Saire Gonzalez, RN and Kimberly Hudson, RN - phaware® interview 448

Dec 22, 2023

Kimberly Hudson and Saire Gonzalez are registered nurses with CVS Specialty Pharmacy who work with patients with pulmonary hypertension (PH). They provide support, education, and guidance to patients who are newly diagnosed with PH and help them navigate their drug therapies and lifestyle changes. They also highlight the role of caregivers and the availability of support groups for both patients and caregivers. @CVSHealth

Kimberly Hudson, RN:
Hello, my name is Kim Hudson. I'm a nurse with CVS Health Specialty Pharmacy working with the PH program since 2018. I live in Southwest Florida. I get to work with people and help them live a happy, healthy life with continued support for their pulmonary hypertension.

Saire Gonzalez, RN:
And I'm Saire Gonzalez. I am also a registered nurse with CVS Specialty Pharmacy. I live in Menifee, California, which is in Southern California. I have been with CVS since the beginning of 2021, so this is a new space for me. But I've definitely enjoyed being able to educate and provide support to the PH community. We're here to tell you what the day in the life is of a CVS specialty nurse for PH patients.

Kimberly Hudson, RN:
I find it so fulfilling as we get to know our patients. I love building relationships. We enter their homes, we learn about their lives, their milestones, even their daily struggles with pulmonary hypertension. We meet our patients that are newly diagnosed. We educate them on their drugs, their prescribed therapies from their doctors, educate and support.

Saire Gonzalez, RN:
In my case, I actually have an old coworker who joined CVS before I did and she just told me what it was that she did and I found that to be very interesting. I did work through COVID, so working bedside through COVID was something else for nurses. So I really wanted to go into a different avenue of nursing where I could still have that one-on-one connection with patients, but not have the burnt out experience that was happening during COVID. I feel like this is just a perfect space, because I get to specialize in an area and have that one-on-one connection with patients and still provide support and education. It's something that I've really enjoyed since coming over to CVS.

Kimberly Hudson, RN:
We meet the patients once they are fully diagnosed with pulmonary hypertension and they're prescribed their drug therapy. As nurses outside of the doctors' office, we are sometimes the eyes and ears for the doctors. We see things doctors don't often see from their office. We see their quality of life, what their needs are at home. We either meet them in their homes or at the hospital depending on their therapy.

Saire Gonzalez, RN:
Just to add on to that, it varies. Most of the time we do meet them in the home once they've been sent home from the hospital or just if they were diagnosed through seeing specialists but not necessarily being hospitalized. We also do see patients that are unfortunately very sick and do have to leave the hospital on infused therapies. Then we do have to start the education process in the hospital. So we see both.

Kimberly Hudson, RN:
I think mental health is a big part of their diagnosis. Their symptoms of PH really affect their everyday life. Changes are necessary in their life, whether they're willing to make them or not. It can affect them financially to not work or work as much, increases in medical costs. Even the side effects of medications can really affect their life.

Saire Gonzalez, RN:
For some people, it's a complete 180 to what their lives used to be. I especially find that for the younger patients, it's a big adjustment that they have to deal with because they're processing that this is a diagnosis that does not have a cure, that is progressive, and that they will see changes in their lives. Sometimes things that they were able to do before are things that they no longer can do. For example, for the patients that have to go home on infusions, something like being able to take a bath or go into a pool or go to the beach, a lot of these things have to be modified. Or maybe it's something that we take for granted, but something as simple as that can really take a toll on these patients because they go from "normal" to now having to deal with this disease.

Kimberly Hudson, RN:
I feel they are very resilient of being diagnosed with this chronic disease. They're either on oral, IV or SubQ therapies. As a nurse, I just try and teach them to be an advocate for themselves. We try and guide them to this level. We see them at the beginning of their journey. It is very scary. I just try to provide them with as much knowledge to give them the power over their disease as they can. I definitely think the caregivers play a huge role in this. They have a lot going on themselves. They have a lot to learn. I think a lot of responsibility does fall on them, so they need to be educated as well, and they need just as much support.

