Camp Nurse

1. Camp Nurse Where the kids are kids

2. Class Discussion • You have been hired as the camp nurse for the new Camp ----------- • One of your tasks is to purchase and collect supplies for the nurse's cabin • Make a list of the items you would include • Based on your client population

3. Consider the developmental stages for the clients that you will be involved with • Psychosocial • Cognitive • Moral • How would you design the nurse’s cabin to be client centered?

4. Nurses:Positions available here.

5. Purpose of camp(diabetes, cancer, special needs, other) Purpose of camp(diabetes, cancer, special needs, other) • Meeting other children with i.e.diabetes - +ve positive • talk with other children who also have diabetes. • learn about diabetes management in a fun, outdoor environment. • learning about blood glucose testing, • administering insulin injections, and • meal planning and exercise programs as part of a healthy lifestyle. • May be beginning of independence from their parents in handling diabetes and taking responsibility for their disease on a day-to-day basis. • Many of our camp 'alumni' say that camp was the first time they ever administered their own insulin. • Meeting other children with diabetes - +ve positive • do not have many opportunities to talk with other children who also have diabetes. • learn about diabetes management in a fun, outdoor environment. • learning about blood glucose testing, • administering insulin injections, and • meal planning and exercise programs as part of a healthy lifestyle. • May be beginning of independence from their parents in handling diabetes and taking responsibility for their disease on a day-to-day basis. • Many of our camp 'alumni' say that camp was the first time they ever administered their own insulin.

6. Camp Nurse • Role of the Camp Nurse: • Ensures safe environment • Provides first aid • Aids in acute illness as needed when at camp • Cares for children with special needs, • Collaborates with specially trained personel

7. CNO Guidelines for Camp Nursing • Nurses are accountable to provide safe, effective, ethical care • Emphasis is on facilitating healthy experiences in a health promoting environment • Nurses are accountable for obtaining client consent when providing care • Exception in emergency situation

8. Medication Admin • Health info about each camper must be obtained • Some agencies require physician’s order to administer or recommend OTC meds • OTC meds such as Tylenol, calamine do not require a Rx • Nurse is accountable for deciding that OTC med is appropriate and is accountable for the outcome of that decision

9. Med Admin • Nurse may administer ct meds from home if in original container • Nurse is expected to use judgment when giving med • All meds should be recorded in the health record • Certain camps may use medical directives for common treatments that may be required

10. Nursing Records • Documentation is essential per CNO standards • Ct records are confidential • Ct records must be maintained for at least 10 yrs • Liability protection is recommended

11. Changing role of camp nurse • More than first aid • On call 24/7 – no holiday • Communication with parents & establishment of trust • Health assessments on each child camper & camp worker • Illness prevention • Cleanliness of kitchens, cabins & washrooms • Injury prevention • Health teaching of children & camp workers

12. Ontario Camping Association • In operation since 1981 • Offers workshops on current health info • Suggestions for management of camp health programs • Mission statement • To promote & develop the highest standards of camp health care and to educate & support health professionals

13. Ontario Camping Association • Have published 2 guideline manuals • For Day Camps • For Residential Camps • Have produced collection of articles re common health concerns of camps • Ie management of allergies, universal precautions, health care professionals at ON camps, medical directives, management of communicable diseases, mgt of sun & heat, drinking water quality, mgt of crises

14. Ontario Camping Association • Have published 2 guideline manuals • For Day Camps • For Residential Camps • Have produced collection of articles re common health concerns of camps • Ie management of allergies, • universal precautions, • health care professionals at ON camps, • medical directives, • management of communicable diseases, • mgt of sun & heat, • drinking water quality, • mgt of crises

15. Nurses:Positions available here.

16. Psychological Issues • Interpersonal tensions • Homesickness • Developmental stages

17. Bedwetting - Enuresis • Common & troubling • More common in boys age 6-8 • May avoid overnight excursions impeding socialization • Anticholinergic drugs • Change of clothing & bed sheets • UTIs

18. Irritable Bowel Syndrome (IBS) • Identified as cause of recurrent abdominal pain in children (pp. 1403-1404) • Classified as a functional GI disorder • Alternating diarrhea and constipation • Therapeutic management • Nursing considerations

19. Constipation • Transient due to environmental changes • Fear of using bathroom • Encourage regular routine ie early am • Encourage intake of fiber ie fruit, bran, peanut butter, beans, corn, popcorn, whole grain breads, vegetables • Encourage lots of fluids • Suspect when child has bloating & tummy ache

20. Injuries • Injuries to eyes & teeth common Others • Aerial flip • Horseback riding • Water slides • Power tools • Ladders • Fireworks

21. Nurse’s role in injury prevention • Prevention strategies • Education • Alert to safety hazards • Evaluating safety risks • Implementing safety programs

22. Avulsed tooth • Tooth injuries require prompt treatment by dentist- can affect remaining teeth

23. Recover tooth • Hold tooth by crown avoiding root • If dirty rinse in water • Insert tooth back in socket – have child hold in place -70% chance for reattachment if within 30 mins • Transport to dentist immediately • If unable to reimplant • -place tooth in cold milk • In saliva or parent’s mouth under tongue

24. Intrusion • Usually caused by forceful injury in an upward direction • Tooth is compressed into the root area

25. Eye injury (see p 1003) Take to emergency room for opthamologist • Foreign object- do not irrigate or rub • Chemical burns – irrigate, close eyes • Ultraviolet burns – patch, close eyes • Hematoma (black eye) - ice • Penetrating injuries – eye shield over affected eye- Eye patch over other eye to reduce eye movements

26. Contusion • Most common sports injury • Damage to soft tissue, subq & muscle • Hemorrhage, edema & pain, ecchymosis Crush injuries under nailbed –release with cautery

27. Cuts/scratches, abrasions • Cat scratch disease • gm neg following bite of animal • Lymphadenitis, encephalitis, hepatitis Tx supportive, analgesics ??Use of alcohol, hydrogen peroxide

28. Strains/ Sprains Sprain • Trauma to joint where ligament is stretched or torn – knee most common • Rapid onset of swelling, inability to use Strain • Microscopic tear to tendon – occur over time • Painful to touch, swollen Tx RICE & ICES

29. Fractures • Goals • Assess for 5 P’s • Regain alignment & length (reduction) • Retain alignment and length (immobilization) • Restore function to injured parts • Prevent further injury • Cover open wounds • Elevate injured limb if possible • Transport to hospital

30. Head Injury • Assess ABC • Assess LOC & q 2h • Stabilize neck & spine - fracture board • Clean abrasions • Keep NPO • No sedation • NVS q4h • Seek medical attention

31. Head Injury • Involving scalp, skull, meninges or brain • #1 health risk & leading cause of death • Head proportionately large & heavy in relation to rest of body • Falls, MVA & bicycle

32. Hypothermia • Cooling of body’s core temperature below 35 deg C or 95 F • 6% drop in blood flow for each 1 deg C decrease in core temperature • Body conserves core T at expense of extremities • Shivering raises metabolic rate to increase heat of blood before it returns to core

33. Hypothermia cont’d • Rewarming: • Monitor vital signs • Treat trauma if applicable • Multiple layers of clothes • Loss of core temperature reduced when stays in fetal position or still in water • Remove wet clothing • Move to sheltered location • Give warm fluids to drink if conscious