health and wellness 9

For this assignment you are a camp director who runs a camp. you need to address the health and wellness of your camp.I have attached soem resources to hep. please answer number 1 and number 2 Please respond with 250 words per question

Assignment

1. Where does your health center fall on time continuum illustrated in the lesson? Is your camp where you want it to be? Why or why not? If not, what are you going to do to resolve the situation?

2. What other knowledge and/or skills must your healthcare provider have at your camp – considering your program and campers?

resources:

Resources attached :

Health and Wellness

Healthcare Personnel

The health and wellness of campers and staff is clearly one of the most important responsibilities for camp directors. It is a tremendous responsibility to be trusted with the health care and safety of campers and staff. The most impressive physical health center with sophisticated medical equipment has little value if it doesn’t have a well-trained staff of competent health care providers. Careful planning around camp goals for health care, the population of campers, and your contract with parents for health care can result in a well-balanced health center that is flexible to the camp’s needs, provides excellent care, teaches responsibility, and adds to the positive camp experience.

The camp administrator holds primary responsibility for health care planning; however, planning should be done with input from key people such as the camp’s supervising physician, the camp’s lead health are professional, and the camp’s insurance (liability) carrier. With the input from these persons, the camp administrator should develop a comprehensive camp health plan, which defines the scope of health care the camp will provide, the various positions required, written job descriptions for health-service positions, a supervision plan for staff and campers, what parents are told about camp health services and how that is communicated, the external camp health services required, and signed medical protocols.

In developing a camp health plan, a director should not only consult with the camp’s physician and principal health care provider, but also examine related literature. A review of the standards of the American Camp Association related to health care is critical. As well, a review the Standards of Camp Nursing Practice provides more detailed information, especially from the suggested practices relative to the principal health care provider5. (Ball & Ball, p. 246)

Health and Wellness – Healthcare at Camp

Camps vary in their healthcare needs based on clientele, type and length of program, number of trained healthcare providers on the camp staff, and distance from professional medical facilities. All camps need a well-thought-out healthcare plan to provide for the needs of campers, staff, and rental groups. Potential health risks to the clientele need to be identified and evaluated, and plans for prevention and care need to be specified.

Camp Healthcare

There are three broad functions of a camp health service:

  1. To manage resources for health care. The purpose of this function is to maintain an effort to promote a healthier, safer camp community and to make policy decisions in the area of camp health. Tasks include defining the scope of health care which the camp will provide, writing job descriptions for health service staff and supervising that group, determining budget, deciding what parents are told about camp health services and how that is communicated, arranging out-of-camp health service, signing medical protocols, and defining the chain-of-command of health-service personnel. These elements comprise the function of camp health care administration, and it is most often fulfilled by the camp director in collaboration with the camp’s supervising physician; however, in a very large camp or a camp serving a population with special medical needs, duties may be assigned to the physician-in-residence at the camp.
  1. To provide care. The purpose of this function is to meet the individual health care needs of staff and campers and to manage the health of the total camp community. Tasks include medication management; screening practices, assessment, care, and evaluation of illness or injury situations; surveillance of the camp community health concerns; collaboration with out-of-camp providers to support recovery of ill or injured individuals; collaboration with other camp staff to provide a safe and well camp experience; collaboration with camp administration in an effort to improve camp health practices; and communication with external medical and health resources. This function is often performed by the camp nurse or camp physician, as the camp health care provider.
  1. To respond to emergencies. The purpose of this function is to develop, implement, and evaluate the camp emergency-response system. Tasks include plans to be followed by camp staff for site emergencies and coordinating with external providers. These tasks are usually identified by the camp director and completed by a group of camp staff, including the health care personnel. Persons with training in CPR/AED (cardiopulmonary resuscitation and the use of an automated external defibrillator) and certifications in aquatics and wilderness medicine often are involved in this process (Ball & Ball).

