Love Camp, Don't Love my Counterpart

[cnolan]

So, I'm having a great time at camp, I love the campers, the staff, the whole experience. I do NOT, however, love the nurse that is here on my days off (Saturday, Sunday, Monday). I came in last week after being off to find crates full of medications, no MARs made, and a complete wreck of an office. (I came in before camp started to clean the office, take inventory, clear out expired meds, etc.)

So, needless to say, I sighed and dealt with it last week. During my four days/nights here, I sent a camper for stitches, sent a staff home with pneumonia, and had other random scrapes, cuts, etc. There was one girl that I was concerned about r/t possible conjunctivitis, so I'd been using our MD's standing orders for it and keeping her in the sick bay. It didn't look that bad, but I'd rather be safe than sorry. So, at the end of my work week here, I left a letter for the other nurse, finished my bedtime meds, and left somewhere in the vicinity of 2200.

When I came back to camp on Tuesday morning (after working a 12 hour night shift at the hospital!), I once again walked into an absolute mess. I had a letter on the table that explained how I'd "forgotten to send meds to Pennsylvania with the camping kids" (which I didn't, actually, they had been sent the day before with the staff), and "don't worry, I covered for you and shipped them". Now, had he called me or emailed me, I would've told him that the box in the cupboard was extra meds for the next out trip planned. GR. But the worst part was the hand written note that said, "This kid came in tonight with a hurt thumb. I suspect he needs medical attention, but it's 9:20 p.m. and I have to go. I don't have time to go find him. Please see him in the morning."

(*@#&$(*($*$!!! :argue:

So, of COURSE, I called him right away and asked 1) who the kid was, 2) where was the documentation, and 3)what on EARTH!??!! So his answers were 1)I don't know his name, 2) I didn't document because I didn't have time, and 3) I think it's dislocated.

Anyway, after much searching, I found the kid with the injured hand, called the MD and his mom and sent him for xrays. It turned out just to be a bad contusion, but I'd really angry - I don't want to be the one who's license is on the line if a parent got it in their head to sue the camp. This other nurse just graduated this month, is a GN, and really has no clue what to do. (His letter actually told me "I had a great time relaxing and fishing this weekend!) Now, I have nothing against GNs because I was one three years ago, but I do have a problem when you're leaving all the work for me to do, leaving a potentially dangerous problem because you "don't have time to take care of it", and when I searched through the med crates, found a controlled substance not locked up!!! :angryfire

I spoke with admin, but if it doesn't get better, I won't be here for next session. I love the kids and the job, but I also love my license too much to lose it over summer camp.

[BonnieSc]

What have you talked about with the administration? Many camp directors know very little about nursing and won't know what to expect. Put it in firm, but not overbearing: the nursing care is unsafe, you're afraid the camp will be sued, and you're very sorry, but you won't be able to stay unless the GN's work improves.

I would expect the camp director to react strongly to the medication that was not locked up, as that is against state and ACA rules. The incident of the medications you "forgot" to send sounds like a simple misunderstanding, although his manner was rude.

Are you supposed to be supervising the GN? IMO, he should get a "shape up" talk and then one more chance.

[cnolan]

Thanks for the reply. Actually, this camp is not run very well at ALL! When I requested a lock box and a safe area for the controlled meds, all I was answered with was, "Well, the nurse is in here and when she isn't, the door is closed.".

Um, no. GR.

As far as the GN goes, I am not his supervisor, so he is on his own. Today I tried to find my splinter removal tweezers (which are suddently missing), and opened up the first aid kits he stocked and found just ziplocs of pills without instructions, doses, ex. dates, lot #s, etc, and ALL OF OUR EPIPENS. So, I wrote him a polite email telling him that those need to stay in our cupboard unless the kit is out of the office in case of an emergency. (What I wanted to say was that I don't have time to be rooting through first aid kits if a kid comes in in anaphylactic shock!!!)

I forgot to write earlier that when I told him of my possible conjunctivitis kid, he said, "Well, if it's draining, I don't have to worry, right?" Um....NO. That is when it is contagious!!!

I just feel awful because I do like it here, but I don't have time to do my work when I'm here, let alone all the work he leaves for me, and the work that needs redone after he leaves.

I think I am going to put in my two weeks next Monday - that will give them three weeks to find a substitute before next session.

[BonnieSc]

Yes, I think you should leave, based on what you describe. This camp is not following state law, if it doesn't have a locked cabinet or box or pantry for medications. I am less concerned about the GN's lack of knowledge than about his failure to chart and failure to keep meds labeled and in the proper place. I hate to think this is happening at any camp, but I can't help thinking "my g_d, I hope it's not a Girl Scout camp!" Based on what you describe, the camp director is equally or more culpable as the GN. If you like it at camp, I strongly encourage you to find a DIFFERENT camp next summer. Good luck--

[CampNurse1]

Here is the problem: There is no Head Nurse! A group of nurses, even two, cannot work well without someone being in charge. At your camp, the Camp Director, a non-nurse, is functioning as the Head Nurse.

I have worked for three camps. I'll share my experience with CDs.

The first one was in his early 30s. He didn't have a clue about nursing, which is fine, it should not be expected from someone who didn't go to nursing school. He was in a bit over his head running the camp, so he pretty much left me alone. I was the only nurse, so not a bad situation.

The second CD was part owner of a for-profit high dollar camp. I was part of a staff of four nurses. Before camp started, I asked who the Head Nurse was. The CD answered, "I am." I should have left right then and there but I put it aside. The CD, or his wife, was constantly dictating dx and tx for our campers. Give this or that drug, no that one cannot go to the doctor. When, during the same day, the CD said, "That's not a fracture, it's a sprain." and "We can take care of that camper (104.5 fever!) in the infirmary." I gave notice, and advised him that he was practicing without a license. I then called, as a mandated reporter, our Dept. of Family & Child Services to see about getting the febrile camper to a doctor. Not a happy time. I swore off camp nursing.

The next fall I realized I still had the camp bug and found a position for a year round nurse. My third CD told me at the interview, "I'm not a nurse and I expect you to run nursing. If it has to do with nursing, what you say goes, but let's work together on it." This CD lets me practice on the wellness model, that is, illness and injury are not considered normal. We look into causes on each case with an eye on prevention. I am allowed to run strong infection control here. We have outcomes that support our practice of evidence-based nursing. I am allowed to hire, fire, and manage our summer nursing staff without interference. I hope to be working for this CD for many years.

You are at the wrong camp. It's too bad, but it takes some tough experience to learn the right questions to ask at the interview. There are great camps out there, and there are some camps that should not be in business.

Good luck!