Saire Gonzalez, RN:
To add to that, I think the good thing is that there is so much support out there for this just with other people that have PAH. There's support groups and there's not just support groups for the patients, but we do see that there's support groups for caregivers. You could find local support groups or there's even virtual support groups where they meet once a month and just kind of have a space where they can express how they're feeling. So that's kind of nice. It can feel isolating at the beginning when they're diagnosed with something like this. But then when we're able to show them that there is a lot of support out there and there are other people that are going through this and thriving, I think that gives both the caregivers and the patients hope that they can still live healthy and fulfilling lives despite this disease.

Kimberly Hudson, RN:
We have also partnered with a platform called Unite Us. This platform provides different types of support to patients in different ways. We see the struggles that patients have firsthand going into their homes. Sometimes it's just the need for food or utility assistance. We provide different support groups that are available or transportation. It's groups in the area that offer assistance, not just to PH patients but to people in general. But we have partnered with this group for our PH team.

Saire Gonzalez, RN:
I've had experience with being present for walks. The good thing is that there's walks in big areas around here in California. We do have quite a few that are relatively travel-wise, easy to get to. Through these walks, we actually meet people in the community. From those walks, I've actually been able to present at support groups locally. I did one for patients that were in the Anaheim area, which is in Southern California. I have another one coming up for patients that are associated with the LA area. Also, it's a lot of networking that we do because we… or at least in my case, I'm able to go to our centers for our physicians where they do presentations for the community. We're also able to engage with patients in that sense, as well. You build networks, you build relationships. We do definitely let them know that the CVS nurses are available to do presentations for their support groups. That's kind of how we get those set up.

Kimberly Hudson, RN:
We have continued education that we attend continually through pharmaceutical companies, through different symposiums, support groups.

Saire Gonzalez, RN:
We also attend the conferences that are available. I know those are a little bit not as frequent. We do try to give the opportunity for all of the nurses across the country to have the chance to go to these conferences, so we know we have to kind of take turns. But the nice thing is that when a nurse goes out to these conferences, they gather all of the information that they obtained through our monthly meetings with all of the nurses across the nation or even just our regional meetings. We share what it is that we've learned. We do presentations within these monthly meetings that we have. So we definitely get to share that information with all of the nurses. We continually grow on the education that we were receiving throughout the year.

I think that definitely during the holidays it can be a bit overwhelming because if there is that financial stress that you have already, because some of these therapies can be very expensive. Or if people are not working or not able to work anymore, there's definitely a financial stress around the holidays. Or even a lot of people travel to see family members around the holidays. I know that sometimes that can be a little bit more involved with PH patients that are either on oxygen or they're on certain medication therapies that do require more consideration when they're traveling. But the good thing is that we have resources for them, both financial assistance and also we do presentations on how to travel being PH patients and how to be prepared so that they don't have to stress over their ability to travel, that there are options for them to be able to see their families and not feel so restricted to just being at home.

Kimberly Hudson, RN:
When I encounter a newly diagnosed patient, I would have this little bit of advice. These drugs are not easy drugs to take. That's why they need our support. They need to be patient, they need to be resilient. They really need to trust us in the process. That's where I really like to be a support system to them, because it's not easy. It's a lot for them to take. It's a lot of side effect management. It's a lot of trusting their doctors. I'm very upfront with them in the beginning. I let them know that they do have a support system, not just in their family or their doctor, but in us. I like to be that person for them. I just feel if I can make a difference in one person's life, it's someone I made a difference with.

Saire Gonzalez, RN:
I think my takeaway would be knowledge is power. I think that no matter what disease someone may have, I think the more educated and the more informed you are on the condition that you have, the better that you can advocate for yourself and that you can manage it. I've definitely seen that difference where I've met patients that have done the research, have joined support groups, are constantly reading what's next, what's being studied. I feel like those patients have a better mindset with this disease. They're the ones that are actually reaching out to the doctors and saying, "Hey, I just read about this. What do we think about this?" So I think that that just applies to everybody. The more knowledgeable you are about things that are affecting your health, the better you would be to advocate for yourself and to maybe learn new ways of treating your disease or just managing it day-to-day. Especially when you're talking to other people that are going through the same experience as yourself, that they better than anyone know the tips and the tricks on how to manage day-to-day things.

My name is Saire Gonzalez.

Kimberly Hudson, RN:
And my name is Kimberly Hudson. And we are aware that our patients are rare.

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