Risk Management: Orient Health Center Staff

Linda Ebner Erceg, RN, MS, PHN

Everyone knows that camp staff need orientation to effectively do their job. Why, then, do health center staff often report that they don’t get any? The team hired for your health center certainly has skills associated with the credential they hold, but they need information from camp administrators to effectively use those skills in a way that will complement camp processes. This needed information is often second nature to camp professionals; yet, because new hires haven’t been to camp, this is content they may not ever consider asking about.

Consider training health center staff before other staff arrive for the official orientation process. This is helpful because people expect health services to be available just as they expect food service to be functioning. Indeed, the potential for staff injury during orientation is fairly high because staff are often doing things they aren’t used to. Help your health center staff be prepared to respond.

So what should health center staff be told? Here’s a list of things to consider. Select those that make the most sense from the perspective of your camp operation.

Describe the Reasons Why Campers and Staff Seek Healthcare

Since health center staff focus on injury and illness, a great way to start their orientation is to show them last season’s log. The log succinctly lists why people sought care. Talk about the common reasons that bring people to the health center and determine if the staff feel comfortable caring for these concerns. Should an area come up about which a provider feels uncertain, target that topic for self-study before camp starts.

This review provides a natural entre to discussing the camp’s medical protocols. Show the health log; if possible, make a copy for them to take home and read. Talk with them about the extent of healthcare provided at camp. This extent describes how far a healthcare provider might go before referring a client to an out-of-camp provider. Knowing this boundary is important because many healthcare professionals come from clinic and hospital work, places where the expectation is to provide needed care. That’s not always the case at camp; some things can be addressed, but referrals for other health needs are expected. The camp health center often is not a clinic or hospital. On the other hand, camps serving medically compromised campers often have health centers with a more robust capacity than camps serving a “normal” population. Regardless, the point is to discuss the scope of healthcare provided by the camp and the point at which a person is referred to an out-of-camp provider.

Also, talk about situations that health center staff must address because they can’t wait for out-of-camp resources. This includes topics such as responding to anaphylaxis, monitoring asthma episodes, and efficiently assessing injuries. It’s common to find that nurses and some physicians need additional training to respond to these “in the field” incidents. Remember: They typically see people who have already been triaged and helped by EMS personnel. Being at camp means the nurse or physician needs these triage skills. Given their educational background, some can add this knowledge by reading a recommended book on the topic, while others may prefer taking a class to acquire the skills. Be prepared to comment about assistance the camp can provide to meet this need.

This might also be the time to discuss the distinction between care of campers (clients) and staff. Health center staff will handle injuries and illnesses pretty much the same regardless of who is injured or ill, but the impact of doing so changes based on client or staff status. Explain this distinction so health center staff are prepared to appropriately respond.

Explain the Role of Other Camp Staff in Health Maintenance

The responsibility for health isn’t solely in the hands of the health center staff. Other staff have responsibilities, too. For example, staff living with campers are responsible for hygiene; food service staff get involved with managing allergies; the maintenance team responds to safety repair needs; and the camp director retains overall responsibility of maintaining a healthy camp environment. Describe these distinctions so health center staff understand how they fit into the grand scheme of today’s camp management processes and can be more effective members of the team.

Provide a List of Health Center Supplies, Medications, and Resources

Health center staff need to know what supplies and medications are stocked in the health center. Provide that list. This helps them adapt their mindset to what will be available. Remember to include emergency items — like an automated external defibrillator (AED) and backboard — that may be located in places other than the health center. Speaking of AEDs, if possible, show the professional the camp’s AED so they can learn how it’s used. Remember, many nurses and physicians are used to their facility’s “crash cart” with all its various medications for managing cardiac incidents. Using an AED may be a unique experience for them.

Orient the health center staff to the cost of the medications and supplies, and talk with them about the health center’s budget so they are in a position to make good decisions. Explain who places the season’s start-up order and to whom they should go if items need restocking during the season. Take time to explain any unusual use of health center items such as using Mediplast for deeply embedded slivers.

Healthcare professionals often consult resources when questions arise. Consequently, list the resources available in the health center. Make sure to include comment about the health center’s computer, if one is available. Tell them if the computer has Internet and e-mail access and/or what computerized processes are used (e.g., software). Include comment about books, too. Having an up-to-date medication reference, a copy of Control of Communicable Diseases Manual, a first aid manual, and back issues of CompassPoint is considered baseline (see sidebar below); camps serving special populations may also have references germane to specific diagnoses. The point is to tell staff what tools are available to support their work.

