Nurses newly hired for your camp’s health center need orientation. What they need to know differs from the orientation needed by general staff. Providing it is critical to a smoothly functioning health center. But what should a camp professional explain to a newly hired camp nurse? In essence, everything. Even nurses who have worked at a different camp need orientation to your camp’s policies and practices. Come to think of it, returning nurses may need orientation too. Theirs can often be tailored to things that have changed and discussion of “pain points” that occurred during their last term of employment.
The content provided here about what information camp nurses need and when it’s best given is not exhaustive. It will trigger ideas for camp professionals who supervise their own camp nurse, especially those new to camp.
Prior to Camp Arrival
People expect the nurse to function upon arrival at camp. The nurse may not even know where to find the health center, but that doesn’t seem to change expectations, so use the time before camp arrival to address some nurse orientation needs. Doing so allows a more relaxed approach and, if done with intention, can build a collegial relationship between the camp director (supervisor) and nurse. Discuss this early orientation with the nurse when contracting for his or her services so he or she is aware of it. Suggested topics to include follow.
Knowing Why Campers and Staff Seek Healthcare
Knowing this — before arriving at camp — enables a nurse to compare his or her skills to those needed to care for reasonably anticipated injuries and illnesses. Doing so also means there’s time for the nurse to address his or her knowledge gaps. So make use of your Excel spreadsheet. Go through last summer’s log to create a list of reasons why people sought healthcare, one listing for campers and another for staff. (Wise camp professionals have incorporated creation of this list in their camp nurse job description which, eventually, facilitates ready access to the spreadsheet, purging identifying information like names of people, sorting information, and sharing as needed.) Create a frequency list for both injuries and illnesses so more commonly occurring incidents can be readily identified. Share the list with the incoming nurse and ask him or her to audit his or her skills to determine capability to both assess and oversee health improvements associated with the most commonly occurring items. Direct the nurse to minimize knowledge gaps by seeking information before camp arrival.
Share a Copy of the Camp’s Health History Form and Other Record-Keeping Forms
An individual’s health history form is core to a nurse’s care planning. Have the nurse read through this document to see the kind of information gathered and the scope of the parent authorization. Discuss expectations for sharing information with other camp staff (e.g., food service gets a list of food allergies; cabin counselors know about campers prone to bed-wetting or sleepwalking) so the nurse understands your camp’s need-to-know policy. This discussion also provides a springboard to talk about the camp’s parent notification policy and your expectations for remaining informed of these conversations. Explain who prescreens camper health forms to identify and address health matters prior to camper arrival; share how this information is documented so the nurse knows what’s been said, by whom, to whom, and when.
Then explain the camp’s health record system. Some readers may use a computer-based program; might the nurse have access prior to arrival to learn the system before needing it? Everyone still uses some paper-based records. Share copies of these. Explain when and how each is used, including the incident report form. List topics about which the camp director should be informed and how soon that information should be shared.
Provide a List of Health Center Supplies and Stock Medications; Share the Medical Protocols
Nurses want to know what supplies and stock medications will be available to them, information that is complemented by the camp’s medical protocols. Have your nurse read these ahead of time to build familiarity before needing it. Remember to include the health center’s references, such as a medication manual, the camp first aid book, a communicable diseases manual, and whether or not there’s a computer with Internet access in the health center.
Explain Supervision of Health Services
Who supervises the nurse and how that’s done is one aspect that can be bolstered by effective pre-arrival conversations between the nurse and supervisor. But also talk about staff who are, in turn, supervised by the nurse. For example, will there be assistive staff in the health center who the nurse is responsible for supervising? Might there also be staff who are intermittently supervised by the nurse, such as the tripping staff’s designated healthcare provider? Discuss the scope of that responsibility (e.g., delegation) and how concerns are managed.
Explain how the nurse’s supervisor stays in touch with health center matters. It is an employer’s responsibility to oversee employees. If your style is to stop in the health center at a certain time each day, let the nurse know and select a time when the likelihood of others hearing your conversation is minimized, if not eliminated. Perhaps you prefer having a meal with the nurse or discussing matters over coffee. Explain how input from campers, parents, and other staff contribute. Regardless, describe the oversight process so experiencing it is a natural outgrowth of the nurse’s camp experience.
Also, discuss boundaries to the nurse’s scope of supervision. These often boil down to matters arising in as opposed to outside the health center such as cabin incidents and/or camp emergency situations. These are times when various people are involved and the camp director, not the nurse, often oversees the situation. The bottom line is helping the nurse understand that healthcare and wellness is a shared responsibility, not the sole proprietorship of the nurse. That being said, tell the nurse to whom he or she should bring observed health concerns.
Discuss Differences between Camper and Staff Healthcare
As minors, campers are “cared for” in ways that differ from staff (employee) care. Your camp nurse needs to understand this distinction. For example, information about care provided to a camper may be shared with the child’s custodial adult(s) and/or counselors, but information about care provided to employees (legal adults) remains confidential unless the employee directs otherwise. This distinction has potential to impact the nurse. The nurse might, for example, enlist the help of cabin and/or activity staff to provide care to a camper, but the same is not true for staff. Staff determine who is told what about their health profile, not the nurse. The nurse can certainly talk with at-risk staff about sharing critical information, but the decision to do so remains with the (legal adult) staff member.
