{"id":8877,"date":"2022-05-09T21:54:11","date_gmt":"2022-05-09T10:54:11","guid":{"rendered":"https:\/\/recoveryafterstroke.com\/?p=8877"},"modified":"2022-05-10T12:30:33","modified_gmt":"2022-05-10T01:30:33","slug":"remote-patient-monitoring-deborah-gulbrand","status":"publish","type":"post","link":"https:\/\/recoveryafterstroke.com\/remote-patient-monitoring-deborah-gulbrand\/","title":{"rendered":"Remote Patient Monitoring – Deborah Gulbrand"},"content":{"rendered":"
Remote Patient Monitoring became a necessity during the covid 19 pandemic as non-urgent patients were unable to attend their hospital appointment for their regular check-ups. Listen to how this technology is set to revolutionize outpatient care.<\/b><\/p>\n
LinkedIn<\/a> Highlights:<\/p>\n 02:27 Introduction Transcriptions:<\/p>\n Bill Gasiamis 0:00 Deborah Gulbrand 0:06 Bill Gasiamis 0:08 Deborah Gulbrand 0:09 Deborah Gulbrand 0:22 Intro 0:58 Bill Gasiamis 1:11 Bill Gasiamis 1:31 Bill Gasiamis 1:47 Bill Gasiamis 2:06 Bill Gasiamis 2:27 Bill Gasiamis 2:48 Bill Gasiamis 3:07 Bill Gasiamis 3:19 Bill Gasiamis 3:36 Bill Gasiamis 3:55 Bill Gasiamis 4:17 Bill Gasiamis 4:38 Deborah Gulbrand 5:02 Deborah Gulbrand 5:08 Deborah Gulbrand 5:29 Deborah Gulbrand 5:49 Deborah Gulbrand 6:04 Bill Gasiamis 6:23 Bill Gasiamis 6:49 Deborah Gulbrand 7:20 Deborah Gulbrand 7:38 Deborah Gulbrand 7:57 Deborah Gulbrand 8:19 Deborah Gulbrand 8:45 Deborah Gulbrand 9:08 Bill Gasiamis 9:39 Deborah Gulbrand 10:08 Deborah Gulbrand 10:39 Bill Gasiamis 11:06 Bill Gasiamis 11:20 Deborah Gulbrand 11:39 Deborah Gulbrand 12:05 Bill Gasiamis 12:39 Deborah Gulbrand 12:46 Bill Gasiamis 12:47 Deborah Gulbrand 12:50 Deborah Gulbrand 13:20 Deborah Gulbrand 13:43 Deborah Gulbrand 14:02 Deborah Gulbrand 14:12 Bill Gasiamis 14:31 Deborah Gulbrand 14:52 Bill Gasiamis 14:54 Bill Gasiamis 15:15 Bill Gasiamis 15:34 Bill Gasiamis 16:03 Bill Gasiamis 16:29 Bill Gasiamis 16:57 Bill Gasiamis 17:16 Bill Gasiamis 17:36 Bill Gasiamis 18:01 Bill Gasiamis 18:27 Deborah Gulbrand 18:45 Bill Gasiamis 18:49 Deborah Gulbrand 19:14 Bill Gasiamis 19:53 Bill Gasiamis 20:14 Deborah Gulbrand 20:39 Deborah Gulbrand 21:01 Bill Gasiamis 21:24 Deborah Gulbrand 21:34 Deborah Gulbrand 22:01 Deborah Gulbrand 22:29 Deborah Gulbrand 22:55 Deborah Gulbrand 23:23 Bill Gasiamis 23:45 Deborah Gulbrand 24:21 Deborah Gulbrand 24:49 Deborah Gulbrand 25:14 Intro 25:37
\nConnect America<\/a><\/p>\n
\n05:04 Deborah Gulbrand
\n07:57 What It’s Like Being A Nurse
\n12:05 Saving Lives is Terrifying
\n18:49 Stroke Denial
\n26:40 From Hospital To Home Health
\n31:57 We’re Not Meant To Live Alone
\n36:44 Connect America
\n39:00 Remote Patient Monitoring
\n51:19 In The Comfort of Your Own Home
\n1:04:28 Improved Patient Treatment
\n1:10:39 Other Applications<\/p>\n
\nHow does it feel to be somebody that saves people’s lives?<\/p>\n
\nIt’s terrifying.<\/p>\n
\nOh my gosh, I would have thought you were going to say the opposite.<\/p>\n
\nNo, it’s terrifying. I mean, it really is rewarding at the end of the day. But, you know, you think about there’s some really big moments in life when someone’s born, and being able to witness that as a nurse, that’s fantastic.<\/p>\n
\nWhen someone dies, that only happens once. Being with that person where they’re in between really, are they going to live? Or are they going to die? It’s a huge weight. But it, you know, it’s a responsibility. And with that, it really is a privilege to be able to walk with that person on that journey.<\/p>\n
\nThis is the recovery after stroke podcast, with Bill Gasiamis, helping you navigate recovery after stroke.<\/p>\n
\nHello, and welcome to another episode of the recovery after stroke podcast. Firstly, a big thank you to everybody who went along and left a review for the show, either on Spotify, or the Apple iTunes podcast app, whatever it’s called, I really appreciate it, it makes a massive difference.<\/p>\n
\nIt means that it’s possible for people who are looking for this type of content because they’ve just had a stroke or one of their loved ones has a stroke, it means it’s possible for them to find this podcast or podcast like this type a lot easier.<\/p>\n
\nAnd you know what it was like when you were going through your recovery. And you needed information. And it was hard to find? Well, this is what the purpose of this podcast is to make it easier for people to access information about stroke recovery, that’s going to make a difference in their lives.<\/p>\n
\nAnd it’s going to improve the recovery. And it’s going to give them hope. So if you are listening, and you can, I would really appreciate it. If you went along to the Spotify app or to the Apple podcast app, or to whichever app you listen to podcasts on and leave the show a five-star review, it really will make a huge difference.<\/p>\n
