Choosing a Camp - page 3
by CampNurse1 7,391 Views | 24 Comments
I've been meaning to write this for some time. Spring will be here before we know it, and many nurses are looking for camps to work at this summer. I hope this will be seen as an open-ended thread. I am eager to read the... Read More
- 0Jul 23, '13 by SnowShoeRNHey everyone! I just wanted to check in (it's intersession right now so I have a few - wonderful - days off to rest before the next 3 1/2 week session starts). So yeah, I've been working at a camp since the end of June and as another poster predicted, I've become hooked. I absolutely love it. I seriously did not think I would love it as much as I do and I really do believe that I would not have had such a wonderful time if I didn't have the kind of experience I've had as a nurse.
It's a fine and manual arts camp, so we definitely get some pretty intense injuries. Nothing super super bad yet, but the camp has powertools and there are sessions on whittling, welding, and things like that. So in addition to the normal cuts and scrapes I've seen some 2nd degree burns, bad whittling cuts, a really bad rib injury (thankfully they weren't broken) and a counselor who got his pinky nail ripped off trying to move some boards. Ouch!
But there's also been some other interesting ones I didn't expect. 2 ruptured eardrums, 2 ear infections, 2 strep-throats, lots of viral pharyngitis, a pneumonia, a Lyme Disease, food poisoning in a counselor, a panic attack lasting an hour, a hyperextension injury, a few infected abscesses, a sprained ankle, and - by far the coolest - a porcupine quill stuck in a camper's knee! She was crawling on the ground and knelt on a porcupine quill. Definitely a first in my nursing career.
I've also come to realize that this is tremendous practice for me as I enter the clinical year of my NP program. We do have a camp doctor who I met for the first time a few days ago, but I really don't consult with him and I'm the only nurse working. 90% of my "diagnoses" have been accurate and I've successfully diagnosed pneumonia, bronchitis, strep, and ear infections in kids and counselors before sending them off to urgent care for it to be confirmed and for them to receive a prescription. I feel so much more confident in my nursing abilities and adore being in the middle of the woods. Not to mention all the love and hugs and thank yous and little gifts I've gotten from the campers and the friends I'm making with the counselors and leadership staff.
It's fantastic. I hope I can come back next year, but let's see how the rest of the summer goes and what this coming year will bring. Thanks so much to all of you.
- 0Aug 7, '13 by CampNurse1SnowShoeRN, I am glad you are enjoying your summer. Camp nursing is pretty amazing, to say the least. Come and work for me next year, lol.
I want to respectfully bring up an important point. I go to great lengths during orientation and during the summer to keep my nurses from getting outside their scope of practice. As nurses, we are getting onto dangerous ground when we diagnose and treat. Diagnosing is fine until the nurse is wrong; we've all been there. If you are wrong, no one will hesitate to throw you under the bus. Not the camp, not the staff, not the parents, not the patient. If a nursing diagnosis or standing orders won't serve, I at least consult our medical director. Stick to reporting signs and syms. As we used to say in the army, "Stay in your lane."
Lay people tend to think we nurses are "mini doctors." That's why they come into the health center and say things like, "I need an antibiotic!" I spend time every off-season gently educating our staff about the difference between medicine and nursing.
And while I am at it, don't give in to the wacky treatment suggestions the staff or Camp Director might give you. I remember setting up an Albuterol breathing treatment from an O2 tank, per standing order, on a wheezing camper with a sat of 97%. The counselor kept insisting I give the camper his rescue inhaler. I'm thinking I'll have this set up in about 30 seconds, and I did. The counselor, during the breathing treatment, pulled out his cell phone, called the camper's mother (his cousin), and shouted into the phone, "The nurse ain't doing right!" I took the phone, and listened to the mother screaming at me until I managed to explain what I was doing. The camper stabilized quickly and left. The scene between the counselor, the Camp Director, and me was not pretty.
- 0Aug 10, '13 by SnowShoeRNHi campnurse1,
I didn't mean to imply that I diagnose in an official way or work outside my scope of practice. That's why I put "diagnose" in quotes. It's more like I assess a patient based on what they tell me, what I know from my experience as a nurse, as well as info learned in my advanced assessment classes, and just kind of say to myself (for example) "seems like they might have strep" before sending them off to urgent care to be evaluated by an MD, PA, or NP. I do the same thing when I know something serious is going on, but have no clue what it could be or just want to be on the safe side. Our camp doctor never visits the camp. He did once just prior to intersession and I've called him 3 times - once to ask his opinion on ranididine dosing for an 11 year old with gastritis, once to ask a question about 2nd degree burns, and once to ask if there was an appendicitis physical exam tactic I was forgetting aside from the psoas and obturator tests. (I didn't know about the standing on tiptoe and thumping down on the ground with your heels).
I'm just pleased that, so far, I've manged to be right in my assessments. I know I won't and can't be right 100% of the time, and I'm certainly very cautious. Like refusing to administer ear drops from a camper's brought-from-home mason jar labeled "boric acid" and distinguishing between asthma and panic. But my "success" (again, in quotes) makes me feel good and more confident about being a NP 9 months from now.
Thanks for your input. You're definitely the camp nurse guru around here and I've enjoyed reading your posts for many years. (:Last edit by SnowShoeRN on Aug 10, '13 : Reason: forgot to include something
- 0Aug 12, '13 by CampNurse1You sound very wise, SnowShoe, and a good nurse. I was mostly speaking from my own experience; I have made my share of mistakes over the years. I do my best to only make them once, lol. Thanks for the compliment. This board is a great place for us to share our experiences and become better nurses.