Voices from the Front Lines : Jay Fulton

We recently joined hospital staff for a few days to document the reality of treating COVID-19 patients in UK HealthCare clinical settings.

This edited interview is part of our ongoing series, “UK HealthCare: Voices from the Front Lines,” highlighting stories and perspectives from our frontline staff who care for the sickest COVID-19 patients, day in and day out.

Jay Fulton has been a chaplain at UK HealthCare for eleven years.

Can you tell me what your day-to-day job was like prior to COVID?

Our main purpose here is to provide spiritual and emotional support to patients, families and staff. I did a lot of work with families and patients before COVID. We would have a whole lot of family members here which, unfortunately, since the pandemic has started, we've not been able to have as many family members here.

How has the pandemic changed your job?

That has changed my job quite a bit, in that I am having to almost stand in for family sometimes and provide support to patients even more than I already did. One of the harder ones are situations where we have a person who is dying where maybe only one or two family members can be here. Sometimes, none of them can be here. And I will be with that patient through that.

I am doing a lot more staff care than I did before. I've been very worried about our staff. I see a lot of traumatic stress. I see a lot of burnout. I see a lot of very experienced, caring, very good providers who have left the bedside because of COVID.

I am seeing families who are more stressed. We're seeing folks who aren't coping as well because they're coming in at a higher stress level just at baseline. People don't have the reserves that they once had – and that has made it difficult for them.

I find that as I come alongside and care for these people, having to walk with them through even more difficult situations than before. They're not things that I can fix, nor do I try. But these are situations where we try to support people as they walk that journey.

What do you try to do to help the staff?

To help the staff, I do a lot of listening. I let them vent what they're feeling. I encourage them to express what they're experiencing and feeling – their frustrations, their sadness, their grief, their anger, their exhaustion, their pleas for people to get vaccinated, the heartbreak that they are going through now seeing so many young people who are so sick and, in many cases, dying.

In health care, as you know, a lot of the providers are younger people, people in their 20s, 30s, 40s. We were seeing patients in their 60s, 70s, 80s.

Now, we're seeing patients who are in their 20s, 30s, and 40s who are extremely sick, who are dying, whose families cannot be with them, who are leaving families at home, leaving young children that they won't be around to raise. And my staff, they're seeing themselves in that, because they're young people.

They have young children at home. They have young families. They're putting themselves in the patient's place and in that family's place, and their hearts are breaking.

So, I do a lot of listening. I let them tell me those kinds of stories. And, all I do is I acknowledge the difficulty of it and let them grieve, because there's a lot of grief that comes with this.

My emergency people, they do a fabulous job. And they are overwhelmed. Even before COVID, in the emergency department, we're used to dealing with large numbers of people. We're used to dealing with a lot of patients coming in.

What we were not used to is as sick as so many of them are and the pace with which we're caring for them, because the staff has to put on all their protective equipment before they can go into a room to care for a COVID-positive person. That takes time.

One of the attending physicians who had been here – he has since left – I remember early on telling staff, ‘in a pandemic, there is no emergency. Take care of yourself first. Put on your protective equipment.’

And in some cases, that's appropriate. And in some cases, that delays care. And that's not who our people are. They don't want to wait.

They want to get to that bedside as fast as they can. They want to provide the best care that they can for those people. And it hurts them that it's slowing them down and they're not there as quickly. That grates on their souls.

As a chaplain, you came into this job expecting to see a lot of grief and death and to deal with that. Did you ever anticipate anything at this level?

No. I never expected anything like this. One of the things I had never expected to have to do is to tell local clergy, local ministers, rabbis, imams, other outside spiritual care providers, tell them they can't come see their people. That hurts my soul, because I know they walk with these people day in and day out and care for them through their lives.

Unfortunately, to keep people safe, we can't have them here. I never thought I'd have to look at a pastor and say, ‘I'm sorry. You can't come see your people.’ That hurts my soul.

What's the most important thing that you want the outside world to understand about what's happening in this hospital?

My people – and that's how I refer to the staff here. My people are broken. They're hurting. They're exhausted. They want to provide the best care that they can for everyone that comes in the door. And they're overwhelmed.

It is too much for them. I see staff that I know and have worked with for years and care about who are burned out and can't do it anymore. I see our people struggling to do the very best they can.

If someone comes in here, they're going to do the best they can for you. But they don't have much in the way of reserves anymore. They've used everything they have. And they're still going. They're running on empty.

And we need people's help. We need people to get vaccinated. We need people to take care of themselves. That's the only way out.

What would you say to folks to really try and give them the message that it's real and it's having a devastating effect both on patients and the folks who are trying to help them?

I wish I could take them on the units. I wish I could introduce them to the patient yesterday who I gave communion to who was short of breath, just before they were going to intubate him, put him on the breathing machine, who looked at me and said, ‘I wish I had gotten the vaccine.’

I wish I could take you down the hallways and see all the young people on ventilators or who are turned on their stomachs or who are on an artificial heart-lung machine because their lungs don't work anymore.

I wish I could have you sit down and just spend 10 minutes listening to our nurses, our respiratory therapists, our techs just about their fears for their families, their fears for their children. I wish I could bring you in to see.