An important plus to detoxification and care at La Hacienda Treatment Center is that we have an excellent on-site health care team which provides a systematic approach to effective and compassionate around-the-clock patient care.
Addiction Treatment Physicians and Psychiatrists
Our team of board-certified addiction treatment physicians and psychiatrists meet with patients daily to monitor their progress and respond to issues that might arise.
The medical staff includes four licensed physicians who are Diplomats of the American Board of Addiction Medicine, in addition to the licensing board for Internal Medicine and the licensing board for Emergency Medicine.
They carefully chosen for their years of expertise in treating addiction and for their compassion for our patients.
Committed to the Practice of Addiction Medicine
According to the American Society of Addiction Medicine (ASAM), a physician becomes an addictions specialist by completing subspecialties and completing board certification by one of the following agencies:
- American Board of Preventive Medicine (ABPM),
- American Board of Psychiatry and Neurology (ABPN),
- American Board of Addiction Medicine (ABAM),
- American Osteopathic Association (AOA),
A physician not only completes their subspecialty and receives status from the appropriate board, but they are also required to perform:
- Treatment for substance use disorder
The additional education, experience, and examination to provide and hone this skill set is evidence of the doctors’ exemplary commitment to the scope of practice involved in treating men and women suffering substance use disorders.
La Hacienda Treatment Center is licensed by the Mental Health & Substance Abuse Division of the Texas Department of Health & Human Services.
Around-the-Clock Nursing Care
Our nursing team, including registered nurses (registered professional nurse), licensed vocational nurses (licensed practical nurses) and direct care assistants, are present 24/7 to assist with health care and patient safety.
Around-the-clock observation is especially important during the detoxification process, when patients need unquestioning support in an acute care setting.
Our nurses treat patients with dignity and respect.
A Daily Medical Consultation for Each Patient
Patients see a member of the medical staff every day of treatment, weekends and holidays included. The body and mind are making daily changes after detoxification and the physicians and nurse practitioners monitor patients’ progress and prescribe medications as needed.
Mental Health Services
Mental health services are available 4-5 days per week with one of our licensed staff psychiatrists.
Nurse Practitioners Expand Care Ability
The medical team is supported by nurse practitioners whose duties include doing admissions, seeing patients on medical rounds, ordering diagnostic tests, and prescribing medications.
Nurse practitioners are national board-certified
Nurse practitioners are national board-certified advanced practice registered nurses with masters, post-master’s or doctoral level degrees. Their scope of practice includes working for health care providers including hospitals, emergency rooms, nursing homes and private physicians’ offices.
Nurse practitioners have the legal authority to implement measures necessary for a patient’s health care which are beyond other nurses’ authority.
The use of nurse practitioners or physician assistants extends our physicians’ ability care for the patients. There is always a board-certified addiction specialist on site to allow ongoing oversight for every patient.
Allow Doctors to Concentrate on Serious Issues
A nurse practitioner handles everyday health problems and routine detoxification and medical management. This allows the physicians more time to address more complex medical issues with other patients.
There are some similarities to a physician assistant, but a nurse practitioner is trained to focus on a specialized role, such as addiction treatment, while a physician assistant is educated in general medicine.
By title, nurse practitioners have been around since the mid-1960s. The American Association of Nurse Practitioners, organized in 1985, represents more than 325,000 nurse practitioners nationwide.
Patient Assessment Precedes Treatment Plan
Upon admission, our medical staff evaluate patients’ condition and treatment needs . This process includes a complete history and physical assessment, a dietary assessment, psychological testing, and further discussion as needed.
The assessment starts when the patient or family member calls and talks to one of our admission specialists. It includes data from the patient’s primary care provider, family, or other person with related health care information.
Patients requiring detoxification are medically supervised 24 hours a day in our Special Care Unit until the patient has successfully completed the detoxification process.
Help With Chronic Conditions
Upon completion of detoxification, the nursing staff continues to assess patients for residual withdrawal symptoms and pain management.
Nursing Staff Available Throughout Treatment
The nursing staff remains available to patients throughout their clinical and physical therapy treatment to assess in a timely manner chronic medical conditions such as respiratory and cardiac disorders that require exceptional care and treatment.
As part of La Hacienda’s health care management program, they also administer and evaluate the efficacy of prescribed medications and assess and treat patient needs for minor medical emergencies and disease prevention.
Unit Clerks Check on Patients’ Welfare
Under the supervision of the on-duty charge nurse, unit clerks perform specific patient care duties to help provide psychological, emotional, and physical support for each patient.
As part of their job descriptions, unit clerks–also called direct care attendants–check on all patients on campus several times per night as well as monitoring the buildings and grounds for safety and security.
Doctors Speak to Patients on Key Issues
In addition to using their medical skills to treat patients, our physicians speak to them about issues important to recovery.
