Tobin, CNO Lynne Wagner, Security Officer James Butler, and Marketing Director Julie Hogan, our group brought audience members on a two hour journey for the performance, which also took place throughout Rose Medical Center.

The “First, Do No Harm” journey follows a woman who arrived at the hospital to find that her husband who was 42 years old was in critical care from a heart attack. The audience experienced this story from the perspective of nurses, the patient, the patient’s wife, and the perspective of death, an actual character.  Weaving together this story is a through line of compassion fatigue, burn-out, loss, grief, life and death. The performance ends in the chapel, with all performers listening to a monologue performed by Death, speaking to what happens after one’s life has ended. Death admits she does not know what happens, and offers an alternative - “Maybe there is dancing?”. This prompts the nurses to enter for a dance finale that reminds us all that our capacity to grieve, is also the capacity we have to feel joy.

 
 

Many healthcare workers attended the performance and we heard important feedback from them, including on attendee who shared that, “It spoke to the decades I have spent witnessing others’ grief and captured the compassion fatigue we are all vulnerable to feeling.”

Overall the nurses in attendance said they felt both seen and heard, as they witnessed their stories being told and brought to life for an audience; nurses said they felt both appreciated and respected for the incredible and difficult work they do daily.  The general public audience also spoke to having an increased amount of respect for nurses after having a better understanding of what it is that nurses have to do and the magnitude of which their profession requires from them.

Brighter and Stronger Connections Between Patients and Nurses

Moving forward, our team of artists and nurses are working together to create The Clinic — a 6-week art based workshop at Rose Medical Center. The workshop will be accessible and free to attend for all Rose Medical Center nurses, and driven by a goal to decrease compassion fatigue and burn-out through guided movement, journaling, music, and acting.  We hope to bring both “First, Do No Harm” and The Clinic to many more hospitals and work with nurses in each hospital we perform in.  

Ultimately when our nurses are suffering, so are our patients. When I was a patient in a life threatening situation, I truly felt the difference between nurses and other healthcare providers when they saw me, heard me and authentically cared for me, versus not caring and not seeing me as a person.  My research to find a solution to help every patient feel seen, heard and cared for has led me to understand that we must first prioritize our nurses and make them feel seen, heard and cared for. Only after caring for our nurses first, will our patients be able to experience this deeper level of care, compassion and connection as well.  

I am excited to see how The Clinic and First, Do No Harm create a culture change in our hospitals and healthcare, as the arts infiltrate our healthcare system.  The Clinic is arming our nurses with the arts, music, movement, self-care tools, and space to remember their inner healer that is then passed on as compassion and authentic connection with our patients.

 

All photos by DW Burnett. Text edited by Sarah Slater.

 

Learn More

Visit The Clinic website to sign up for their newsletter and get involved.

Listen to Colorado Public Radio’s interview with Tara Rynders here.


Funding the Arts in Colorado

Arts in Society is a collaborative grantmaking program founded in 2016 through a partnership between Bonfils-Stanton Foundation, Hemera Foundation, Colorado Creative Industries and Scientific and Cultural Facilities District (SCFD). Two year grants of up to $50,000 per project are administered through RedLine Contemporary Art Center, located in Denver, Colorado.

The purpose of Arts in Society is to foster cross-sector work through the arts, by supporting the integration of arts and culture into multiple disciplines critical to the health and well-being of Coloradans.

The Arts in Society grant program funds projects that engage arts organizations and individual artists as partners in illuminating and finding solutions to a wide array of civic and social challenges faced by our communities.

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