I understand that life can quickly become crowded with various burdens and a patient’s health is often the last thing on their mind. Addressing essential personal concerns such as finances, depression, anxiety, housing, family, and basic nutritional needs, leave their blood pressure on the back burner. To these patients, listening to the science and statistics behind educational information on their health can feel like useless noise unless they understand how it applies to them. It is imperative I create a relationship of trust with the individual to gain a better understanding of their life—who is important to them (pets included), their personal roadblocks, and what makes them want to change their lifestyle. With this perspective, I tailor the education in a way that becomes personal to them. 

As an RPM nurse, I was assigned to contact a patient whose blood pressure was Hypertension Stage 2 according to the American Heart Association. He was friendly, but politely declined the program letting me know he certainly would not commit to checking his blood pressure, taking his medications daily, or talking to me weekly. After spending a little time and becoming acquainted, I was able to secure his participation, not commitment, for two weeks. 

Our first call following his agreement was wonderful! He touched my heart as he spoke about his foster daughter, how he loved her and would do anything for her. Immediately I knew she was his “why”. Learning more about him, I came to appreciate him as an individual. He was an amateur boxer, had great Christian values, and was a little unconventional, but had a desire to do the right thing according to his conscience. 

The first few weeks were a tossup. Sometimes he answered, and other times he didn’t. Because of his reluctance to apply what he was learning through our calls, coupled with inconsistently taking his blood pressure and medication, his blood pressure remained elevated. 

The fourth week proved to be the inflection point in his journey. Whether he realized I was not going away or knew that I truly cared about his health, he started making small changes and participating. I recommended he schedule an appointment with his primary care physician, which he did and began consistently taking his medication.

Realizing he was successful, he became excited and more interested in the education I was providing him through the program. He understood he could manage his hypertension which would benefit his long-term health and allow him to live longer for his little girl.  

From that point, he was in command of his blood pressure and became excited about his successes. During our phone calls, he knew why his blood pressure was elevated and what he needed to do to self-manage it because taking his blood pressure and medication daily was no longer an overlooked task. 

Today, this patient is now in control of his blood pressure, knows how to manage it, and the necessity of doing so. His story is one that I feel exhibits the success of this program. I simply developed a trusting relationship with him, then helped him put it all together but at the end of the day, it was a sweet little girl who changed his life!

I believe that while helping a patient manage their blood pressure it is crucial to understand their medication concerns and beliefs. Some may have a strong desire to function independent of medication while others may be suffering from the financial burden of unaffordable medications. No matter the cause, I encourage the patients to be open and honest about medication adherence and let them know we will celebrate their successes. No failure must ever be final. 

Once the patient is consistently taking their prescribed medication and their blood pressure remains above 140 systolically, the patient is directed to schedule an appointment with their primary care physician. Going into their appointment, the patient is equipped with the data needed to support a request for a possible medication adjustment. When the necessary adjustments are made, and the patient can see the results of their hard work, they often become excited and are motivated to continue.

This program has been labor intensive, requiring frequent communication with multiple patients and providers. Due to their extremely busy schedule, primary care providers have little time for interaction with vendors/partners. Creating a relationship with them is critical to efficient lines of communication and effective patient monitoring.

Watching patients change their lifestyle by learning to control and manage their blood pressure has been an amazing experience. I believe that patients learned to do so because we cared about them, made it personal, and found out why it mattered to them guilt free. Knowledge is key-- especially when it comes to the patient’s health. 

Creating a relationship of trust with the patient, creates an environment conducive to growth and learning.  It is each individual patient who changes their life on a quest for better health and long term quality of life.

-Tina Scotto, RN
Care Team Manager
TupeloLife Digital Therapeutics

TupeloLife.com