Need help drafting camp dr. request

[kcangel, LPN]

Okay,

After agreeing to rewrite our church camps nursing policies I have discovered that there is no medical director for the camp. The nurses have been operating there for years without standing orders, etc. It's possible they had some years ago but the policies I looked at were extremely outdated so who knows. The current camp director is wanting to solve this problem as soon as possible.

We have decided to draft a "help wanted" or petition to send out to the local congregations of our church to see if there is a physician out there willing to heed the call if you will.

I've been asked to assist in writing this request and wondered if you all would be able to help with any ideas that I should or shouldn't do.

It's not a medical camp but a church camp. The nurses keep all of the campers/staff meds in the office and hand them out at the appropriate times. We also tend to all of the little bumps/bruises/fractures, etc. The camps are usually 1 week long for each district.

Thanks.

angie

[edgwow]

Dear Angie,

My camp offers an annual stipend to the physician, $100, just to sign the standing orders and I call the office of the physician if I have a question, ie: hoof and mouth disease, infection control measures.( over 6 years, I have only called the physician 3 or 4 times in a summer, if someone neeeds to be evaluated by medicial dr, ie : fracture, asthma attack, I call 911.) Standing orders need to specify reasons to administer, dosage, as per bottle label directions and frequency. We also have the parents sign a form on check in day a standard form that states, I give the nurse permission to administer the following over the counter medications on an as needed basis for certain health conditions, Tylonol-headache, fever greater than 101 oral, Tums-upset stomach, Benadryl- allergic reaction, Ibuprophen- menstrual cramps.

Once the standing orders are signed, we just place a new updated sheet on the top of the old one, the first year is more work for the doctor, but after that, the physician only needs to be contacted to sign a new agreement of standing orders every summer. In church bulletin:

Church X is seeking a physician to act as a consultant for the church camp. Requires meeting with the nurse once prior to the summer and on call for medical questions. Stipend to be provided.

[kcangel, LPN]

Thanks for your reply. I have submitted a basic draft to the camp director. Now it's in his hands. Hopefully we will get a good response.

[dragonheart, MSN]

I have a question in regards to prescriptive authority/standing orders. It has been increasingly difficult each year in the MD/DC/VA area to obtain this type of order.

Physicians in this area are reluctant to sign and recommend self-medicating, as is now the standard of practice with inhalers for asthmatics.

Is the standard of practice shifting to self medicating, especially when hospitals/clinics have put a lot of effort into patient education in regards to self -medicating.

[kcangel, LPN]

I don't really know although I don't know how you would do that for minors taking OTC meds. Someone needs to make sure they have the right dose, etc.

[BonnieSc]

We haven't had any difficulty finding a doctor to sign for our treatment protocols (CA). I don't use them often, however. I'm not sure what you mean by "self-medication"--obviously I can't tell seven-year-olds to decide what OTC medications they should take--but what I do, routinely, is check the health form to see if the parents have given any directions; then ask the child what the parents normally do at home. Generally, they say "my mom gives me medicine" (in which case, say for a headache, I give the recommended dose of Tylenol) or "I just rest for a while" (and, of course, that's what we do). If I'm ever not sure, I call the parents and ask what they'd like me to do.

What is it they're reluctant to sign for? Most of ours are things like "Head injury: keep calm and bring in for exam." "Bee sting: remove visible stinger, apply ice, may use Benadryl for swelling and/or itching." Pretty standard stuff.

[dragonheart, MSN]

I don't really know although I don't know how you would do that for minors taking OTC meds. Someone needs to make sure they have the right dose, etc.

I didn't think so either,. It would seem that during the camp physical prescriptive authority could be assigned via the "family MD"

However, this is a current requirement by the state.

As I take the position, I find that there is not a physician on board and am int he process of recruiting. Nonetheless, they are thinking the same way so far....

[dragonheart, MSN]

I didn't think so either,. It would seem that during the camp physical prescriptive authority could be assigned via the "family MD"

Thanks and it seems that your hard work is proceeding well .

[edgwow]

The dosages for OTC medications that can can be given to minors are "as per label directions". The dosages for OTC medications for children are listed on the bottle. I would never give a camper any dose without speaking to a physician if there was not clear cut directions for use on the label. I always try to contact the parent by phone first, even for Tylonol, Benadryl . That is the only dosage I go by. I never give an OTC medication for another purpose than what is directed on the label. ie: no Benadryl for a restless camper at 2 AM. When the physicals for camp go out with the camp package, the parents have to have the family MD fill it out , there should be a section the MD can initial, giving you, the nurse ,authority to administer Tylonol-headache, fever greater than 101 oral, Tums-upset stomach, Benadryl- allergic reaction, Ibuprofen- menstrual cramps.per label directions.

if needed, therefore the nurse has an order for the OTC medication, just like in school.