Highs And Lows

By Terri Nighswonger
Photos Courtesy of Camp Ho Mita Koda

If you were to visit Camp Ho Mita Koda in Newbury, Ohio, during staff training, you would probably observe a fairly typical camp:  plenty of procedures, protocols, and program training. Hearing leaders talking about highs and lows, you might think they were discussing the many moods of teenagers.

However, as the oldest continuous camp in the nation for children with diabetes, the Camp Ho Mita Koda staff has the added responsibility of caring for kids with a life-threatening disease. The highs and lows might indicate a bad mood or a school-girl crush, or they may mean that blood glucose levels are out of the normal range.

“It is different from other camps,” says Kyle Chones, camp and youth-programs manager. “We have to be aware of how diabetes affects the child in every aspect. If a kid’s blood sugar goes low or high, it does affect their behavior. They do have mood changes, and that plays a huge part. You have to understand why he’s acting the way he is, rather than assume he just had an argument with his bunkmate.”

Diabetes-Specific Training
While many of the staff and counselors do not have diabetes, they all have to learn how to manage someone else’s blood-sugar levels.

“It’s good to have those who are experienced with it. They know how to deal with it,” Chones says. “The ones that aren’t experienced--it’s a little bit more challenging. When you’re at camp, it’s different. Not only are you supervising the kids for behavior aspect, but you’re also managing their diabetes.”

The goal of Camp Ho Mita Koda is to give children with diabetes a fun camp experience where they can be medically supervised, while also learning how to manage their diabetes. Some kids who come to camp have parents who have done everything for them 24/7. A parent monitors blood-sugar levels, gives insulin, and guides food intake. While counselors take over that role at camp, the child is given more responsibility as the week progresses.

“When you’re at an activity, a child may not be feeling well due to their diabetes, or they may actually be sick,” Chones says. “There’s a lot of different factors that come into play. In training we try to cover as much as possible, within the given time that we have. That’s why we do training for a week, while other camps go maybe two or three days. Here, it’s a lot different. It’s so important.”

In the camp’s week-long staff training, counselors are divided into small groups and role-play different scenarios. Experienced leaders guide and oversee the training, particularly teaching newer counselors how to handle any situation that might arise.

Training for the dispensary staff is normally two days with either a diabetes educator or a veteran nurse leading the group.

“My first summer (2012) I hoped to have a good understanding of how to treat and care for children with type 1 diabetes,” says Kara Henningsen, a nurse who will be returning to Camp Ho Mita Koda for the 2014 season. “Nursing school does not spend much time teaching us about type 1, so I had very little knowledge coming in.”

“The training was very interactive and allowed us to practice doing job duties we would be performing throughout the summer,” Henningsen says. “These duties consisted of changing pump settings, doing calculations for carbs and shots, giving shots, checking campers in, and documenting blood-sugar readings.  On the first day of camp, I felt ready to do my job. The staff members who were doing the training were very knowledgeable and open to our questions.”

“At a normal camp, you’ll have maybe two nurses for 100-200 kids. Here, the ratio is 1:5,” Chones adds. “This past summer we had a lot of new nurses who never worked in diabetes management. It was a good experience for them.”

The staff also inventories the dispensary, counting out insulin, meters, strips, syringes, and pens, and makes sure all of the supplies are organized for the summer.

Mock Camp
Once the staff and counselors have completed their training, they congregate for a mock camp day.

“We’ll wake up at 7:30 a.m. and  have breakfast. Then the counselors head to their program activities where the nurses join them because there has to be a dispensary staff person at every activity,” Chones says. “Basically, we will run through a whole camp day. At the end of the day, we will talk about what worked well, what didn’t work well, and how to make changes. We practice preparing for emergency situations like a fire or tornado, or if someone comes to camp with a gun. It pays to know what to expect in case of an emergency.”

Henningsen thought the mock day helped her and other dispensary staff acquire a good understanding of the flow of camp. Because they have to be present at all activities, it was important for the staff members to be on time and know what they were doing, she says.

“I think it is important to allow the staff time to practice the skills they will use throughout the summer, and I believe it is very important for the staff to be prepared for check-in. This is a parent’s first impression of the staff, and if we look confused and unorganized, then the camper’s parents are not going leave with a good feeling,” she says.

Chones, who started in the 2013 season, agrees. “Surprisingly, we need to touch more on the diabetes part. Even though we did such a great job last year, I think it’s important to keep reinforcing it,” he says.

Chones also wants to place an emphasis on homesickness training. “We had a lot of homesick teens. I was kind of surprised because when I was at camp, I was glad to be away from home. With them--at 14 or 15--it was the exact opposite. We will work with the counselors on how to address that issue,” Chones says.

A Word Of Advice
“The one thing I would consider from the standpoint of a camp director is, if you have new staff, or even staff that’s returning, the main thing is to try to get their attention right away,” Chones says. “We kind of worked through that my first couple of days there, but everybody fell in line. Overall, our counselors are pretty good because most are former campers, and they really look forward to working with the kids that come to camp. The staff training is important because it can really make or break your summer. I had to absorb a lot, and I thought, ‘I’m prepared,’ but you’re not prepared until you are at camp and you have a situation that happens, and it goes well.

Chones shared an experience about a camper who had a low blood sugar in the middle of the night. “We all rushed down to the cabin and were trying to decide what to do because her blood sugar just wasn’t coming back up. We wondered, ‘Do we take her to the ER?’ We called the doctor in charge, who told us what to do to get her blood sugar back up, and it ended up being fine.”

“You can train as much as you can, but when the kids get there, that’s the best kind of training you can get,” Chones says.

Terri Nighswonger is communications specialist for Diabetes Partnership of Cleveland, Ohio. Camp Ho Mita Koda is a program of the Partnership. She can be reached at tnighswonger@diabetespartnership.org . For information about Camp Ho Mita Koda, go to www.camphomitakoda.org .