\nAnd I’ll really appreciate it. So today’s episode is episode 193. And my guest today is Deborah Gulbrand, a registered nurse who transitioned from helping patients in a hospital setting to developing a solution for monitoring patients from the comfort of their own homes.<\/p>\n
\nNow remote patient monitoring has been around for a while. But its benefits were never more obvious than during the pandemic as hospitals stopped seeing patients for their scheduled regular checkups in fear that it may lead to additional COVID infections and place a further strain on hospitals.<\/p>\n
\nTheir ability to care for sick people, and then also put people who were not quite sick, or were just needing care at risk of getting COVID and then becoming quite unwell.<\/p>\n
\nSo if you’re the type of person that finds it difficult to get to your regular appointments because of distance or because of your mobility, remote patient monitoring might be something that you could benefit from and you might find this podcast episode quite interesting.<\/p>\n
\nNow, most of the episode is not being allocated to discussing remote patient monitoring, we get to learn about Deborah who was a nurse and still is a registered nurse, and what it’s like being a nurse and going through the process of helping people who are quite unwell.<\/p>\n
\nAnd then from there, towards the end of the podcast episode, we talk about her transition to remote patient monitoring and the benefits of it and how it helps, and how much additional information and data can be collected on somebody’s vital signs by having their vitals monitored remotely.<\/p>\n
\nRather than going into a hospital once a fortnight or once a month and doing checkups because in the time between your appointments we’re missing a lot of valuable information. There’s a lot of gap between each appointment, and that additional information makes a huge difference.<\/p>\n
\nThat’s why I did this interview because I think it’s really important for people to understand how they can get better care by being at home with a product like remote patient monitoring. So anyway enough for me. Let’s head straight to the episode. Deborah Gulbrand while Come to the podcast.<\/p>\n
\nThank you so much for having me, Bill.<\/p>\nDeborah Gulbrand<\/h3>\n
\nBill Gasiamis 5:04
\nMy pleasure Deborah tell me a little bit about what you do.<\/p>\n
\nWell, I’m a registered nurse, I also have a business degree. I started out in the ICU in critical care. And from there, I went into the cath lab. So if you were somebody that was having a stroke, or if you were someone that was having a heart attack, I would be the one that you saw first.<\/p>\n
\nSo I did that and afterward went into home health. One of the things that I did when I was in home health because I did have a lot of experience with cardiopulmonary medicine, was I was tasked with developing a remote patient monitoring program.<\/p>\n
\nAnd once I did that, you know, it was before it was even reimbursed. But once I did that, and I saw the effect that it had on our patients that were really, really critically and chronically ill, I was hooked.<\/p>\n
\nAnd so many, many years later, 17 plus years later, I am still working in the field, which is a huge passion of mine. And the company that I work for now Connect America brought me on to help develop their remote patient monitoring program.<\/p>\n
\nVery good. Very good. Let’s get back to the beginning. Because you would have experience that most patients who are going through a really, really tough time, kind of don’t like doctors, but really loved nurses. We think that nurses are the best. You know, we talk amazing stuff, we say amazing things about nurses.<\/p>\n
\nWhat’s it like to become a nurse at the beginning? You’re this person who’s young, and you’ve got these big dreams of helping people and making all this all this amazing work. But you’ve got to go to university, and you’ve got to work through getting a degree and what you’re getting exposed to is really difficult situations because nurses see it all right? What’s it like to transition from being naive to being a nurse?<\/p>\n
\nWell, you know, it’s interesting, because I already had my business degree, when I decided I wanted to go back and become a nurse, I thought I was going to be a lawyer. My mom was a lawyer and a retired judge. But I was very interested in holistic medicine.<\/p>\n
\nI was a massage therapist for eight years and decided, you know, I really want to explore and really have more of a cerebral relationship with my patients. And so I wanted to learn more. And I felt like a natural extension of that would be to go to nursing school.<\/p>\nWhat It’s Like Being A Nurse<\/h3>\n
\nAnd my eldest brother who’s a cardiologist, and a doctor asked me, why don’t you just go become a doctor. And I told him, I don’t want your life. So I went back to nursing school. And it was different this time, because first of all, mom and dad paid for that first degree. And this time, I worked while I was going to school.<\/p>\n
