When do you medicate?

[BonnieSc]

A camper comes in with a headache. How do you decide whether to give her Tylenol, have her lie down and rest in the health center, or tell her to go back to her group and drink some water?

This is one of our biggest challenges. The health forms make interesting reading, because we get the parents who are afraid we're going to medicate their kids too readily ("no over-the-counter medications! ever!") and others who are afraid we won't give their kids medicine if they need it ("if she says she has a headache, give her medicine. Do not tell her to just drink water"). Most of the health forms, of course, do not give such specific instructions. They just give us permission to use OTCs when the situation calls for it.

What do you do at your camp (or expect to do, if you haven't been yet)?

[purplemania, BSN, RN]

assuming there is no health history of concern, I would try the simplest things first. If that works, you don't have to worry about side effects to meds. Also it would teach the child that a pill is not always the answer.

[glascow]

I think it would depend on the age of the camper. Ask them what they normally do when they get a headache (this will help you see if the parents normally them give them tylenol), and also ask them if they want some medicine, or do they just want to wait and see if it will get better with non-pharmacological treatment. Give them the choice.

[live4today, RN]

Have them drink some water, lie down for maybe thirty minutes with the lights dim, then reassess them. They may just need some cooling down time if they've been outside playing hardy in the hot sun.

If they still have a headache after trying the above, you can always contact the parents for their suggestions on what their child might be needing. That way they can't accuse you of trying to medicate their child unnecessarily.

Also, keep in mind the age and sex of the child coming in with the headache. Girls will present with different reasons for having headaches, cramps, possibly starting their monthly menses, and both boys and girls could have migraines the parents aren't aware of, or perhaps forgot to mention. It's tough to tell with kids. You will just need to assess them individually based on the health history the parents provided, the age and sex of the child, and/ what's going on in camp that day that might be bothering them. :)

[BonnieSc]

I generally do what Glascow describes, unless I have further information. Because our girls only come for a week at a time (sometimes less), I try not to keep them in the health center unless it's really necessary... if I have them lie down to see if the headache goes away, they might be missing their one chance to try archery that summer. I always ask what the next activity is, though. If they've planned to play volleyball, I'll always suggest that the camper sit in the shade for at least a little while. If I had kids who were at camp all summer, I think I'd be a lot more likely to keep them in the health center.

I always ask the camper how much water she's had to drink, too (and not just "lots"--I ask to see her water bottle and then have her tell me how many times she's filled it. They have funny ideas about "lots"!). Even if I do decide to medicate, I try to impress upon her (and her counselor) how important it is that she continue to drink water. Our camp is VERY hot and dusty!

Thanks for your responses. Camp nursing must be one of the more isolating branches, since so many camps only employ one nurse, and so I seldom have people to bounce ideas with.

[marybethm]

I generally would ask if they're nauseous, check if there's a temp or another reason for a headache, like it's so ungodly hot out or trouble somewhere. I don't mind giving tylenol. I give it to my own kids when they have a headache....I don't really think we're going to teach them anything by not giving it. If they came in every four hours for it, or every day, then I'd rethink it, but holy cow, those kids are so busy all day and sometimes it is so hot you wonder that they all don't have heat stroke. I always had them wash their face and hands with cold water, too. Sometimes if I wasn't busy I'd have them soak their feet in cold water to cool off.