Lost T3 at camp

Miriam57RN · Aug 5, 2007

Hi Jewel,

Do you mean the whole prescription bottle of Tylenol #3 was missing? I don't like the sound of it. Do you know if it was paid for under camp insurance, or the parent's? Either way though, it should be returned to the parents when the camper leaves camp, as all other meds are. The parents also should have been informed about the camper's visit to the doctor - why and what was done or prescribed.

I just came off of working two 10-day sessions as a camp nurse this summer and would have loved to have had a nursing student as my assistant. It's a camp for underprivileged NYC children - between 800 - 900 children come through the summer over 4 sessions. Many from foster care or group homes. Lots of meds, injuries (fights and other situations).

I was the only RN there, my assistant was a college student (not a nursing student) who, since she helps a relative with insulin dependent diabetes, thinks she knows how to be a nurse and basically was given responsibilities by the camp enough to "play nurse" for the whole summer, such as administering meds and doing treatments. I would have been much more supported by her keeping the infirmary clean (she didn't) and the supplies refilled, etc. The other RN who worked the other two sessions (1st session and will be doing 4th) is 75 yrs. old and has delegated more and more responsibilities to untrained staff over the 7 yrs. she's been there.

This was my first summer there and first time working camp. The "nursing assistant" came for orientation before camp started (I had none except one day in the health center with the other RN), and was there for the first session thus had already built up a rapport with the young (high school and college aged) staff, so I had the extra challenge of reigning her in (while I myself was new) as she presumed to make nursing judgements. She was young, cool and hip and the staff and campers would come in looking to her with their physical c/o in the beginning because they knew her and she had a good pretense as "nurse".

A nursing student assistant would have had a much greater awareness of her limitations and the seriousness of making what should be professional nursing judgements. On the last day of 3rd session I saw a female staff member walking out with yellow coban wrapped around her wrist like an ace bandage. The "assistant" gave her this 'pretty colored' coban behind my back (she wanted yellow) and I had to stop her and have her take it off as it's not made for that (can restrict circulation) and she didn't even need an ace (let alone a coban). This is only one example.

This same "assistant" had said "I heard of a place in the Bronx where you can become a nurse in 4 months" (it was probably a CNA course) - she obviously highly underestimated the profession and what it takes to become and to be a (real) nurse. One night I was in the med room and overheard a 12 yr. old boy ask her if she was a registered nurse. She said no but did not reassure him that there was an RN present (me).

If they want me back there next summer, I'm going to have a good talk with the director and asst. director first about how the (one lone) RN can really be supported... certainly not by people allowed to play nurse all summer who neglect the duties that would really support the RN such as cleaning, restocking, taking information etc. A nursing student would be a much more appropriate assistant to give clinical duties to, under the teaching and supervision of the RN... especially if she (the assistant) did her other duties first. I saw 50 - 60 people in the health center daily and had to expend a lot of energy on things that should have been looked after by the assistant. I also lost sleep because of her late night phone calls (this was reported and came to an end) and one night one of her friends came by at 1:30 AM saying she had to give something to her - but really came to sleep in her room. Her unit leader came to the door at 6:00 AM looking for her (waking me up yet again in the process) - she had broken curfiew that night and didn't go back to her cabin. I had also woken up a couple of hours earlier at 4:00 AM with a splitting H/A (Excedrin H/A #9). This girl caused me more stress than support. I'd rather work alone than have someone like this "help" me.

Anyway, I have a new appreciation for nursing students now. And aside from all of the above - I love working with this population of campers, and hope to return - but with some new rules and guidelines in place...mine. I left there on Friday and am still thoroughly exhausted and drained. It doesn't have to be like this.

What state do you live in? I'm in PA.

CampNurse1 · Nov 30, 2011

Wow! As far as the lost Tylenol #3 goes, this should be reported to the Camp Director. I hate to start counting meds at camp, but I see the day coming. I strongly discourage controlled substances here just for that reason.

I had a similar experience with an assistant who wanted to play nurse. After some pretty inappropriate behaviors, I informed the CD I had no further use for her. He met with her, and asked me to give her another chance. She came back to me in tears. It was against my better judgement, but I agreed.

I decided to try education. I sat with her and told her she was practicing nursing without a license, a criminal act. I laid out her duties and let her know this was her last chance.

I could tell she was trying, so I found myself explaining what I was doing with campers as they came in. We spent down time talking about the nursing process, the differences between signs & sims, nursing vs. medical dx, etc. One morning I opened the med cabinet and told her to pick out any med she wanted. When the med was picked, I told her the intended action, adverse reactions, side effects, and the possibility of paradoxical reaction,and contraindications. "Sweetie, a good nurse has to know these things about every drug in the med cabinet." "Did you know I have to think about seven things before every I give every single med?" Then I explained the seven rights.

"What kind of wound is that?"

"I dunno, a cut?"

Then, I explained wound classification, staging, and care options. I wanted this girl in awe of nursing, and, eventually, I succeeded. I talked about long hours in clinical making beds, and cleaning, and why clean is the most important part of infection prevention. Clean may have saved more lives than PCN.

To my surprise, for the rest of the summer, I had the cleanest infirmary around, and, I found myself with a truly helpful assistant. I encouraged her to consider nursing school.

This won't work with short sessions, and some things simply cannot be fixed. In that case, tell the CD you can't use this "assistant," and work alone. Remember, if you are on-duty, you are in charge! Every brick, medicine, door hinge, and person in the Health Center is yours. Without this leadership, safe and therapeutic nursing practice is not possible. If the CD, or camp culture, prevent you from exercising your leadership responsibility, try education. If this does not work, a change in your camp employment should be strongly considered.

Some camps do not let us practice nursing. They want us to practice a civilian stereotype of nursing. That kind of camp culture is toxic, and, when something goes wrong, will hang the camp nurse out to dry.