\nAnd I felt like I had a little bit of an edge over some of the people that I was in school with, because they were first of all, they were younger than me, and maybe not as focused as I was. So I felt like that was a huge advantage for me. But you’re right, you see things. And most people they think of a nurse, oh, that, you know, it’s a great job, you can make a good living.<\/p>\n
\nBut they don’t understand all of the things that we have to do and see. And after you go through nursing school, and you’re in that first year of working, and you’re out there, I remember the first thing I thought I was just in this panic, yes, I thought I hope I don’t accidentally kill somebody or you know, because of something I didn’t know.<\/p>\n
\nAnd what you discover is so much of what you learn, you learn after you graduate, and it’s that on the job training. And so I feel like it’s important for anyone that’s thinking about going into that career, to have in the back of their mind to go out there and jump into something that is really difficult. You know, the ICU the ER, something that’s going to force you to learn as much as you can.<\/p>\n
\nYeah, definitely intense places to learn if you can learn under those conditions where you have, really but if you can, then it really does sort of train you for all levels of nursing from the very benign and the very basic to the very high intensity and it’s all very important work now, how old were you when you decided to study and become a nurse?<\/p>\n
\nI was in my mid-20s. And so like I said, I’d already been through school and had gone back to school. And it was hard. It was a struggle. I felt like, honestly, it was harder than law school for me. I just felt like it, you know, just the critical thinking. And some of the different things that I was challenged with.<\/p>\n
\nYou know, you say that going into the ER, or maybe some of those high-paced adrenaline-type jobs. But when you have somebody that comes into the hospital, normally, decisions have to be made very quickly. And so being in that environment, trains you to be able to adapt, triage the situation, and then be able to move forward with a plan.<\/p>\n
\nThat it’s a really intense situation, you have to come up with all these decisions, do the right thing, and then keep moving forward, and you can’t stop. And it sounds like you can’t really stop and think about it too much.<\/p>\n
\nI imagine there’s some cognitive focus and processing that’s happening. But the overthinking is definitely not able to happen. You can’t overthink a situation, what if I do the wrong thing, etc, you really have to take action. If you take too long, there could be a problem as well.<\/p>\n
\nIt’s true, it’s true. I mean, one of the worst things to do is nothing. And so what happens is, you have all this information that you’ve learned in nursing school. And then when you’re put in that situation, although it’s situational awareness, that you didn’t necessarily learn in school, it was all of that information that you learned in school that you draw upon, in that situation.<\/p>\nSaving Lives is Terrifying – Deborah Gulbrand<\/h3>\n
\nSo that’s when it really starts to come together. And, you know, the reason I say I think it’s so important, because we are going to be talking about stroke, is that in and of itself is one of those situations where time is everything. And so I feel like you know, training yourself in one of those areas, really sets yourself up, to be able to go through those types of situations and make good decisions that save your patient’s life.<\/p>\n
\nHow does it feel to be somebody that saves people’s lives?<\/p>\n
\nIt’s terrifying.<\/p>\n
\nOh, my gosh, I would have thought, you’re gonna say the opposite.<\/p>\n
\nNo it’s terrifying. I mean, it really is rewarding at the end of the day. But, you know, you think about there’s some really big moments in life when someone’s born, and being able to witness that as a nurse, that’s fantastic. When someone dies, that only happens once being with that person where they’re in between really, are they going to live? Or are they going to die.<\/p>\n
\nIt’s a huge weight. But it you know, it’s a responsibility. And with that, it really is a privilege to be able to walk with that person on that journey. And myself having been in the hospital in emergent situations in my life.<\/p>\n
\nYou know, I feel like it has given me a very good understanding so that I can empathize with patients when they’re going through these things. I know that when you’re in that situation, you’re not thinking about all of the minutia.<\/p>\n
\nYou know, when people always ask you’ve got these patients and they’re at home and how come they can’t figure out that they need to go to the doctor or how come they can’t figure out this step or that step?<\/p>\n