Discuss Communication with Parents about Camper Health

Camp administrators make certain agreements with parents about how and when they’ll be contacted regarding their child’s health. Show health center staff the materials that describe this agreement. Explain how and when you want parents contacted — and if you, the administrator, should be part of this communication. To minimize inadvertent communication errors, also explain the need to make sure one is talking to custodial parents/guardians. Remember that many healthcare professionals are used to initiating these contacts when they see need. Without an understanding of the camp’s policy, they may inadvertently disturb the communication chain desired by the camp. Finally, explain how and where to document these communications, including unsuccessful attempts to contact parents/guardians.

Also describe the boundaries of communication with parents. For example, should the camp director be consulted first when a camper needs to see an out-of-camp physician, or can the health center staff make that determination, consult with parents, and simply inform the director?

One of the most common pain points reported to the Association of Camp Nurses by healthcare professionals occurs when the nurse or physician has one opinion about a person’s health status and the camp director has a different one. Talk about how these differences are resolved, including a straightforward statement that the camp director’s opinion trumps that of health center staff, if that, indeed, is the case.

Describe Health Center Routines

Many camps have routine practices that health center staff need to know. Orient them to these practices. For example, describe how daily routine medications are distributed. Explain the daily “walkaround” (camp sanitation check) and, if applicable, awards associated with this check. Describe how health forms are prescreened before campers arrive and opening day’s screening at the health center. Explain who is responsible for cleaning the health center and how to route maintenance requests.

Also describe the camp’s recordkeeping process. If possible, have a copy of each form for review. Be explicit about the health center staff ’s responsibility for each form and how to complete the form. Distinguish between forms that are retained with individual health records and those that must be passed along to others (e.g., first report of injury to the camp director, list of food allergies to food service staff).

Explain the health center’s role in communicable disease control. Explain the camp practices already in place that minimize the potential for these illnesses to move through the camp community, but also explain how health center staff serve as sentinels for communicable disease. They will see people with these illnesses before an outbreak occurs; their task is to recognize the potential for communicability and bring that concern to the camp director ASAP so an appropriate response can be initiated.

Remember to orient health center staff to their role when responding to camp emergencies. Explain the more common emergencies (e.g., lost campers, weather threats) and talk about how camp response is often coordinated by the camp director. Typically, health center staff focus on injured people in these situations; they may not direct the actions of the entire response team. Explain this distinction so health center staff understand their role and do not inadvertently disturb what may be a well-functioning system.

Also orient this specialized staff to what they should do when something comes up that’s outside the parameters of the expected or when problems arise. They need to know where to bring their concerns.

This description of basic orientation needs will go far in helping your health center staff provide effective services to campers and staff. By discussing these things during orientation, your staff will be in a better position to work effectively with you. It’s well worth the effort.

Core References for the Camp Health Center

The Basics of Camp Nursing, by L.E. Erceg and M. Pravda (2009)
CompassPoint — back issues available from Association of Camp Nurses (www.ACN.org)
Control of Communicable Diseases Manual, edited by D.L. Heymann (2005)
First Aid manual, such as Wilderness First Aid, by Backer, Bowman, Paton, Steele, Thygerson & Thygerson (2008); and/or Advanced Assessment and Treatment of Trauma, by M.D. Pante and A.N. Pollack (2010)
Medication reference, such as Nursing 2013 Drug Handbook
Scope & Standards of Camp Nursing Practice, from Association of Camp Nurses (2005)

 

 

 

 

 

 

 

Healthy Camp People 2020 Objectives:

Here are some objectives associated with the Healthy Camp People 2020 initiative. Does your camp measure up?

  • When camp snacks are served, especially ones that are fat and/or calorie heavy, is an alternative snack also available?
  • On a daily basis, does each camper meet aerobic physical activity guidelines (increase their resting heart rate)?
  • For resident camps, does each adolescent camper and staff member get an average of eight hours of sleep per night?

Want to know more? Access the complete assessment tool by going to www.ACN.org and following the link you’ll see on the homepage.

 

 

 

 

 

 

 

 

 

Linda Ebner Erceg, RN, MS, PHN, is the associate director of Health & Risk Management for Concordia Language Villages and executive director of the Association of Camp Nurses in Bemidji, Minnesota.

Originally published in the 2013 March/April Camping Magazine.
 

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