When Staff MESH Impacts Camp

Linda Ebner Erceg, RN, MS, PHN
March 2015
Everyone has a mental, emotional, social health (MESH) profile. For most of us, our MESH profile is within a “normal” range. Some days are better than others. Some things push our buttons, others don’t. Some days we have a higher tolerance for situations that, on another day, put us on edge. We can be chuckling with mirth in the morning and grumpy by the time supper rolls around. Regardless of our minute-to-minute MESH profile, we typically maintain a fairly predictable profile, one that others come to know as “us” and with which others can effectively interface.
 
But some people aren’t like that. Some have MESH profiles different enough that their profile impacts their ability to effectively interact with others, care for others, and/or work in a changing environment. When this kind of person is working at camp, he or she may negatively influence camper retention as well as the job satisfaction of others.
 
How might a camp professional respond? What strategies might be utilized that limit the potential to attract these individuals to one’s application pool without being off-putting to the majority or impacting the American with Disabilities Act? Many camps genuinely try to be as inclusive as possible; consequently, just as there’s a camp for every child, so too might there be a position for every would-be staff member — or not?
 
As a precursor and before getting into this topic, recognize that employee situations in the MESH domain typically have legal repercussions. These often vary from state to state, so be sure to discuss ideas that may be generated by this article with your legal representative.
 

Review Your Job Descriptions and Hiring Process

As previously mentioned, the nature of camp work means interacting with others to accomplish things, including caring for others and work environment changes (e.g., weather impacts, varied camper needs, special day schedules). Because job descriptions and their accompanying list of essential functions are critical to communicating camp needs to prospective applicants, might your job descriptions need updating to reflect MESH abilities? These are typically not included in many camp job descriptions yet, I would argue, are essential. Check yours. Do they include the need for emotional resiliency, effective adaption to changes in schedule and work assignment, and the ability to effectively interact with others, especially children, in camp’s youth-centered environment? Prospective applicants need to know the essential functions of the job they are considering include MESH components.
 
Use the staff application and interview to probe for indicators of MESH resiliency. Completing a staff application typically allows an applicant time to think through his or her written responses whereas the interview, especially one conducted so body language can be seen, often provides a stronger indicator of the potential staff member’s MESH profile. In creating a question set, keep in mind that questions asked of applicants must pertain to job skills and comply with state employment law. With that in mind, consider questions such as these:
 
  • Parents will be leaving their child in your care. Why are you a good candidate for this? What do you find rewarding about caring for children/youth? Challenging?
  • If you and I were working together, how would I know that you’re stressed about something? How are you likely to behave?
  • What do you do to keep yourself emotionally healthy? Describe how you’ll utilize these strategies while at camp. How will you respond if you can’t implement your coping strategies?
  • Tell me about a time when you became emotionally drained and needed time for yourself. What triggered this for you and how did you respond? How will you respond if you feel like this and your camp responsibility means you have limited or delayed access to down time?
  • Imagine that I’m your supervisor at camp. What would you like me to know about you so that we could effectively work together?
 
As skilled interviewers know, questions like these scrape the proverbial surface of an applicant’s response. Probe for a more thorough response and note the congruence or incongruence of body language; it speaks volumes. Some prospective staff have appropriate self-awareness and adequate coping skills; they do well with questions like these. Others do not. Using the interview to intentionally create stress often enables one to more accurately see and evaluate the individual’s MESH profile. In so doing, however, it’s also important to debrief the candidate. A comment such as “I’ve intentionally put you under some pressure, a situation that will occasionally happen at camp. How are you feeling right now?” goes a long way toward helping someone feel more grounded while you assess his or her resilience.
 
There comes a point when one simply has to make a hiring decision. For good reason, employers are typically prevented from asking a prospective employee about his or her MESH profile, but employment law recognizes that some jobs require an individual have and maintain a certain level of emotional and mental stability. The care of campers is one of these.
 

Address the Stressors of Camp Life with Staff

Interestingly, people in the U.S. are most comfortable when others are “pleasant” to be around. We like to see smiles, appropriate eye contact, and open body postures. When we don’t intuit cues such as these, we become hesitant and more guarded in our approach to the person. We do this so readily that we’re often not even aware of what triggered our perception. We simply know that “Joe’s having an off day” or “Sally seems really touchy.” And then we generally go about our business and allow the person time to work it out.
 