According to Linda Ebner Ergeg, all camps need to clearly identify two positions:

  1. Health services administrator: The person who develops the health care plan and coordinates all health services functions and promotes health and wellness best practices for staff and campers. This position is responsible for the first functional area of health services. The position might include overseeing health care but more often coordinates various health care providers.
  2. Healthcare provider: The person or persons with day-to-day responsibility to implement the healthcare plan and promotes health and wellness best practices for staff and campers.

In choosing your healthcare provider or a nurse, a careful examination of the individual’s experience and approach is critical if it is to be a good experience for both the camp and the healthcare provider. For example, a nurse who has spent an entire nursing career in a hospital or doctor’s office may be reluctant to take any step in a camp health center without direct, immediate orders from a doctor. Experience in an emergency room, as a school nurse, or in pediatrics is more likely to provide the experience comparable to the camp health situation. The healthcare provider also needs direct experience in first aid, because many of the minor ailments of camp life require that sort of attention rather than diagnosis or long-term treatment.

The role of the nurse in health education with both the camp staff and campers is not to be overlooked. Kris Miller Lishner points out: The camp nurse is a health education resource person, collaborator, and consultant for the staff … Everyone in camp is a health educator and has some responsibility for health teaching. Activity directors, kitchen managers, and administrative staff engage in health education when they point out safe ways to do activities, perform jobs and maintain environmental health and safety. In their daily routines with campers, counselors are their primary health teachers (Ball & Ball p. 245).

American Camp Association standards recommend that, in a day camp, if a physician or registered nurse is not available; the camp should have a previous written arrangement with a physician or registered nurse to provide consultation and daily health care support. In resident camps where such personnel are not available, it is acceptable to make similar arrangements with a nurse or physician who comes to the camp site daily to consult. Of course, in camps that primarily serve persons with special medical needs, it is crucial to have a resident physician or registered nurse on site. As noted previously, the Health and Wellness (HW) standards of the American Camp Association are minimum standards and each camp needs to assess its own needs based upon program, location, and persons served. Those needs may be different from the camp down the road.

In addition to these requirements, it is mandatory to have individuals in camp at all times who have training in first aid and CPR/AED. ACA acknowledges variations in the degree of training needed by the health care provider, depending on the proximity of the camp to an emergency medical system. If professional medical help is 30 minutes or less away, certifications in first aid and CPR/AED are minimum qualifications. Where the time for access is more than 30 minutes, at minimum, certification from a nationally recognized provider of training in wilderness first aid plus CPR/AED is required. In all cases, previous arrangements with health care personnel and facilities away from the camp site should be made in writing (Ball & Ball p. 246).

Note: In some camps, both positions may be assumed by one individual who reports to the camp director. Within these positions, various other health care personnel may be involved.

Resources:

Rethinking the Health Center: Assessing Your Health Center and Setting Goals

March 2001

The health center is a critical link in developing and maintaining a safe environment for your campers. However, providing adequate care to an active young population can be challenging. How should your health center be set up to best serve your campers? The following ideas will help you evaluate your health center and determine how you can provide adequate care while teaching campers personal responsibility.

Assess Your Situation and Set Goals

When evaluating your health center, your first step is identical to the nursing process and begins with an assessment. Followed closely behind is the redevelopment of goals. Ideally, both the camp director and camp medical director or nurse should be involved in the process.

Population served
Questions that need to be addressed begin with the desired level of care the camp will be capable and willing to provide (e.g., a basic first-aid station and triage center or a more complex level of a care requiring sophisticated equipment and a highly skilled staff of professionals). Part of this decision will be based on the population you serve, the length of camp sessions, and the activities offered. Will your population be mostly “well” staff and children? Will you expand to include differently abled children? If so, have you determined the review process and facility changes necessary to make their stay successful? Does your camp specialize in one particular type of illness or syndrome? Does your camp provide off-camp experiences? Do you offer unusual activities that might require special endurance or medical clearance?

Size of center
A determining factor for the size of your health center is accessibility of medical care in the surrounding community. Are you located in a rural area with only basic emergency care provided or is there a trauma-level hospital offering timely life flight services close by?

