What's you Health Screening Policy/Procedure at Check-In

teeniebert, LPN · Jun 27, 2009

We also check temperatures, heads, and feet at check-in. I set up 2 benches outside the Health Center (sometimes 3 if I'm lucky enough to have 3 helpers), each with a 'check-in basket' that contains check-off forms, written instructions, photos of head lice and athlete's foot, gloves, thermometers, and probe covers. Each camper has to take their socks and shoes off and sit on a bench to be checked. It takes about 1 minute per camper, because that's how long the thermometers take to register. Anyone who has a temperature above 99.6 or shows signs of athlete's foot or lice has to come into the Health Center and see me. After the screening, the camper or their parent/guardian is asked if they have allergies, take medications, have chronic conditions, or have been to the doctor (besides a physical or check-up) in the last two months. If the answer to any of the above is 'yes', then come in and see me. I check in all medications, re-check heads, feet, and temperatures, and make note of allergies, asthma, etc. Anyone with head lice is sent home. Athlete's foot or ringworm, they get a pair of flip-flops (if they don't already have them) and their counselor is alerted to bleach the shower stall after that camper is done using it. High temperatures get re-checked and asked about recent exposures and other symptoms. It's my call whether they're allowed into camp or not; I've only had to send one person home and she was allowed to come back after being cleared by her doctor. I get complaints sometimes about check-in taking too long, but usually parents are satisfied when I remind them that it's to protect their child's health. Also, I put up signs saying, "Please be patient--this is your LAST STOP before moving into your unit!" and that seems to help.

CampNurse1 · Nov 21, 2011

I work year round for a special needs camp, so this might not apply to many of you.

I have about 100 campers come to seven five-day sessions, so every Sunday afternoon we check in a new batch. We do our check-ins in our dining hall. The tables are arranged in a "cattle chute" fashion (a single row from the entrance to keep our families and campers on track, and to keep them from wandering). Along the way are different stations. The first station is a couple of strong camp staff, who pull the camper's chart, take their temperatures, and have the family sign who is authorized to check the camper out on Friday. They write the temp on the chart and hand it back to the family.

The next stop is with the Dietary Director, who confirms dietary requirements against a list I have prepared for him.

The next stop is with the Camp Director and his assistant, who greet them, check them off their master list, then send them to the camper's nurse. The nurses' tables are at the very back of the dining hall, since this is the last stop. I have a full time staff of three RNs or LPNs and I talk one or two volunteer nurses into helping with check-in. If possible the camper will check-in with the nurse assigned to them for the week. The Camp Director only allows one camper and family at a time at each nurse's table. If the nurse is checking in another client, the camper is sent to one of the volunteer "overflow" nurses to save time.

The camper's MAR (computerized) is in their chart. The nurse pulls the MAR, checks the camper's meds against the MAR, and does a focused assessment. "When was the last seizure?" "What?! He got out of the hospital yesterday?" "How do you like to do the g-tube at home?" Stuff like that, lol. We define a fever as 100.4, per WebMD. If the camper is febrile we keep him in a holding area, with his family, watching TV, for 30 minutes in the air conditioning and hydration. It is HOT here in Alabama and the walk or ride across the parking lot can make some of our clients febrile. We do this twice, if necessary. We do not admit if the camper is still febrile. Don't give them Tylenol.

We do a visual check for head lice (a show stopper), and wounds. Draining wounds are not admitted. Decubitus ulcers are not admitted. We politely make sure the parents understand that a wound discovered at shower time will result in a 'come pick up your camper' phone call first thing Monday AM. The final decision to admit or not to admit is up to the Camp Director, after conferring with me. Luckily for the nursing staff, our Camp Director likes happy nurses, and, we both want to admit every camper we can to this wonderful camp.

I try to have my nurses do as little writing as possible, so I spend a lot of time during the off-season preparing MARs. I call families with questions. I train my nurses to expect at least one or two of their campers to have four meds on their MARs and show up with 28! We try to send those to our overflow nurses because it will take 30 minutes to check them in, delaying those families who filled out their applications properly.

I worked at another camp once that had four and eight week sessions, and many of the campers came from the airport. Four or five of them could be counted on to be febrile and would get off the bus and be admitted straight to the infirmary, with parents unavailable on vacation. It was an infection control nightmare. I never could get camp administration to understand the nursing process, and I did not return. My first clue should have been when I asked that Camp Director who the head nurse was. He, a non-nurse, said, "I am."

Sorry for the long post, but check-in is one of the most stressful, and, most important things we do. Think about what you need to do, how you need to do it, and get organized. Choose STRONG staff to assist you. Train your team. I am lucky; I have all winter to prepare. Some nurses only get a week of "orientation" to organize dozens, or hundreds, of MARs and health forms, and prepare for check-in. Good luck, and contact me if I can help.

jenriske · Apr 12, 2012

Thanks for this information.

This summer I'm heading to a camp in NY for 3 months. I was there for the last 2 weeks of last summer's session. The camp operates in 2 ways. Kids (6-17) come on Sunday afternoon, leave on Friday afternoon. Adult special needs campers come on Monday, leave on Friday. The camp health center usually operates with 1 or 2 nurses, each only doing 1 week at a time (I was the only one who did 2 weeks in a row last year).

There wasn't really any consistency. There was no health screening on check in. The most I did at check in was make sure I had the signed MD order form and check in medications. It was usually hard to keep the camper/family attention long enough to do these things, let alone any real screening. Usually there were a couple campers that never even checked in with me.

I'm not sure how to address this. I know I'm going to be given more control this year. I'm leading part of counselor orientation this year and my job starts 2 weeks before camp does. Even with that, I don't think I'll get much actual physical support for any check in process. Some weeks I will have a second (volunteer) nurse with me.

Suggestions?

rikergirl · Apr 18, 2012

the only real screening was lice check. one staff member asks how feeling and have been sick recently.

anyone who had medication or checks of a medical condition comes to see me at my table. we dont have med orders signed by doctor. goes by what parent hands you and what is on bottle. inhalers and epipens are kept by the cabin leader so availabe quickly if needed. i do 8 one week sessions so every week is different.