For supervisors of camp staff, that last behavior may have long-lasting repercussions. Humans need to cope with stress, especially stress that triggers negative behaviors. And camp humans — especially those working with kids — need to cope effectively. A long-ignored supervisory skill is the one in which a supervisor not only notes stressed staff, but also does something to help mitigate that stress level. Failure to do so means risking that the stressed staff member will take it out on a convenient target. Campers might fall into that category. Or the task that should be done. Or other staff. Skillful supervisors are aware of these situations and help staff cope effectively. Does your supervisory training include comment and guidance for this skill?
 
With the ebb and flow of camp life, many staff members are capable of adjusting their behavior so it remains appropriate in spite of their MESH status at any given time. But other staff may be inexperienced and/or less capable. They may over-identify with a novel situation. They may be reacting because of incomplete situational knowledge. Or they may have a mental, emotional, or social health diagnosis that has not been disclosed.
 
When a staff member’s behavior indicates a MESH problem, it is best to talk with the individual after he or she has calmed down. Label the problematic behavior, describe the impact it had on others and, in cooperation with the staff member, develop an agreement for future behavior. Most individuals respond well to this approach. But egregious behaviors — especially those that impact the safety of others — require an immediate response. One may not have the freedom to wait. Having the support of another staff member, even if it’s only to act as a witness, is helpful. In these situations, knowing that one’s essential functions include statements that address the MESH domain is critical. And yes, one may occasionally have to release a person who cannot maintain the mental and emotional stability needed. This is easier to accomplish when essential functions align with that.
 

Appropriately Involve Health Center Staff

Your camp’s health center staff typically assess clients who seek care. The healthcare provider asks a series of questions designed to elicit information so the professional can provide appropriate care. Some camps formalize this through strategies such as staff screening, a process similar to that used for campers. Other camps have a different approach. Health center staff may, for example, do the assessment when/if the staff member seeks care.
 
Note that personal health information needed by a healthcare professional about a given staff member is distinct from the health information needed by employers. In fact, most employment law states that employers do not have a “need to know” personal health information about their employees — but healthcare providers often do. Knowing that a person is allergic to particular substances or what medications are taken informs the professional’s provided care. Indeed, failure to ask these questions may be grounds for malpractice.
 
However, because they’re used to working in medically focused settings like clinics and hospitals, many camp healthcare providers forget to assess an individual’s MESH profile, a dimension they may recognize as a person’s psycho-social domain. Here’s where a camp professional can be helpful. When orienting health center staff, talk with them about your desire that employees meet the essential functions tied to mental, emotional, and social health. Ask health center staff to include assessment of a staff member’s MESH profile by asking questions such as, “Do you have a mental, emotional, or social health concern that impacts your work at camp?” Such gate-keeping questions may disclose information that otherwise would not be known. This also means one must be prepared to appropriately respond should that occur. Because we’re dealing with staff, such a disclosure can be reflected back to the staff member. Saying something like, “What’s your plan for handling this?” or “Might you share this information with your supervisor?” often provides the gentle nudge needed by some staff to address the concern if it is impacting their work. If their work is not impacted, the discussion need go no further.
 
This personal health information should remain confidential. The health center provider has no business disclosing it to others — including the camp director — unless there is a safety concern. But the healthcare provider is in the position to coach staff who may require assistance or, if the need arises, be with a staff member trying to explain things to his or her work supervisor.
The bottom line is camp directors should enlist the help of health center staff. If asking MESH-related questions is part of this staffs’ routine assessment process, they will often be in a position to help a staff member decompress before things get to a critical state.
 

Where Do We Go from Here?

My hope is that the few ideas discussed have triggered further reflection on the reader’s part — reflection that results in continued improvement as we seek to hire appropriate staff to work with campers. I do not believe we’ll eliminate the challenge posed by the MESH domain; these areas are an inherent aspect of being human. But we can get better at recognizing signs of stressed individuals, providing supports so staff don’t get overwhelmed, and become more adept in our hiring and observational practices.
 
Linda Ebner Erceg, RN, MS, PHN, has over 30 years of specialized work in the area of camp health services. Currently coordinating the Certificate of Camp Nursing for Bemidji State University, Bemidji, Minnesota, Linda is a Standards visitor, frequent speaker at conferences, and co-author of The Basics of Camp Nursing. She worked for more than 30 years in a year-round camp nursing position and recently stepped back from 25 years as executive director for the Association of Camp Nurses (ACN). Contact Linda at erceg@campnurse.org or by calling 218-444-5923.