I've waited a few days to post, hoping to find a clear way to write about a very complicated issue.
KA-THUMP! That is the sound of the nurse being thrown under the bus when things go wrong! We nurses are just hired hands, while Camp Directors, full-time employees, and Boards of Directors have a deeper investment. They are not going to let any incident threaten their jobs or their camp. Human nature being what it is, it will be the nurse, now long gone, who ends up "taking one for the team."
It is complicated and simple at the same time. The complicated part is to know how to pick your battles, what to let slide. The simple part is falling back on our training, and practicing in a proper, defensible manner.
I have run into CDs that loved to practice nursing, dictating medications and treatment, and wanting me to practice based on their untrained assessment. One I was able to gently educate, the other I ended up giving notice and leaving at the end of a session. I should have notified the state board about that guy. In my article "How to Choose a Camp" this area is a critical part of the interview process. "Who is the boss in the infirmary?" The only good answer to that is, "The nurses are." Anything else is a huge red flag.
It is not a bad thing to read the particular state's nurse practice act. My state, much to my surprise, even had a section on camp nursing. Repackaging, always risky, is not illegal in most places. It is here. This section of our nurse practice act has been "bullets in my gun" when changing traditional, set in stone practices that no one here knew were illegal. But it took some doing!
I think it is best to not fight any battle that does not have to do with nursing practice. I am often asked, sometimes at the last minute, to change the location of a med pass to help with keeping this or that programming smooth. Sure, I'll show up with my nurses in a pirate hat and tutu (don't ask) if that is what is needed. But, even in a pirate hat, I expect my nurses to pass properly, safely, and to follow the 7 rights of med administration. Then I can sit in a witness stand and defend myself if something goes south.
Non-nurses giving medications while nurses are around give me a cold chill. Some people, going on a stereotype, think they know how to nurse without the bother of nursing school. Nursing without a license in any state is a criminal act; these people neither know nor care. I do not have to tell you brother and sister nurses that giving even a Tylenol or Benadryl without doing an appropriate assessment is a recipe for disaster. Lay people at camp do this all the time. When a non-nurse (forbidden at my camp) gives a med or provides other nursing care, I would document that they, not you, did it. Let them defend their practice. I would certainly not sign off on a med someone else gave, not ever.
This kind of practice is tempting to lay people because, let's face it, they nearly always get away with it. They've been giving Benadryl for years and nothing bad happened. "He has a fever, I'll give him Tylenol." Did they check for allergies? How high is the supposed fever? What is the client's fluid status? Did they check the dose? Does the client have a Mic-Key they can't see? Did they check the last time the client was medicated? Did they document what they did? If anything does go wrong, the CD will say there was a nurse present.
Repackaging, one nurse pulling meds and another administering (maybe not even knowing what he is giving), not using proper identifiers, etc., is all pretty risky. Would you accept a syringe that another nurse tells you is 10 units of insulin? Would you administer it? Would you accept a lay person's assessment? Bad news in the hospital, bad news at camp.
What makes it tough for the camp nurse is that you may find yourself in a bad situation that has been going on for many years. It is mighty tough to fight city hall when you are a 6 week employee. Voice your concerns respectfully, and if that does not work, you must pack your bags and go. Why risk your license, your ethics, and your well-being for a summer job? I think the CD that fired the nurse did her a tremendous favor. I also think there may be more to the story.
As for the camp counselor that did not bring a camper because it was only an allergy medicine, I would say nothing to the counselor. Obviously, this is not his decision to make. I would talk to the head counselor about it. Always be best friends with the head counselors! I bake for them during the summer.
I am fortunate in that I am in residence at camp year 'round, so I am better able to craft the nursing culture than a temp hire. I advise summer nurses to find out during the interview about nursing practice. Ask specific questions.
In short, be flexible on non-nursing matters, draw a line in the sand when it comes to how you practice. I work for a big charity, and yes, people even sue charities. KA-THUMP!