Profile of a crisis team of nurses

POSTED: 05/10/12 3:48 PM

Contributed by Director of the Mental Health Foundation, Eileen Healy

CAYHILL- Since the Mental Health Foundation (MHF)  started its services on St. Maarten Crisis management of patients with psychiatric problems has been a priority. Patients and families needed adequate care, meaning the proper treatment, a diagnosis the right medication and guidance.

MHF in October 2006 started with one nurse Elena Reyes, with not much experience in psychiatry she was guided by Dr. Miriam Montoya a psychiatrist from Curaçao who visited on a monthly basis for one week and who was always available by phone to give advice and support.

The team expanded to 4 nurses in 2010, two nurses are social psychiatric nurses and 2 are Registered Nurses trained on the job by the psychiatrist’s and through cooperation with several psychiatric institutes in Holland and the US.

How does it work? The nurses rotate being on-call for a crisis. The police, ambulance, hospital and general practitioners call the emergency number that is available 24 hours.

For security reasons the nurse always needs assistance from the police in a crisis situation. For privacy reasons the foundation has an unmarked car and it happens that the police waits on the corner to be picked up to drive to the home of the patient.

Until October 2011 most crisis patients were flown to Curaçao after being stabilized at the Police station or on the prison sick ward. Stabilizing takes about three days and the patients is guided by a nurse and a Police officer to Capriles Clinic in Curaçao.  In a crisis the patient is mostly treated involuntary for this permission is requires from the Minister of Justice.

The MHF crisis nurse was the one who took care of all the paperwork, tickets, contacts family, the patients general practitioner, airline doctor, has to find a nurse and police officer to guide the patient, and in Curaçao contacts  Capriles Clinic, and the Ambulance.

Since October 2011 St. Maarten has its own facility and crisis management is on the rise mostly due to dual-diagnosis, this means drug use combined with a psychiatric disorder.

The crisis nurse on call has a full time job during the day she is also the ambulant care nurse, who visits patients at home and in prison, advises and assists the family, follows up on clients that did not show up for their medication, assists and helps in finding jobs, banking and social welfare.  When called at any hour of the night the nurse is at work the following morning because the 4 nurses are case workers with their own patients to see and visit. Each nurse has a case load of 45 patients to follow-up on.

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