Contract of care
Another important piece of data collection is your contract with the parent for the level of care you provide and the type of disabilities and chronic illnesses you can reasonably support. Even if you are working with only “well” campers, you will need to be able to manage both environmental disasters, such as hurricanes and tornados, and medical disasters, such as an epidemic or a mass trauma.

Assess the Areas of Camp Impacted by the Health Center

Once you have established goals for the health center, the next step is to look at all the areas of camp the health center impacts.

  • Campers and counselors: The health center provides medical support and supervision as needed, including medication management, temporary and long-term treatment of common episodic injuries and illnesses, and problem-solving difficult behavior and adjustment issues.
  • Administrative staff: The health center keeps legal health records, maintains contact with parents when appropriate, and responds to urgent situations as they arise.
  • Program staff: The health center ensures activities are planned safely and makes recommendations based on accidents treated. The health center might also provide first-aid kits specially designed for each activity with the specific supplies needed per predictable injury for that area and basic first-aid supplies and problem-solving support through radio consultation of sick or injured campers for off-camp experiences.
  • Kitchen and housekeeping staff: The health center staff works closely with these individuals to ensure the public health of the camp.
  • Camp budget: Providing appropriate medical care is not an inexpensive endeavor. Though a health center can be run frugally, it is no place to cut corners.

Properly Positioning and Equipping the Health Center

When planning the physical placement of the health center, the first area of concern is location within the general layout of the camp. A location that is central to the cabins is preferred over one that borders the camp. This location affords easy access in the middle of the night if the need arises, especially given the limited outdoor lighting of most camp settings. Plus, it has the added benefit of an “extra pairs of eyes” during the daytime for supervision. The facility needs to be kid friendly and easily accessible, yet at the same time not be mistaken for anther activity on camp. For many campers, the idea of seeking out help for their health-related needs is part of the learning experience of camp.

The health center building
The building needs to have flexible space. Keep in mind that during sick call as many as 5 to 10 percent of the camp population may be present for evaluation. The front area of the building requires an open space that allows for evaluating campers’ illnesses and injuries, a contact area for parent calls, and a storage area for charts and paperwork. Throughout the health center, locked storage space that protects supplies and equipment from the elements and camp critters is well worth the investment.

Space for semi-private outpatient examination and evaluation areas need to be set aside. The number of outpatient examining areas needed depends again on your present goals and number of campers. These areas should allow for evaluation and treatment of the camper and should be equipped with locked storage if medications are kept in the area. Many injuries at camp require soaking for cleansing and enhancing the health process, so you may want to designate an area for foot soaking. Each exam area should also have access to a sink for hand washing to control the spread of infection.

Depending on what level of care you are able to provide on camp, you may need a separate trauma/treatment room. This room would be set aside for urgent trauma evaluation, extensive ongoing assessment, suturing, minor surgery, and procedures. It may also double as a satellite laboratory for basic tests.

The inpatient area is another section that is dependent on the number of campers and the type of campers you service. Per ACA standards, approximately one inpatient bed is needed for every fifty people on camp for a “well” children’s camp. Adequate bathroom and shower facilities need to support the inpatient area. If you provide inpatient coverage at your camp, you will also need a kitchen area to feed the campers. This multipurpose area receives heavy use even if the number of inpatients is small.

Experience has also shown that the restrooms in the health center get very heavy use. In particular, “shy” campers seem to migrate to the seeming privacy of the health center restrooms.

Managing medications
Managing medication effectively and safely requires the health center to have a secure area where medicines can be stored and locked. This area will also need a sink and lockable refrigeration dedicated to medications only. As more children with chronic illnesses are able to enjoy a full life, they are also able to leave home and participate in a camp experience. They may bring with them a large compliment of medications. In recent years, as many as 30 percent of campers have arrived at camp with multi-dose maintenance medications.

To meet this increase, many camps are moving toward medicating campers as needed at mealtime in the dining hall where the campers are a captive audience. Experience has shown that this provides the best compliance with a medication schedule and is less complicated for the campers. It also helps separate the correlation of taking a medication and being sick at camp.

