by Linda Ebner Erceg, R.N., M.S., P.H.N.
The summer camp season is imminent. Campers have enrolled, staff have
been hired, and more supplies are arriving every day. As part of this
"getting started" process, camp professionals are pulling
out last year's orientation notes to shape this year's program.
We do well getting the largest portion of our staff, the counselors,
oriented to their job, especially if we remember that orientation is simply
that — getting people pointed in the right direction. It's
not an end-point for staff formation, merely the launching point. But
one aspect that often gets short-changed is the camp's health services.
Orienting your camp community to the camp's health services is more
than just talking about what goes on in the health center; it includes
orienting staff and campers to the scope of services provided by camp,
how to access those services, and the individual's role in health
maintenance. It has distinctions based on the role of the person in camp:
camper information varies from staff information, and what gets told to
health center staff may well include items unnecessary for other staff.
Preparing this segment of your orientation begins by reviewing the components
from a management perspective.
Orienting Health Center Staff
These frontline people are often the folks who first spot "pink
flags" of concern in the camp's health profile. Their ability
to effectively and efficiently interface with other camp administrators
is important. To do this, they need information that establishes the parameters
of their work, and they probably need this before arriving at camp. Think
about it. The camp's food service and health service are often the
two functional areas of camp expected to deliver services way before the
counselors begin taking care of campers. Many camp nurses tell stories
about arriving at camp, responding to "What's your job here?"
and immediately getting told about health concerns when the nurse hasn't
even seen the health center! Seriously consider orienting this staff before
the others. Points to talk about include:
- Describe a typical camp day (not the campers' day nor a counselor's
day). Share with them the scope of their tasks; time the health center
opens; meal times; how and where routine medications are given; when
the walk-around occurs (cabin checks); when the health center closes
at night; personal time; and so forth. Talk about time management; acknowledge
the frenzy of opening day but also explain the more usual and casual
routine of camp.
- Talk with these staff about the difference between caring for campers
and caring for staff. It's easy for health center staff to treat
people all the same; after all, the person came into the health center
and asked for help. Care for campers often stems from a diligence based
on in loco parentis care whereas staff are employees. Admitting a camper
to the health center has a very different impact from admitting a staff
member. Discuss this so everyone is on the proverbial "same page"
regarding care plans.
- Explain when staff and campers are screened and talk about how this
happens. Use your protocol to discuss the scope of the screening process
so health center staff, in their zeal to do a good job, don't
assume you need full physicals. Remember to explain what they should
do when someone presents a problem during that screening process —
head lice is a great example.
- If your camp hires health-care providers with different credentials,
explain who supervises whom and discuss the implications of each credential's
scope of practice at camp. A good reference for this is in Armand and
Beverly Ball's book, Basic Camp Management (2004, p. 201). This
is especially important when questions arise about decision making.
Include a discussion about delegation, especially if health-care personnel
will be working with tripping staff to deliver medications or cabin
staff to deliver personal care to special needs campers.
- Determine how and when health-care staff will communicate with other
camp administrators. Is there a time each day when the camp director
gets a summative report of who's been in the health center and
for what reason? What incidents warrant immediate contact? This is also
a good time to discuss confidentiality, especially regarding concerns
that have safety implications for an individual or others, and a good
time to remind health-care staff that they may not know everything about
everyone.
- Explain the difference between health services provided by the health
center and those provided by other areas of camp. Sometimes health-care
providers think they're the only ones with responsibility for
health when, in most camps, this is a shared responsibility. Cabin counselors
do their things, food service staff do theirs, maintenance has their
role, activity staff do theirs, and the camp director has other aspects.
Be sure health-care providers understand how they partner with a variety
of people. Along with that understanding, talk with them about how and
when to approach others when health needs must be addressed.
- Explain the camp's Emergency Action Plan (EAP) and the health
center's role in that plan. Emergencies are hot buttons for health-care
staff. Many have anecdotally talked about not being able to sleep at
night or enjoy their time-off because they "were sure something
would happen." Often these folks simply need to understand that
responding to an emergency triggers a response from a variety of people.
Who are these folks and how is the team rehearsed? Explain what emergencies
would trigger the EAP and how often the camp's had to use it.
- If your health center staff provide orientation to other staff or
campers, tell them when they'll be doing this and what content
you want covered. Ask them what additional content they'd like
to include.
- Verify their understanding of your camp's medical protocols
and health center policies. Talk through the variety of forms used to
document various things. Talk about timeliness of charting; challenges
with medication distribution; and how to access out-of-camp providers
such as dentists, the clinic, or pharmacy. In describing these elements,
also talk about communication with camper parents. Can health center
staff simply initiate that on their own? Is such communication documented,
where and how? How does communication about staff health differ from
that done for campers?
Having this discussion does more than provide information. It also provides
an opportunity to form a collaborative relationship between the professionals
in the health center and those running the camp. Experienced camp directors
tell stories about "how the camp nurse saved the day for us,"
but they also tell stories about "when it all went bad." In
addition, one component of job satisfaction is matching employee job expectation
with what the job really is. An orientation discussion that addresses
these points goes far with establishing a strong baseline for the summer.
