My name is Jennifer Guy and I am a registered nurse. I began my career with Eastern Health 27 years ago on August 16, 1991, and since that time I’ve worked in many different fields of nursing – from general surgery to urology, cardiology and day surgery.
Throughout the majority of my career, I practiced in the Cardiac Intensive Care Unit (CICU) where I provided care to the most critically ill patients following their cardiac surgery. It was here that I honed my nursing skills. I learned so much about the human spirit, and the ability of patients to beat seemingly insurmountable odds to become well again. To me, this is the true meaning of resiliency.
I’m a people person. I have always enjoyed getting to know my patients, learning about their health history and developing a plan of care to assist them through the most stressful time of their lives. My patients are always my number one focus. Whether advocating for patients who are unable to speak for themselves, or helping patients to understand how to manage a chronic health condition, my goal has always been to help my patients be the healthiest that they can be.
Partners in care: The Remote Patient Monitoring Program (RPM)
Last July, I became a member of the Remote Patient Monitoring (RPM) team. I feel that my years of experience led me to this new and innovative approach to providing health care. The primary focus of the RPM program is to educate patients to manage their chronic health condition from the comfort of their own homes. This includes managing diseases such as congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus (DM). The idea is that when patients feel empowered, they are better able to manage the physical and emotional aspects of their disease and avoid unnecessary trips to their primary care provider, emergency department or hospital.
The RPM team provides patients with monitoring equipment including a tablet, blood pressure cuff, weight scales and, depending on their diagnosis, a pulse oximeter. Each day the patient performs a daily health session that records biometric data and symptom assessment information. This information is then transmitted to an RPM nursing team member who analyzes the information and provides health coaching accordingly. The tablet also provides daily educational content and videos about the patient’s chronic disease.
The patient is responsible for performing their daily health session and, in turn, their daily self-management. They become a partner to the RPM nurse and their primary care provider in managing their chronic disease. It is truly a proactive approach to providing health care.
Changing lives: Jerome’s story
Jerome Slaney, a former patient of mine, is a shining example of how the RPM program is meant to work.
I first met Jerome in November of 2017 when he called our office to enquire about his eligibility to enroll in the program. Jerome has lived his life in St. Lawrence, NL. His father worked and died a young man in his 40s from lung cancer. A few short years later, Jerome’s mother died unexpectedly leaving a family of 10 children behind.
Jerome became an electrician, married and had a family. He worked for a short period in the mines, the local shipyard, and retired from his career at the U.S. Memorial Health Care Centre in St. Lawrence.
Jerome is an impressive person. From our first conversation on the phone it was obvious that Jerome was an intelligent and genuine individual who was desperate to improve his quality of life while living with his COPD. He had led a healthy lifestyle – never smoked, ate well and was active. He still loved to do his electrical work, go to the cabin, fishing, coach soccer and take care of his family.
Jerome had been experiencing repeated acute exacerbations of his COPD – causing symptoms such as increased shortness of breath, and coughing requiring several regimes of antibiotics and steroids with no relief of his symptoms. This severely affected his ability to sleep and go about his daily activities.
According to Jerome, he felt lost and depressed. A proud father and fiercely independent individual, he spoke of sitting in his living room window with his eyes filled with tears, after a snow storm, as he watched his son clear his driveway for him. “I just couldn’t manage it anymore,” Jerome recalls.
Jerome learned about the RPM program when a nurse practitioner and friend of the family gave his wife a pamphlet about the RPM program. At first, he was ambivalent about the program as he felt that no one could help him, but after a very difficult night of trying to breathe, he felt he had nowhere else to turn and nothing to lose. Jerome called the very next day.
Building partnerships in care
When I first began working with Jerome, he would be breathless walking from one room to another just to answer the telephone. To manage his breathlessness, I began by teaching him about his medications: their purpose, dosage and the proper way to use his inhalers. This was followed by coaching on deep breathing exercises, effective coughing techniques and encouraging him to pace his activities.
Through the RPM program, I provided education on the early signs and symptoms of an acute exacerbation of his COPD. In turn, Jerome worked with his family doctor on an action plan that allowed him to start antibiotics and steroids when he first experienced the symptoms of an exacerbation to prevent his symptoms from worsening.
When Jerome was having a bad day, he contacted me for coaching and support and I was able to bridge the gap between his doctor’s appointments. Based upon our discussions, along with the health coaching, Jerome advocated for himself to have further assessments and diagnostic testing completed, and his medications have been adjusted.
‘Keeping up with the best of ‘em!’
Today, Jerome is a new man.
Although it takes him longer to accomplish some tasks, given he has to take ‘spells’ (rests) during any form of work that requires energy, Jerome walks every day, mows his own lawn, goes fishing – and he and his wife go to their cabin every chance they get.
Jerome was a very engaged patient. He took notes when we spoke, made notes from the information provided on the tablet and in the instructional videos. He will be the first to say that he is not used to using computers, but found the RPM equipment very easy to use.
In fact, Jerome has volunteered to help other RPM patients in the St. Lawrence area to learn how to use the RPM technology. Upon completing the RPM program, Jerome acquired his own monitoring equipment, and continues to record his measurements each day. He has reached out to other people in his community who also suffer from COPD.
Jerome says they get together and have a chat about their health and share things they have learned. In this sense, Eastern Health’s RPM program exceeds its expectations by not only improving the health of the individual patient involved in the program, but the population in general.
“I can keep up to the best of them now!” he jokes. Jerome now knows exactly what to do if he starts feeling sick again. He is aware that there is no magic cure for his COPD, but he now feels fully prepared to manage his chronic disease. His desperation has now changed to confidence.
“When I enrolled in the RPM Program, only nurse Jennifer knew how difficult it was for me to breathe and how sick I really was with the sleepless nights and nowhere to turn. It was her help and inspiration that pushed me forward to accomplish what I have done and for that, I just can’t find the words to say ‘Thank you.’ She sure is a great nurse with a very special way of helping patients like me get through some difficult times. I want to thank her and the team for everything. As of now, I am feeling great and should the tables turn, I still have nurse Jennifer to fall back on should I need her help. God bless.”
– Jerome Slaney, patient, Remote Patient Monitoring Program
Supporting health. At home
According to Kim Ghaney, RPM program manager, supporting health at home is at the core of the RPM program, and this mission is accomplished through the dedication of an amazing team. “We actively work to reduce barriers and improve access to care by adopting technology in health care,” Kim adds.
Jerome’s wife, after realizing how it has improved Jerome’s quality of life, has also joined the RPM program. It is very satisfying to see how patients can grow and become empowered to manage their chronic disease and overall health. As part of the RPM team, I am happy to see the success of the program demonstrated in stories such as Jerome’s, and proud to be part of the RPM team at Eastern Health. ■
This story was written by Jennifer Guy, registered nurse with the Remote Patient Monitoring Program at Eastern Health.