Changes this year

Jun 23, 2008 08:04 AM

by Miriam57RN

This year we have a new Director who has made some changes. Last year me and another RN alternated working 11-day sessions. We were there 24/7 so there was always an RN on the premises. We had one nursing assistant.

This year, he hired two nursing assistants. An RN will only be there for 12-hrs/day. (We are alternating 7-day sessions - I work for a 7-day session, she works the next 7-day session). He feels confident because they are nursing students (it turns out that one of them is not even in a nursing program yet but has only done some pre-reqs.) and sent them for Wilderness First Aid Training.

What are the implications for our licenses? (me and the other RN).

He expects us to train them to know what they will need to know to provide services while we are not there (but on call). I am very, very uncomfortable about this set up.

Also, the campers will no longer be coming to the health center for PM meds. We are going to be preparing them and putting them in labeled envelopes in a zip lock bag which the unit leaders will pick up and administer to their campers in their cabins.

Thoughts? Advice?

M

JoshuaAdamsRN · Jun 27, 2008, 05:25 PM

Re: Changes this year

This is similar to the first camp I worked at, which was huge (~1200 campers per 12 day session). We had 1 RN, who had "office hours" during the day (like 8 am-5:30 pm), but then she was available by pager the rest of the time. The staff who worked in the health lodge was trained in Red Cross standard first aid, but there were also three EMTs.

The medication situation makes me kind of nervous, even though both camps I worked at did this. There's a limitless potential for mix-ups if you're not meticulous.

Wendy79 · Jun 28, 2008, 10:57 AM

Re: Changes this year

What is the reason for the change in PM med administration? I think that's a huge mistake. The only time our counselors administer meds is when they're out on trips, and even when I have carefully trained them in med administration, mistakes occur. I'm also concerned about the meds being unlocked during that time. And surely there are some meds that need to be administered in the health center! And what about liquids? This sounds to me like a change that's being made for a minor convenience to the counselors. I fully believe the health center should work around camp, not vice versa, but not when safety is involved to such a great extent. There's no question about this in my mind: it's wrong, wrong, wrong. Counselors are not equipped to administer medications. I very occasionally send one out for special reasons: if the kid is already in bed and getting them up would be too hard on her, for instance. When I was a counselor I had a kids a couple of times who needed their medication immediately on waking, and I kept one dose at a time with me and gave it in the unit. But multiple medications? Every night? WAY too much room for error! I have serious doubts about this camp director's understanding of risk management, to be honest.

I also like to SEE my kids who take daily medications, no matter what for. Allergy pills? Gotta assess how they're working. Anti-depressants? How's the kid feeling? Pain medication? Is it effective? etc.

As far as the nursing assistant situation goes--the impact for your licensure depends on your supervisory responsibilities and so on. I can see why this makes you uncomfortable, but to be honest, this is the reality for many camps--in fact, many camps don't have a nurse on duty at all, ever, because they are so difficult to find.

Train them extremely well in the five rights, and make very clear what kind of documentation they need to do. Make sure they understand the situations in which you absolutely want to be called for a consult. Don't personally delegate anything you don't feel comfortable with, with the understanding that the camp director might "delegate" some of those duties.

Good luck, and please let us know how it goes. I would put my foot down about that med administration policy--perhaps it would help to come up with ways to make evening med administration more convenient, while keeping it under your direct watch (or that of your trained assistants).

Miriam57RN · Jun 28, 2008, 04:30 PM

Re: Changes this year