Orienting Staff to the Camp's Health Services
Getting staff pointed in the right direction sounds easy. They arrive
bright eyed and bushy tailed, ready to take on anything campers would
like. We do a great job talking with staff about camper needs and buoying
their skills at facilitating the developmental tasks of campers. But we
also need to address staff health needs — as employees. Staff members
are not campers. And staff groups have their own health needs. Some arise
from their own developmental tasks, and others are associated with simply
being at a camp.
Let's talk a bit about those associated with being at camp. Risks
common to staff, no matter what kind of camp, often include: (a) constant
exposure to children; (b) a fairly programmed day; (c) limited access
to communication with the outside world; (d) a significant change in privacy;
and (e) the need to stick to camp procedures. These may sound benign but,
over time, these can have a significant impact upon staff health —
if not addressed early and assessed as the camp season unfolds. This introduces
the domain of mental and emotional health, an area often neglected simply
by oversight.
Being around children day in and day out can be wearing. Having a schedule
that plots most moments of the day and steals "need to be alone"
moments under the guise of "good supervision" elicits stress
for most adults. Limiting contact with the world the person both came
from and will go to after camp can also be stress-provoking, especially
for people used to being "connected." Factor in our need for
staff to follow procedures with their more natural tendency toward hubris,
and it becomes apparent how being an adult at camp can be a challenge
to one's health.
Strategies that address these risks are camp-specific. The point, however,
is to recognize that the stressors exist. One can then talk with supervisors
about intervention strategies as well as behaviors to monitor that indicate
a particular person may be overwhelmed. One of my personal favorites is
to watch who hangs out in the staff lounge and when. The place is often
almost empty during the first week of camp but, as things get going and
energy fatigues, more staff drift in more often. They no longer "hang
out with the kids," but choose to crash in the staff lounge. If
this sounds like your camp, try to determine why. Determining the reason
often enables one to then craft a counter-strategy.
In addition to tackling mental and emotional health with staff, there
are other components about staff health that we often forget to talk about.
We remember the easy things: how to get medication, when the health center
is open, what to do if a child wets his/her pants, their first response
to an injury, attending to notes lovingly provided by parents to "my
child's counselor". But what about the staff's ability
to manage their personal health so they remain capable of doing the job?
Is a statement of this ilk on the camp's personal performance forms?
Acknowledging that it's a staff person's job to manage their
personal health — not the camp's — allows staff to retain
that responsibility. Asking them to talk with their supervisor, early
on, when what the camp asks of them gets in the way of this opens the
door to more effective communication (it may also indicate a point of
intervention to the supervisor).
Staff members should also be oriented to their boundaries insofar as
health care is concerned. Each of our camps has made certain promises
to parents and medical protocols have been developed based on certain
expectations, but when can a staff member initiate care for a camper's
health need? A growing number of camps have developed a section in their
staff manual to address this very thing and, because of challenges like
the risk of blood exposure, have taken the position that staff are limited
to coaching a camper in self-care to the level of the staff member's
credential (what a person with basic first aid would coach differs from
what the Wilderness First Responder might do). Other camp programs would
consider such a statement too broad and may default to the old adage,
"The first band-aid is first aid; anything after that gets referred."
Finally, there's more going on during health orientation for staff
then just delivering content. Staff are also making judgments about how
serious the camp takes health services as well as how approachable, how
competent, and what kind of caring attitude is displayed by various people.
An organized, informative session for staff goes a long way in communicating
some of the more subtle aspects of the program. Attention to delivery
style is well worth the effort!
Orienting Campers to Camp Health Services
Camps often formalize this by having the nurse talk to everyone on opening
day; other programs have counselors deliver the message during cabin council
or a similar meeting. It's the time when we tell campers about the
health and safety issues that affect them. Just like the staff, campers
also are making judgments about things that will impact them.
Readers who have listened to Marge Scanlin, executive officer, research/intellectual
resources, talk about the research will recognize that some campers report
feeling "not safe" while at camp. In spite of a camp's
diligent work with EAPs, despite first-aid kits at all the right spots,
regardless of buddy check and other such systems, kids are telling us
that they don't feel safe. Some kids report wondering if people
bring guns to camp, if someone will beat them up, if they'll be
bullied, if the darkness at camp is concealing things in the bushes or
if something is under the cabin and "might get me." Childhood
fears are real to the child and may be based as much on imagination as
anything else. Nonetheless, those fears should be addressed so the energy
spent guarding is freed to enjoy camp.
This is a unique opportunity to add a dimension to your camp's
health service program while improving the comfort of children at our
camps. Consider the sociodemographic background of your campers. Ask what
risks exist in their day-to-day world that are of concern to children.
Kids from a city, for example, often report feeling uncomfortable with
darkness. They're used to street lights. The sounds of their urban
world are very different from what they hear outside the cabin at night.
We teach our nation's children a set of survival skills appropriate
to urban life: never go anywhere by yourself, don't talk to strangers,
never take something from them, never undress in front of people you don't
know, and if you're going someplace new, go with at least three
other friends.
Then the kids come to camp, but no one tells them the rules have changed.
We need to address this.
Originally published in the 2005 May/June issue
of Camping Magazine. |