\nWell, it’s easy when you’re on the outside looking in and myself as the clinician, I’m looking out going well you need to do this, this and this, can’t you understand that? But you cannot because your brain is so focused on what is happening to you in the moment. And really just your overall wellness.<\/p>\n
\nThat’s a very big one. I speak to stroke survivor after stroke survivor who says I thought it was a headache or I thought it was something I did to my neck or I thought it was something I ate or you hear all these stories. I ignored the symptoms for seven days before I did anything about it.<\/p>\n
\nYou’re lucky to be sitting here.<\/p>\n
\nI am, it’s an absolute miracle. I was lucky because the bleed that was occurring in my had because of an AVM was just a really slow bleed. And it was just kind of leaking instead of gushing. But I had a couple of big bleeds where they did gush and caused a lot of issues. And I couldn’t delay seven days worth.<\/p>\n
\nBut the first the very first one, I noticed a numb sensation in my big right toe. And then over seven days that numbness spread from my big right toe, all the way up and to the left side of my body, my entire left side. And that’s when I finally listened to the chiropractor who told me there’s nothing wrong with my back.<\/p>\n
\nAnd my wife, who has been noticing me walking differently for three or four days. That’s when I finally listened to them, and went to the hospital. And was completely shocked when they said to me, you’ve got a shadow on your head. And we don’t know what it is yet. That was day one. So day two. The second time it bled was six weeks later. And I was against doctor’s orders went to work.<\/p>\n
\nAnd we have a painting company I wasn’t working though, I wasn’t working, I was sitting on a chair, watching my guys working. And I started to notice the numbness. And the room started to spin and I started to feel nausea. And I said to them, look, I’m not feeling well guys, or what I need you to do is finish what you’re doing, which was the job that we were there to do.<\/p>\n
\nIt took about an extra hour or two to finish something like that. Finish what you’re doing, and then take me home. I drove with them. They drove me past the hospital to my house, which was about an hour’s drive by the time we got there because we were in the city and there was traffic. Then I got to my home, told my wife to take me to the hospital.<\/p>\n
\nShe thought okay, she took me to the hospital when we walked out of the car door. And I went to emergency triage emergency. It was about a 50 meter walk. Now we were conversing in the car as you and I are now.<\/p>\n
\nBy the time I got to triage I didn’t know my name, what I was doing there or anything. And I blanked out. When my wife came, I didn’t recognize her. When she finished packing the car and came to see me I didn’t recognize who she was, I didn’t know what I was doing all that type of thing.<\/p>\n
\nSo that was bleed two, and bleed three it all happened between February 2012 and November 2014. So bleed three was in November 14. And that time, I was driving because I had got back to work, I had got back to driving, everything was okay. The doctors were telling me that things were improving, I started to feel a lot better.<\/p>\n
\nAnd I started to feel sunburn sensations on my left side. And I drove myself to the hospital. The first time I had no idea that I should go the hospital the second time, I was a bit hesitant to go to the hospital. The third time, I looked up at where my car was parked.<\/p>\n
\nAnd it didn’t occur to me to ring the ambulance and say to them come and get me from this location. I’m parked outside of this particular street. It didn’t occur to me to do that. But it did occur to me to ring my client and tell them that I won’t be able to come to see them today.<\/p>\n
\nYou’re not thinking clearly, you know, your brain is not functioning properly.<\/p>\nStroke Denial<\/h3>\n
\nZero. It’s what you said it’s when you’re going through the process. And you don’t have the nuanced understanding of these things because you’re only dealing with them maybe once in your lifetime or twice in a lifetime, even three times in your lifetime. You just make excuses. And you do the whole “It’s not me. It can’t be happening to me”.<\/p>\n
\nBecause you don’t want to be having a stroke. That’s not the thing that you’re going to admit to yourself. Even if you’ve already had it, which you know, the phrase that kept coming up to my mind listening to you talk was just in time you got there, just in time you got there just in time over and over again. And, you know, you maybe this is partly what really your real life’s mission is is that and that is educating other people because obviously, the good Lord needed you here for something and gave you multiple chances.<\/p>\n