Electrical outlets and equipment
There never seem to be enough electrical outlets in a health center or adequate lighting. Separate refrigerators need to be maintained for food, medications, and laboratory needs. Many pieces of basic medical equipment, such as nebulizers and thermometers, also require electricity and specialty outlets. Also, if you are moving to upgrade the level of care by including monitoring equipment, you will need to have a constant source of predictable electricity with a back-up generator.

There is much discussion of late surrounding the inclusion of defibrillators in the camp’s health center. As with every new approach to health care, use of defibrillators would require year-round monitoring by staff and training in its proper use.

Infectious disease control
A contingency plan needs to be in place in the unlikely chance of an epidemic. Solutions might include expanding into cabins or general-purpose areas to isolate sick campers from their healthy cabin mates. An isolation room with a separate bathroom needs to be available in the event of highly infectious diseases such as meningitis.

Archival storage
One area that is often overlooked in the health center is a central storage location for archival of health charts. This requires an easily accessible space that protects the paperwork from damage and provides availability if the documents need to be retrieved in the off-season. The legal requirements differ from state to state as to the actual time that health records must be kept, but as a general rule, seven years past the age of majority (eighteen) is thought to be the regulatory requirement.

The Health Center as Part of Camp

Once all the hard work has gone into assessing, setting goals, collecting data, and formulating a workable plan, it is time to take a step back and evaluate how the health center is working within the camp system. Is it providing the expected care? Is complete documentation of medical care readily available in an easy-to-decipher form? Are preventive measures reasonable and are they making a difference? Are you able to keep your contract with parents? And lastly, is the health center a safe, camper-friendly place that provides the appropriate standard of care while teaching personal responsibility?

It is a tremendous responsibility to be trusted with the health care and safety of campers and young staff. The most impressive physical plant with sophisticated medical equipment has little value if it doesn’t have a well-trained staff of competent health care providers. Careful planning around camp goals for health care, the population of campers, and your contract with parents for health care can result in a well-balanced health center that is flexible to the camp’s needs, provides excellent care, teaches responsibility, and adds to the positive camp experience.

Nancy S. McMillan, RNC, FNP, is the founder of CamperCare, a consultation service. She has served as the health center director of a large nonprofit camp. She can be reached via e-mail at nancy@campercare.com.

Originally published in the 2001 March/April issue of Camping Magazine.

resources

Camp Forum: For Campers/Parents: Camp Scholar:
Is Your Camp’s Health Center the Center of Health?


DrThurber
Camp Psychologist / Moderator

Nov 7, 2007, 8:25 AM

Post #1 of 1 (31663 views)

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Is Your Camp’s Health Center the Center of Health? Can’t Post

In her 1912 book Notes on Nursing, Florence Nightingale wrote, “I use the word nursing for want of a better. It has been limited to signify little more than the administration of medicines and the application of poultices. It ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet—all at the least expense of vital power to the patient.”

OK. I had to look up poultice (It’s a kind of absorbent, medicated wound treatment), but the rest of the quote hits the mark nearly 100 years later. It almost seems as if Nightingale is talking about camp nurses, not just nurses in general. Camp nurses don’t simply dispense meds; they work on the front lines to keep us healthy. Perhaps this is the reason most of my camp nurse friends insist on “Health Center” now instead of “Infirmary” to designate their building at camp. Some camps have even converted to a “Health & Wellness Center,” thereby signifying their holistic view and preventive stance toward human welfare.

So what makes an excellent health center? Well, before I get into details, I should offer the disclaimer that I’m not a nurse or a medical doctor. I also haven’t memorized the health and wellness accreditation standards for the US or Canada. (Interested readers can visit the Association for Camp Nurses, or peruse ACA Accreditation Standards for Camp Programs and Services). What I can offer are the perspectives of a former camper, current camp staff member, father, and allied health professional.