Make sure you also orient the nurse to the difference between health outcomes for campers and those of staff. Good health is certainly desired for everyone, but the health center should not become a clubhouse because the nurse is lonely. The nurse oversees the camper recovery process so the camper can return to their camp program, but staff (employees) are responsible for overseeing their own recovery. They may certainly seek coaching from the camp nurse, but acting on that is at the staff member’s discretion. Not so for campers. The nurse must address the camper who ignores or partially complies with care directives and elicit the assistance of others to accomplish this.
Orienting at Camp
Background in these areas means that one’s nurse arrives with some understanding about the care he or she will provide as well as a relationship with his or her go-to person when questions arise. But the nurse’s orientation isn’t yet complete. It should include items such as these once the nurse is on-site (unless this content can also be built into pre-arrival conversations).
Learn the Camp Layout
Your nurse needs a tour of camp — where things are and what goes on at various places — just as any other staff member. When doing this, point out access routes to places that are more remote or utilize one route for vehicles and another for pedestrians. Include comments about communication variables such as barriers to line-of-sight radio transmission and/or the best place for cell phone use.
Learning the camp layout includes learning where key people might be found and how to access critical services. Office locations, the mail drop, and how to get maintenance needs addressed illustrate these points. Point out the location of emergency supplies such as the automatic external defibrillator, fire extinguishers, and first aid kits. Discuss who needs to know when the nurse admits someone to the health center and how that communication is accomplished.
Provide a Written List of Tasks to Be Done before Campers Arrive
New camp nurses, even if they claim to have an understanding of what’s going on, benefit from a written list of tasks to accomplish before opening day. Add a due date to those needed prior to camper arrival. For example, the head cook often needs a preliminary list of people and their food allergies for menu planning. Talk the nurse through this task list, pointing out where coordination with other staff is important (e.g., talking with the waterfront manager) and when the director wants the nurse to present content to the rest of the staff (e.g., the nurse’s talk during staff orientation).
Talk through opening day’s screening process, especially the need to prescreen health history forms before camper arrival so opening day’s screening moves along. Remember to address the load of medications that will arrive and how those meds might be organized. Ask the nurse to practice opening day screening with staff during orientation week to hone and streamline the process. Talk about health concerns that have been discussed with parents, where notes about those conversations are located, and how the nurse should handle concerns that present on opening day (e.g., camper arrives with no health history, with exposure to communicable illness, or has head lice). Revisit the reasons why the nurse might want to call some parents prior to opening day and the director’s need to know of these conversations.
Attend Staff Functions
The nurse is a member of the camp staff, so expect the nurse to attend staff meetings and other staff functions. Granted, not every topic is germane to the nurse, but he or she needs an understanding of what’s happening, who’s involved, and to feel welcomed. Do not isolate the nurse in the health center. This quickly leads to marginalized health center staff and feelings of “I’m not part of camp.” Expect the nurse to attend orientation (and the summer’s subsequent staff meetings) just as any other staff member. Invite the nurse to bring paperwork to meetings when planned topics aren’t directly associated with the health center; he or she can sit toward the back and work on those things but is readily available should pertinent content come up. Remember to include the nurse when staff parties and other recreational experiences are offered.
Describe a Routine Day from the Nurse’s Perspective
The nurse’s daily routine differs from that of campers and other staff, but it also complements those other routines. Talk about this. For example, explain when daily medications are given, how the “no swim list” is both created and routed to the waterfront manager, when the daily sanitation check (the camp nurse’s walk-around) is done, and how to order health center supplies. In concert with the nurse, determine when “office hours” are held for people with emergent health needs. Discuss how that might be adjusted for staff who also have varying schedules. Identify times when the nurse must be present at camp functions like meals, evening program, and/or staff meetings. Explain how others know where to find the nurse when he or she isn’t in the health center. Discuss the best times for the nurse to take his or her daily “down time” and when that might be impacted by urgent health needs. Identify when the health center tends to be busy and who to notify if help is needed. Make sure the nurse understands the conditions under which leaving camp is acceptable and, should that happen, who needs to know.
A well-oriented nurse benefits many and contributes to the nurse’s job satisfaction. A nurse who understands how he or she will be supervised and where to go with questions means communication is supported and campers tend to be satisfied with their care. A nurse with a good grasp of his or her role in relation to other aspects of camp is in position to complement camp routines rather than frustrate them. This helps everyone. It also pays dividends should the unforeseen occur.
There’s a lot to be said for planning and delivering an organized and thorough orientation to your camp nurse. Do it.
Linda Ebner Erceg, RN, MS, PHN, is the program coordinator for Bemidji State University’s Certicate in Camp Nursing (MN). Her experience includes over 30 years as a year-round camp nurse for Concordia Language Villages and deep experience in working with camp professionals to address camp health needs. She currently chairs ACA’s Healthy Camps committee where her time at camp as well as her former role as executive director for the Association of Camp Nursing now contribute to her educational and research activities.