Comment: Seasoned nurses fear that the Crisis Triage Center is being so poorly run that it could really harm someone and harm Doña Ana County.
It is run by RI, specifically Karina Diaz, a certified art therapist / psychotherapist who is not a nurse. Prior to the opening, a source said Diaz “kept laying off employees, amazing people,” including Freddy Hernandez, a very experienced nurse who called the source “a ray of sunshine.” RI says it did not fire Hernandez, a temporary worker, and that it did not fire any nurse on the CTC employee.
When contacted, Hernandez spoke calmly about his experience at CTC, adding that he wanted to contact Jamie Michael because he doubted she was aware of the depth of the problem. He had been on committees trying to make CTC a reality and was “utterly disappointed,” especially after these long community efforts. He said Diaz had no experience with such a facility. “They didn’t know what to order, when to order, or how things should work,” but still micro-managed people. “She sneaked up to us and said, ‘Why are you talking?’ and you had to ask permission to go to the bathroom. “He warned her,” You are going to lose your nurses. You have to treat them like adults. ”Mental health care workers are in short supply. When asked if I could use his name, Hernandez replied, “Of course. It is very important that the district knows about it. “
Another nurse who came to (and then left) CTC said that Diaz was so rude to nurses that after an incident, another member of staff asked, “Why is she always after you?”
Another nurse said, “I’m scared for our county. Something bad is going to happen to you. We need the CTC, but we don’t need it under the rule of this woman, “added,” The county thinks everything is going well because that’s what Karina reports. “
More recently, veteran RN Pamela Field, who is fairly well known locally, has worked with CTC. She called it “dangerously badly managed” and “a gross waste of taxpayers’ money”. There are only a few “guests”. According to one source, most of the guests are either developmentally challenged people who “bring the home in after a seizure, mainly to give the home staff a break,” or homeless people. “It’s a safe place. They have their clothes washed and move on. ”(Some have psychotic outbursts and belong there.)
Diaz reportedly insists on admitting people whose safety requires hospitalization. Field said CTC is trying to detoxify alcoholics with very high alcohol levels without medication. This is a serious medical situation, not just psychological, and potentially dangerous, especially in the absence of readily available medication. CTC has no drug, but tries anyway; and some of the necessary drugs are not easy to obtain. Field said Diaz was “not qualified to oversee nurses. She shouldn’t lead the nurses’ discussions or deal with controlled drugs. ”Field eventually turned down a shift because she couldn’t ethically try to detox someone with high blood alcohol levels without medication. RI says it is ethical and will be applying for a license shortly to allow controlled drug storage.
One man reportedly presented with congestive heart failure and severe fluid overload, as well as anxiety. Diaz reportedly spoke out in favor of admitting him to treat anxiety, despite the fact that his situation was medically dangerous and the CTC did not have an EKG machine or medication to treat fluid overload. (RI does not agree to this account.)
I hear this from highly qualified nurses who want the county council and citizens to hear the truth. We should listen.
International response from RI:
Comment: Please accept this letter in response to the opinion column published on October 3rd on the Doña Ana County Crisis Triage Center (CTC) in Las Cruces. The column reads as an attack on the program director, who is a bilingual clinician practicing independently in New Mexico and New York, has years of experience running programs with a focus on Hispanic communities, and who represents someone in Juárez / El Paso. grew up / Las Cruces community. The column falsely reports that (1) management restricts the team’s use of the toilet, and (2) “admission” decisions are made by the director if the continued stay is made by licensed physicians (psychiatrists) based on an individual assessment It establishes a review of assessments by licensed clinicians and nurses. The Nursing Manager, a bilingual registered nurse leader who has long lived and served in this community, provides supervision and support for the nurses who work at the center.
RI International operates more crisis reception centers than any other organization in the country and serves as a service provider for the Crisis Triage Center (CTC). The program is designed to connect people with mental illness and drug use crises to care in real time. This is the only program in the region that offers the kind of direct access to mental health and drug use that those with acute physical health problems find in every hospital emergency room. We know that many potential team members have spent their entire behavioral health work history in programs that weed out individuals at the doorstep, and this is a big change for them. RI International hopes to find more team members interested in making a life-changing impact on the lives of those we serve on some of our guests’ toughest days. Our direct approach to triage all those in need corresponds exactly to what the best practice standards in the SAMHSA National Guidelines for Behavioral Health Crisis Care require.
In addition, there is incorrect information about the guest who attended the CTC with congestive heart failure; However, RI will not discuss guest services that may contain identifying and proprietary health information. It is important to note that every guest who comes to the CTC is consulted with a doctor regarding individual care. In cases where a guest is moving from another facility, it is common for doctors at each facility to speak to each other prior to being admitted to the CTC. As mentioned above, everyone is welcome at the CTC and a doctor ultimately decides the appropriate level of care.
Program Director Karina Diaz has embraced the values of providing crisis services to anyone, anywhere, anytime; including adults with developmental disabilities, homelessness problems, substance abuse and anyone who volunteers in services aged 18 years or older. Much like the hospital emergency room analogy suggests, the CTC is a short-term crisis intervention aimed at resolving the immediate crisis and / or connecting the individual to the care that best suits the individual / family’s needs. In the case of guests who require a higher level of care, the person is sighted, assessed and associated with the necessary care. The CTC operates within the limits of our licenses from the Department of Health and the Board of Pharmacy. We store uncontrolled medication on site and obtain controlled medication from a local pharmacy after it has been prescribed by our psychiatrist (doctor) based on the individual needs of the person being treated.
We welcome suggestions to improve our services, but believe that these comments constitute an open personal attack on the director. As her supervisor, I have continuously witnessed Karina Diaz’s strong commitment to this community and her team. Karina and the CTC leadership team understand the importance of treating those we serve and our team members with respect. The CTC strives to provide the best possible guest experience on one of the most demanding guest days.
At RI, we pride ourselves on our ability to serve those in crisis wherever they are, wherever they are, and whenever they are needed. We look forward to continuing to serve the needs of our community.
Thanks very much,
Vice President, Southwest Region