Creating a Healthy Camp Community.

Health care staff can provide training and guidance

Camp counselors are wonderful organizers, great playmates, and creative thinkers, but usually the domain of taking responsibility for their camper's wellness is one in which they have limited experience. Yet, the expectation is that counselors are responsible for their campers' well-being. Fortunately, the health care staff can offer much-needed support for counselors. Through precamp and in-service training, the health care staff can alert counselors to problems and support them in providing a positive, healthy environment for campers.

Some areas that the health care staff can assist with include:

* daily hygiene issues of young children

* basic understanding of common chronic illnesses that their campers may have, such as asthma or epilepsy 

* observational skills to detect illnesses in their campers

* some elementary public health tutoring to keep their cabin group as healthy as possible

* a review of OSHA medical standards

Counselor Challenges

Taking responsibility for campers' health requires counselors to carefully observe the subtle changes that take place in their campers as they interact with them on a daily basis. This level of observation requires listening to the intuitive part of the brain that says something is not quite right, let's get a second opinion.

Consider where counselors are in their own developmental growth. Many counselors have never had to take care of anyone but themselves. They are working toward individuating themselves from their family of origin and trying to be as different from their parents as they can. The thought of being responsible for someone besides themselves can be daunting.

To that, add the dramatic change in the type of campers who arrive at camp these days. Medical advances now allow children who twenty years ago would have been essentially home bound to fully participate in camp activity. Campers are also coming from a more global cultural mix, which adds another dimension to the complexity of today's campers.

Parent expectations

Parents also present their own expectations for their campers. Many times full information about a camper's medical condition is not given, possibly because parents are trying to normalize their child for fear that they will be prejudged and not given a fair chance in a cabin. Parents also bring different expectations of how health issues should be handled. In some families, colds and other viruses are rarely treated with anything more than chicken soup, while other families bring out over-the-counter medications at the first sign of a sniffle.

You are asking counselors to be responsible for their campers' health and safety, but are you giving them enough information and support for this complex task? Recently, much emphasis has been placed on the safety aspect of counselor training. Now is the time to include basic health education given by a health care professional.

The focus of health education should be toward giving enough information so counselors understand their campers' situations, understand their piece in helping campers stay healthy, and recognize the changes that may require another level of intervention.

Planning Counselor Training

So, what is the best way to incorporate your health center professionals in supporting the counseling staff? The first place to start is including the health professionals in the planning of both precamp and in-service staff training. An outline of topics that need to be addressed by the nursing staff can be worked through to compliment other areas of staff training. Suggested areas should include:

* Signs and symptoms of common camp illnesses, awareness in change in status, visual inspections of the campers, listening to their concerns.

* Basic OSHA blood-borne pathogen orientation.

* Information about how to keep campers healthy, including sleep needs, hydration, daily hygiene, and elimination habits.

* Eating habits, both good and bad.

* Where, when, and how to access health care on camp.

* Discussion of medications and who can medicate a camper.

* Counselors' responsibility in an emergency.

* A discussion of the resource information available from the medical staff.

Once planning and outline are in place, presenting the information to the counselors in an engaging open dialog form that is understandable as well as inclusive sets up the atmosphere for future interactions. A great opening line to catch their attention would be, "This information could save your life." Time should be allowed for questions and answers from staff.

Other training ideas

The health staff can also be a resource to counselors and staff members in several other ways.

* By education, the health center personnel bring a maturity and intuitive thinking critical to providing a unique perspective to problems.

* In chart review, the health care staff identify campers with chronic illnesses and pass this information on to the cabin counselor, with basic education and cautionary information if needed.

* In helping with challenging campers, the nursing staff can address the intimate mind/body connection of the camper. The nursing staff should keep careful documentation of active plans to help a challenged camper.

* The health center should be documenting accidents around camp and suggesting interventions, if needed.

* Staff training should include the health center staff addressing basic hygiene needs, such as clean fingernails and hand washing, and emphasize public health issues, such as health dangers of sharing of personal items. A large portion of camp "viruses" can be stopped by the simple action of hand washing before each meal.

* The health staff can provide a safe haven for counselors with adjustment problems or stresses outside the camp community.

* The health center is an extra set of supervising eyes during the daytime.

* In conjunction with the counselor, the health center staff can be a conduit to parents for information concerning camper well-being.

* Health center staff can help counselors remain safe by supporting and instructing them in OSHA standards for body fluid exposure and cleanup.

Health Care Staff as a Resource

Another area the nursing staff can support the counselors is during their medical chart review. Medical information that is critical to help campers enjoy positive camp experiences may be gleaned from their charts. Campers with special needs, chronic illnesses, or idiosyncrasies such as sleepwalking or bed-wetting should be brought to the attention of the head counselor and cabin counselors along with pertinent information to guide them in supporting these campers.

As the need arises, the nursing staff could explain a camper's chronic illness and the extra support or preventative measures that might be required. For example, preparing counselors for a camper with epilipsy and the possibility of seizure, though an unlikely occurrence, would reassure counselors of their capabilities and help them support the rest of the cabin. This also helps demystify a camper's condition and helps the counselors feel some level of control and support.

The nursing staff, by virtue of their job, also keeps careful watch of emerging illness patterns on camp. If a particular cabin is experiencing more illness than the rest of camp, the health center will collaborate with the counselors to try and solve the contagious outbreak and make recommendations for change if indicated. In the larger picture, the health center looks for camp-wide patterns in accidents and illness with the same goal of making camp a safe and healthy place for all involved.

The benefits to both the counselor and nursing staff to have a cooperative relationship is well worth the extra effort and time it takes. The nursing staff will sense that the counselors who spend the most time with the campers are being vigilant, looking for the subtle changes that may indicate a change in physical status.

In addition, counselors feel empowered and find a new advocate and support system for their challenging job of being surrogate parent, teacher, friend, and guide. By helping campers learn health responsibility, they will have a fuller camp experience and parents will have the reassurance that their campers were well cared for. Counselors want to be successful in their responsibility and the added support system already in place can make a difference in how they view their success.

Nancy S. McMillan, RNC, FNP, is the founder of campercare, a consultation service. For the past eleven years, she has worked as a camp nurse at YMCA camp Sea Gull in Arapahoe, North carolina. She is also the author of Camper Care counselor Quick Reference.