Diabetic issue

[MrsMig, BSN, RN]

Okay -- so I leave for camp this coming weekend and I am all ready faced with an issue :::sigh:::

I have a camper, 15 y/o who is a controlled diabetic on a pump. I have been in contact with the parents and they have informed me that in the past, this camper was allowed to carry her diabetic supplies on her person at all times and only check in with me in the evening. Obviously, I was not comfortable with this and contacted the previous nurse. His response was, "that did not happen." Sooooo, I'm obviously dealing with a camper & parent who feels they should not be keeping all sharps, testing supplies & supplies @ the infirmary. I have not contacted mom and am trying to finalize what I'm going to say to her but am hoping that someone might give me some guidance of a foolproof statement (so to speak) that they can not argue with. I'm comfortable with the camper coming and going and testing on her own (as mom requested) but it's the whole bloodborne pathogen issue and safety of sharps (although potentially minor) to the other campers.

Any insight? Mom may take it easily but I'm trying to be prepared before calling her and I want to inform her that ALL campers are my #1 priority but didn't know if anyone had some documentation or wording that supports this in the Camp environment. I mean, we all know this girl has to check and keep all supplies in a school setting....camp is also a controlled environment but what regulations can I refer to?

[CloudySue]

I would think that the camp has a policy that all meds and medical equipment must be locked up in the med room at all times. I believe that's an ACA regulation. There should be a parent handbook or list of rules/regulations that they are automatically agreeing to by enrolling their child at that camp. A rule like that would be non-negotiable. Even the counselors have to keep their stuff locked up. Speak to your director to back you up. If the director does not back you up you might have to go with the flow. Some camps kiss up to the parents, others hold tight to industry standards. Hopefully you have management in your corner.

If you have to really be convincing, the camp's insurance agent could back you up too.

[bethm214]

I agree that all medical supplies must be locked up. The only things I allow to be under the camper's control is the actual insulin pump (with a letter from the physician that it is to remain with her at all times) and inhalers that come with MD orders for them to be self-carried but used under the supervision of an adult and reported to the medical staff as soon as feasable.

[tashacorinne]

I volunteer yearly at a children's diabetes camp. We keep all of the medications and supplies in the infirmary (insulin, pump site change items, other meds). As for testing, every counselor has a testing kit and small sharps container (which is actually a urine sample cup that they empty regularly). I don't know how your camp works, but I think there should be two accesible testing kits for this child. One with a counselor that will be around her most of the time, and one in the infirmary. If the kid is out on a hike or doing an outside activity away from the infirmary, she will need quick access to her testing kit.

[Alex Egan, LPN, EMT-B]

Bring your camp director in on this issue immediately. I agree injection supplies and other medication muse be secured. Perhaps they could be stored some place more convenient than the health center, but they must be regulated somehow.

[smurfynursey]

What about a lock box with 2 keys...one for you and one for the head counselor?

Just a thought....

[PediLove2147, BSN, RN]

I don't see an issue with the insulin and extra supplies being locked up but the child will need to have testing supplies near by, at all times.

Could the counselor have a kit in their bag? They sell small sharps containers if that is a worry. The counselor should also have a juice or something in case of a low blood sugar. You of course could be contacted but if the child is 55 they should have quick access to something.

[MrsMig, BSN, RN]

Thanks for all the replies. The short version? I had the parents obtain a MD order stating meter and strips should be on her at all times and that she is monitoring BGS w/o medical supervision (as they wanted her to randomly check in). All insulins, sharps & waste are kept with me. So far, so good. She's actually very capable ...but as you all know, it goes beyond that in this type of setting. Oh and my camp director was useless. I just took control as I got no guidance from anyone... Soooo although it worked out, I wonder if this is the place for me long term??! Any how, thanks again!