Voices from the Front Lines: Samantha Poston

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.

Samantha Poston has been a staff nurse in the emergency department at UK for four years.

What was working in the ER like prior to the pandemic?

The ER has always been busy. It's always been a challenging job. We've always had high patient volumes and the sickest patients around. But I've never felt quite this stretched thin before.

It comes with the territory of being an ER nurse, that you're going to do the most with the least. But we are trying to do the most with really way less.

And you've been here the whole time through COVID?

Yeah. I've been here the whole time during COVID. It's interesting – more of my career has been before COVID than since COVID, but it doesn't feel that way. It's almost like I don't remember before. It's strange to try and describe the way things used to be and how we used to practice so differently to newer nurses, because everything's changed.

We used to be able to go more liberally into patients' rooms. Or if someone arrived in distress, there was not this moment where you freeze and you're like, ‘hang on, let me put on everything before I go help them.’

You just go. You just jump on it. It's been so stifling. It's just been – there's this whole degree of extra separation and extra eggshells to walk on just to get people what they need. It takes so much longer.

At the beginning of the pandemic, we saw a lot of people, but they were spread out. They were sick, but this is different.

The people coming in (now) are so much younger – and they're so much sicker. We are intubating people that are my age. They're younger than my parents.

What keeps you coming back to work and doing this day after day?

Because someone has to. The whole nation is struggling for nurses right now. And this is the ER – the biggest ER. It's the most high-acuity ER in our community in Central Kentucky. This is where all the things happen.

So, if you live in this area and your family needs something extraordinary to survive, this is where they come. This is where my family would come. It's really terrifying to think (what would happen) if all the nurses leave.

If my family comes in, someone has to be here. So, I have to show up for the rest of the community. It's too essential to just not come.

What is the most important thing that you want people out there to understand about what's happening?

I think there's a prevailing idea in the community that COVID is this bad flu. And if you're young, if you're healthy, as long as you're not medically fragile, it's not a big deal. You'll kick it at home. You'll kind of get over it.

That is not true. There are young people here who come in struggling for air. They get intubated probably within the hour of being here.

I think everyone needs to do a risk-benefit analysis when it comes to the vaccine. Everyone needs to kind of weigh the options in their lives. What are the risks if I were to contract COVID? What are the benefits of the vaccine and vice versa, because you can spread it to your family.

You can spread it to children. Children who don't have vaccinated adults in their lives, they can bring it home from school and spread it to those adults. Those adults can spread it to children. It's just very real.

This particular variant has made young people very sick. They are not immune. They're not out of the woods just because they're young. It's something different.

Are there any moments from the past year and a half that stick out in your mind?

I helped intubate a gentleman. We asked him prior to intubation if he would like to call his family, and he wasn't sure what to say. He ended up not taking that opportunity.

And we didn't have time to impress upon him the severity of this – the reality that he might not get that opportunity again. And I went home, and I grappled with this a lot. I talked with my husband about this a lot.

I don't know if I should have pressured him more or if that would be too much stress in an already stressful situation for him, because he did get intubated. And it's the emergency department – so these people, we only see the front end. We don't know how it turns out.

But I struggled and struggled and was like, ‘was that the right thing? Should we really have pressed more? We didn't have a lot of time. What would he say, anyway?’

I struggled. And my husband was like, ‘why are you so fixated on this?’ And I was like, ‘because it's going to happen again. This is not going to be the last person who comes in very sick that has a couple moments to decide, do we want to make a phone call? Do you want to make it? Do we need to make it before they get intubated?’

There have also been some triumphs. It showed me that my coworkers are very, very strong. And I think the fact that we've been so adaptable here in the ER has been a testament to how strong we are as a group of people, how flexible we are, how important we are. I think it's demonstrated it to the rest of the hospital and hopefully to our community when they have had to come in contact with us.