America’s Nurses Have PTSD: Will Anyone Listen To Them?


                                                               By Tara Rynders, RN

My first clinical rotation as a nursing student was on the same floor where my mother died of cancer. And my very first patient was a young Hispanic man with four children. I was asked to tell him that he had pancreatic cancer and very little time left. I was 21 years old and the only Spanish speaker on the floor – back in those days, interpretive services were rarely available.

As I told this beautiful family that they were losing their patriarch, I remember his wife beginning to cry, silently at first. Then, she fell to her knees and wailed into her hands. I looked at his children – all under the age of 7 – and felt my tears falling as well.

I remember repeating, “lo siento, lo siento, lo siento.”

Lo siento. Directly translated from Spanish, it means “I feel it.” I feel your pain. I feel it as if it were my own.

In many ways, the translation is a poignant definition of post-traumatic stress disorder (PTSD) and secondary traumatic stress – something that many nurses and health care workers are wrestling with now, after a global pandemic. When our patients suffer, we feel it – and it makes our job, nursing, incredibly difficult.

Most Americans today associate PTSD – “a condition of persistent mental and emotional stress occurring as a result of injury or severe psychological shock” – with the aftereffects of soldiers who see active battle. But PTSD and secondary traumatic stress disorder – “a set of observable reactions to working with people who have been traumatized” – are far more pervasive, and health care professionals who have worked through the pandemic are beginning to report its aftereffects now.

As nurses, we’re taught to desensitize – to harden – ourselves to the pain of others as a coping mechanism for the work we do and the suffering we see on a daily basis. The problem with hardening is that it makes it very difficult to only harden to certain situations and unharden for others. Once I began to harden in order to safeguard myself, I found that I’d lost my connection to my heart, my humanity, and my empathy. I lost what I had loved most about my job: courageously caring for another as they experience life’s darkest moments.

I realized that – to heal myself, and others – what I needed most was not to harden, but to soften.

Many years ago, I watched my mother slowly deteriorate from cancer and eventually sedated by medication as she passed away. This was the most traumatic event of my life. And I couldn’t bounce back – my grief and loss were just too heavy. In the months that followed, I came across too many situations, like the one above, that triggered my own grief – my memories of my mother’s last days. It was almost impossible to continue caring for others while I figured out how to survive her death. I was experiencing PTSD and secondary traumatic stress by taking care of patients. And the only way I knew to save myself was to skip caring for patients that I knew might trigger my own trauma.

Once there were very few patients left that I felt I could care for, I realized I needed help.

I decided to stop nursing full-time and go back to school to get my Masters degree in dance. Dancing had been my only coping mechanism through a difficult childhood and I hoped that it would come to my rescue, yet again. So, I spent the next three years dancing and grieving. And, as life does, it threw me another curveball: my sister – my happy, vivacious, full of joy sister – was struck by a rare disease that left her quadriplegic. I moved into her hospital room and, as I helped feed, bathe, and move her, I also reminded myself to move.

One day, I put on Miley Cyrus’ Party in the USA – a happy anthem that, at the time, was my sister’s favorite song. I danced around the hospital room and made a total fool of myself. And though my sister could not speak or move, I realized she could still laugh.

Throughout these difficult years, I found community, hope, and healing. I learned to care for myself in a way that I had never done before – by prioritizing myself and my healing, and by moving my body. Dance allowed me to soften – feel my emotions and share the trauma I witnessed, let it move through me and, eventually, out of me. When the global pandemic thrust us all into uncharted territory, I felt – again – as if we all needed a place where we could process our collective grief, together.

So, I brought together a group of nurse friends and started “workshops” that combined nursing and dance to find healing through the arts, movement and play. The focus was on creating spaces where we could collectively experience our grief and open pathways in our bodies and minds to post-traumatic growth. After one workshop, a friend said that even though talking to her husband and her therapist about work helped, it was only coming together with fellow nurses – “they just get it” – that made her feel understood.

I knew that we were on to something: that these spaces are necessary for health care workers, now more than ever.

We must debrief, we must dance, we must play, we must celebrate, we must have spaces to tell the truth about how we are feeling, and we must find people to do this work with. We need people to listen, to sit in discomfort with us and not fix us. Grief and trauma doesn’t need to be fixed, it needs to be heard, felt, and released.

My workshops are now being held for nurses around the country – and whole hospital systems, from Kaiser Permanente to Denver Health to Northwell – are seeing the utility of helping our nurses grieve. We start the day by washing the hands of every nurse in the workshop as an opening ritual – to let them know they’re entering a space where they will be taken care of. Next, we take part in “play exercises” to help create a sense of trust. In one exercise, nurses use tissue paper and tape to create astronaut uniforms and then take a spacewalk as they work to fix a problem together. The day also includes an opportunity for storytelling – to unload themselves of stories that have been causing them pain and grief and share them with fellow nurses who understand and empathize. The workshop concludes with a joyous dance circle in which nurses celebrate each other and themselves. And yes, sometimes we listen to Miley Cyrus.

In between – we have moments of silliness. Silliness. Because when your job is to care for others, sometimes you need the world to not feel quite so heavy.

On days when my grief feels deep – those still happen – I often think back to that family I met many years ago. I wonder if they’ve found their healing.

Lo siento.

Resiliency isn’t about not feeling – it’s about allowing ourselves to feel deeply because we know, from a place of deep, unshakeable conviction, that we can experience loss and come back from it. Our nurses need to hear this, feel this, especially after COVID.

The pandemic is over. But what happens now? What happens to those of us who are still struggling to process our memories of those dark days? What happens to the nurses who walk into a patient’s room and clam up – their bodies seized by panic? We need help now. We need healing. We need hospitals to make our well-being a priority.

Tara Rynders is a nurse, dancer, and choreographer.


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