At 11 a.m. daily, the patients gather in the Bodega for a presentation by a physician or other staff members.
Subjects addressed by a physician can include medical complications of drugs, relapse prevention, process addictions, the importance of good sleeping habits, and the hazards of sexually transmitted infections.
Compassion is Important
Our nursing administrator says the main quality sought in a nurse is compassion, “because what we are doing is very much about caring for our patients.”
Open-minded, flexible, and willing to learn are other traits sought in nursing applicants. Individuals who are not afraid to speak up and to take the initiative to help both patients and co-workers are also sought.
And, as with staff throughout the campus, being a team player is another welcomed quality.
Outstanding Nursing Practice
Most nurses are chosen for how well they fit the La Hacienda culture, rather than specific experience in working with addiction, where they received their nursing education. Abilities acquired elsewhere are important, but so is their ability to be a team player here.
It’s very hard to find nurses with pre-existing skills in substance abuse care, says our nursing administrator. We seek people who fit our team and have outstanding nursing skills. Many gained their experience at major hospital settings.
“They come here, adapt to what we do, and become very good at it.”
Patients Healing is Their Reward
The nurses’ reward is seeing patients’ transformation as they provide nursing care throughout their treatment at La Hacienda.
Our nurses see that the patients have renewed hope, they’re healthier, and they’re re-establishing relationships with loved ones.
Putting Together a Medical Team
La Hacienda’s current medical practice setting took form in 2002 under the direction of Dr. Daniel Boone, MD.
He quickly realized there were more patients than he alone could handle, and invited his younger brother, Dr. James Boone, who had a medical license for internal medicine, to help in the special health care clinic for a few weekends.
After thinking and praying about it, he joined the team in November 2004. Two more physicians and a psychiatrist and several nurse practitioners have been added since.
A Passion for Taking Care of People
Their backgrounds vary widely, but medical staff members have at least one thing in common.
They have a passion for taking care of people with addiction and helping them realize the joy that comes with healthy recovery.
Unique Medical Care
Two things make medical care at La Hacienda unique.
First, the manner in which the doctors are involved in patient care.
Second, La Hacienda has an openness to spirituality that you don’t find elsewhere. Doctors, nurses and other staff will pray for and with our patients.
Being in the Texas Hill Country, one of the state’s most attractive rural areas, is another plus. There serenity and beauty of the location helps patients heal.
History of Addiction Treatment as Medicine
Dr. Benjamin Rush, a signer of the Declaration of Independence described alcoholism as a disease in the late 1700s, but it was not until the 1930s that the concept gained traction when Dr. William Duncan Silkworth, in Alcoholics Anonymous: The Big Book, said it was a disease caused by an allergic reaction.
Formation of the New York City Medical Society on Alcoholism in 1954 started the modern addiction medicine movement.
The drug revolution of the mid-60s lead to the formation in 1972 of the California Society for the Treatment of Alcoholism and Other Drug Dependencies, the first state organization advocating a specialty in addiction treatment.
Recognition of Addiction Medicine as a Specialty
In 1988, the American Medical Association officially recognized addiction medicine as a specialty practice.
While state licensing of physicians and nurses impacts the field directly, the federal government also regulates some functions of addiction treatment, for example, when applicable laws regulate controlled substances used in medication-assisted treatment.
Nursing organizations such as the American Society of Addiction Nursing (created in 2020) provide leadership, education and support for nurses in the field and the recruitment of students interested in it.
La Hacienda’s Modern Special Care Unit
The current Special Care Unit was constructed in 2013 to house 18 patients in medically supervised detoxification and the center’s medical offices. It includes a work hours office area for nurses and unit clerks, private offices for four physicians, a pharmacy, examination rooms, a small kitchen/dining area, and storage for additional resources.
The State of Texas has licensed La Hacienda to operate a Special Care Unit since the treatment center opened in 1972.
It is worth noting that not every addiction treatment center has this level of physician and nursing care onsite daily to tend to patients’ health concerns.
Primary Health Care Provider
As authorized by state law, this is a physician (Medical Doctor or Doctor of Osteopathic Medicine), nurse practitioner, clinical nurse specialist or physician assistant, who provides, coordinates, or helps a patient access health care services that vary widely
Texas Board of Nursing Scope of Practice
The legal scope of health practices for professional registered nurses is outlined by the Texas Nursing Practice Act.
Joint Commission Credentialing
The Joint Commission, which certifies addiction treatment facilities through a review process, requires that physicians and nurses present evidence of licensure, education training experience, or other qualifications.
Difference Between Doctor and Nurse
A doctor attends medical school and completes a residency before receiving certification, a process that also includes earning a bachelor’s degree and a master’s degree. A nurse can achieve licensing after two years of post-secondary education with an associate degree or four years with a bachelor’s degree.