First and foremost, an excellent health center is staffed by qualified personnel. You can refer to the accreditation standards for details on certifications and degrees, but anyone in the health center needs to have experience with blood, bugs, and barf. Seriously.

You’d be surprised by the number of urologists or obstetricians I’ve met who are doing a stint as “camp doctor” but haven’t a clue about emergency medicine, wilderness first aid, or even how to perform CPR. An actual quote from one of these camp docs: “Don’t worry, Chris, all the staff have CPR and first aid. I just oversee med call.” Gee, I wonder whether the director or the campers’ parents see it like that.

I’ve also watched camp nurses—with specialties in areas as diverse as midwifery and geriatrics—send asthmatic campers up a mountain with their steroid inhalers (such as the Advair discus) instead of their rescue inhalers (such as Albuterol), claiming, “It’s the same thing.” Tell that to the camper who feels suddenly as if he’s breathing through a straw.

Show me someone—RN, MD, PA, EMT—who knows how to stop bleeding, stabilize broken bones, treat anaphylaxis, clean up an infection, open an airway, and grab a bucket for that kid about to puke and I’ll show you someone who is ready to work at a camp health center. Camp isn’t a war zone, but it is the front lines.

The next thing you need is a team player. The best camp health centers aren’t just neat, clean, centrally located, and well stocked; they’re staffed by men and women who understand children and camping. In a healthy camp culture, everyone is expected to contribute, from the skits to the clean-up and everything in between. Having health center staff who participate in camp outside of their job description pays dividends by making them visible and accessible. If campers and staff see the human—and sometimes humorous—side of the health center staff, they’re more likely to tell them about their nasty rash in that private spot or suggest policy changes that benefit the community.
Camp health centers also need to collaborate. Remember that the nearest definitive care facility is also part of a camp’s health center team. The camp must cooperate with local hospital and EMS personnel to ensure ambulance drivers know the routes into camp; to create emergency action plans that factor in travel time; and to coordinate care when campers are treated by or transferred to area specialists.

Health center staff should also be teachers. If you think that all campers and staff know everything there is to know about personal hygiene, then you haven’t spent much time around a 9-year-old boy or a college student lately. So much of camp health hinges on prevention, such as hand washing, proper cough technique, good sleep habits, proper nutrition, and wise use of time off. (Now I’m really starting to sound like Florence Nightingale.) Health center staff need to preach these points and more in an ongoing, entertaining fashion. That might be a tall order for someone who’s used to sitting behind a desk or roaming the hospital halls most days, but it’s a cinch for a health care professional with a camp background or kids of her own.

Health center staff must also educate parents—either directly or through the mouth of the camp director. Of critical importance is accurate, candid, and thorough completion of the camp’s health form. Sadly, many parents fail to understand how helpful it is to provide the camp with a detailed profile of their child’s physical and psychological functioning. Often, parents leave camp staff struggling to figure out some behavioral, emotional, cognitive, or physical problem that it took a team of experts a decade to diagnose. A high quality health center insists on high quality information for all of their campers and staff. No form from you = no camp for you.

Last but not least, a high quality camp health center needs the staff’s support. Frontline camp counselors and cabin leaders need to remind children who take medication to go to med call. They need to be trained in first aid and CPR. (By the way, “certified” is not the same as trained. Health center staff should provide instruction and practice drills for staff throughout the summer. Blitzing through a quick course on first aid or CPR does not equip most people to provide care in an emergency. Staff need practice.) Camp staff can also support the health center staff by setting a sterling example of proper hygiene and sleep habits for the campers. And staff need to regulate all those adventurous activities in ways that minimize the likelihood of serious injury.

Florence Nightingale was right about the scope of nurses’ duties, but she missed the mark a bit by restricting those duties to nurses. Everyone in the camp community shares some responsibility to “nurse” staff and campers in true Nightingale fashion. Seen in this light, an excellent health center is not a building. It’s a collaborative process of promoting the entire camp’s health.

Author Note: For a fascinating look at recent research visit ACA Healthy Camp Study. For information on creating a healthy camp, visit ACA article: "Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

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