Most people can handle — or tolerate — a certain degree of risk. The edginess provided by risk adds verve to being human, and often gives us that gentle kick in the seat of our pants needed to prod us along in life. Risk tolerance, however, exists on a continuum. There are times when a person is more comfortable with risk than at other times. In addition, risk tolerance varies from person to person. Some thrive on the thrill associated with it, while others may be paralyzed.

Our camp world masterfully stages risk based on an individual's risk readiness. Beginning with the decision to come to camp, campers progress through swimming, archery, and other skills as readiness deepens. Even interpersonal skills are coached using techniques that help people expand their repertoire of risk-management skills.

Yet, every once in a while, camp professionals grapple with risks that present a challenge. These are especially impactful when the outcome of inadequate or inappropriate risk management makes a difference to the health and safety of people.

The Concept of Inherent Risk

Those who read articles by the recreational lawyers Charles R. Gregg and Catherine Hansen-Stamp recognize this concept. It's used to describe risks related to the nature of an activity. An inherent risk is impossible to manage or give away; doing so would change the nature of the activity.

Given this, the decision to attend camp typically presents inherent risks to one's health. One of the risks is the exposure participants have to the flora and fauna endemic to the camp's geographic area. Be it ticks, mosquitoes, bats, poison ivy/sumac, or the occasional skunk or sea urchin, it's impossible for a camp to eliminate exposure to these inherent risks. One might minimize the exposure, but eliminating it is impossible.

Another inherent risk, one associated with bringing people together for an experience like camp, is communicable disease. As experience with illnesses such as novel influenza H1N1, chicken pox, and the common cold has demonstrated, one can screen for communicable illness but screenings are no guarantee of protection. Humans interacting in community pass some illnesses from one to another; it is inherent to human interaction.

Why the Tension Surrounding Risk?

The tension surrounding risk in our camp world comes from two sources. One occurs when a client, often the parent of a camper, doesn't understand the camp's inherent risks and/or the notion that a camp's ability to protect a given individual's health status can only go so far. To combat this, camp literature could proliferate in an effort to include comment about everything. Perhaps, the better solution is to utilize the concept of inherent risk in combination with comment about risk reduction strategies. It's an idea worth talking about, especially with the camp's legal counsel.

The second tension arises from a camp's interest in minimizing risk, even inherent risks. This tension exists between doing what is reasonable and doing all that's possible. Strategies such as screenings, educating campers and staff, and utilizing tools like insect repellents and sunscreen, all help minimize risks, including some inherent risks. But these strategies are not sufficient to eliminate the risk. About the only way to totally eliminate risk would be to choose non-participation (not come to camp). Since this is not a viable option for most, we seek to position ourselves someplace in the middle, that place where risk reduction measures are utilized, acknowledging that the risk may be reduced but not eliminated.

Techniques That Minimize Risk

Writers in the field of risk reduction describe strategies commonly used to manage risk exposures (Coutellier, 2008; Robertson, 2007; Wilde, 1994). These techniques can be applied when addressing any risk, even inherent risks, and are as follows:

1. Prevent the creation of the hazard. Camp professionals exercise this when they choose not to do an activity because it poses too much risk. Sometimes other entities — like insurance companies — impose this by refusing to insure things that exceed the company's risk tolerance (e.g., eliminate the diving board; no trampolines).
2. Reduce the amount of the hazard. This strategy is used when the maintenance staff clear poison ivy from under clothes lines or along commonly traveled paths. It's not that they can eliminate poison ivy but they can reduce the amount of the hazard within the environment.
3. Prevent the release of a hazard that already exists. This explains why combustibles are locked up and why some foods are maintained within a safe temperature zone. The hazard exists; one is controlling the release of that hazard.
4. Modify the rate or spatial distribution of the hazard. This is why swimming occurs in a designated area rather than anywhere along the camp's lake shore, and why cabin beds are placed with at least 32” between sleeping heads.
5. Separate, in time or space, the hazard from that which is to be protected. This is illustrated when walking paths are separated from motor vehicle driving lanes, or why people with contagious illness are isolated from the healthy population.
6. Separate the hazard from that which is to be protected by a material barrier. Arm guards in archery, knee pads for volleyball, protective shoes in the kitchen and riding stable, and hearing protection at riflery all illustrate this point.
7. Modify relevant basic qualities of the hazard. This explains why there are guard rails on bunk beds and lifeguards at the waterfront, why one keeps kitchen knives appropriately sharpened, and the reason for using a soft rather than hard ball for many games.
8. Make what is to be protected more resistant to damage from the hazard. This strategy explains the reason for vaccinations, why campers condition or warm-up before some activities, why insect repellents and sunscreen are used, and provides rationale for swimming lessons.
9. Begin to counter the damage already done by the hazard. Granted, this strategy happens after the fact; its value lies in protection from further damage. For example, it's why we're interested in getting first aid care to injured people in a timely manner, and it's why people learn CPR or how to use an AED.
10. Stabilize, repair, and/or rehabilitate the object of damage. This is the reason for alerting maintenance staff to things needing repair, rotating fatigued people out for a rest, and periodically re-conditioning equipment or surfaces.

Challenging Risk Assumptions

Risk surveillance is a reality of life for most camp professionals. We intuitively see things needing attention and make a point of addressing that observation using the strategies just reviewed. Yet sometimes we neglect to consider risk from the perspective of our clients or staff, forgetting that they may need reminding of camp's inherent risks. And, we sometimes forget to challenge our own mindset: when is risk tolerable? To borrow from Wendy Mogel's message, when might there be virtue in that skinned knee?

Linda Ebner Erceg, R.N., M.S., P.H.N., 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 2010 January/February issue of Camping Magazine.