\nAbsolutely. It does feel like it’s my mission to do this. And I have had to have I have some really difficult conversations with people that have lost children to AVMs and their loved ones to stroke. And I never signed up for that part really, I didn’t.<\/p>\n
\nI didn’t even know that it was coming. But that’s kind of what how I know I’m not comparing myself to you. But that’s kind of how I see nurses is that you guys don’t really sign up for what you end up experiencing. You kind of sign up for something different, I imagine it’s completely different to what you expected.<\/p>\n
\nIn some ways, it is, you know, I would say this, that whatever I thought it was going to be. In those cases, it was that times 100. And then it was all the other stuff that I didn’t really understand. And I honestly feel that that other side of it, which to me is the human side.<\/p>\n
\nHaving been a little bit older, I felt like I was a little better prepared for it. And, you know, I think that you definitely have to have that sympathy, empathy, understanding and caring, and want to be able to help people that are really in crisis mode.<\/p>\n
\nDo nurses get encouraged to get counseling and support to help them deal with the things that they have to experience?<\/p>\n
\nYes, in fact, I would be very surprised if you were to go to a large health system. And they would not have as one of the benefits, that there was some type of psychological counseling are one of those things, because, you know, everywhere that I’ve worked, there is something like that that’s made available, because you are dealing in some really stressful situations.<\/p>\n
\nAnd, you know, people always say, Well, are you here, people say, well, let’s don’t get too attached, don’t do this, don’t do that. And in my opinion, I think the exact opposite. I think that you absolutely should be attached, you absolutely should care. Because the person that you’re dealing with is somebody’s mom, or daughter, you know, or some type of family member and someone loves them.<\/p>\n
\nAnd so that can take a toll, just that amount of emotion. The one good thing about it is because it usually isn’t something somebody that’s part of your family. When it’s necessary, you can put that emotion to the side and say, Okay, I have a job to do, and this is what it is. And then when you’re done, you can go back to, you know, feeling and caring.<\/p>\n
\nBut yeah, it is difficult, especially when you have someone and for me, it’s not just the patient, but when I have someone and I’ve gotten to know their whole family, you know, and they’ve been telling me things that they haven’t even told some of their family members, you know, it’s just that type of a situation where and it happens to me everywhere I go too when I’m in the grocery store.<\/p>\n
\nMy husband’s like, why do people tell you these things? And I don’t know, I guess that I’ve learned to be a good listener, but you start to be part of that niche. And when you lose someone like that, then that’s the really hard part.<\/p>\n
\nDo nurses ever get to the point where they are going to work and because of situation, because of a life that’s happening outside of work. And then because of what’s happening at work? The nurses ever get burnt out feel like they don’t care anymore and can’t be there anymore and do all those tough tasks. Is it taxing? I imagine it’s a level of emotionally and psychologically taxing for some nurses to do that kind of work.<\/p>\n
\nIt depends on the person. Some people absolutely live for that. And I know there’s different areas of nursing where people that tend to be able to, like live for those types of situations. They stay in. One of those is the neonatal ICU, the nurses that do that, they love it, they usually have that job and they had that job forever.<\/p>\n
\nYou go to most really big health systems that have you know, good benefits, and you’re gonna go look in that NICU and you’re gonna see nurses that have been there. For years, but yes, you’re right. I think it really just depends on the person. But I will tell you for me, I had children later in life.<\/p>\n
\nSo I was able to go and be a nurse, and do all those high adrenaline jobs where it’s intense, you know, so you bring that home sometimes, okay? Being on call, and having to come in for an emergency. Like I said, someone’s having a heart attack, someone’s having a stroke, you know, you’re gonna see me probably on the worst day of your life.<\/p>\n
\nIf you’ve had a stroke, and you’re in recovery, you’ll know what a scary and confusing time it can be, you’re likely to have a lot of questions going through your mind, like, how long will it take to recover? Will I actually recover? What things should I avoid in case I make matters worse, or doctors will explain things but obviously, you’ve never had a stroke before, you probably don’t know what questions to ask.<\/p>\n