More Than Bandages And Aspirin

By Beth Morrow

Of all the tasks required to keep a camp running, one of the most critical is organizing the medical center. Although no one--staff or campers--intends to be sick at camp, illness is inevitable. Whether your camp medical center is a sprawling, modern complex or a two-room cabin, advanced planning will help keep distraction and distress to a minimum.

A: Accessibility
When organizing a camp medical building, accessibility on multiple levels should be the primary concern. We’re not talking about a drawer stocked full of bandages and aspirin, either. Accessibility covers everything from record availability and confidentiality to quiet, solitary areas for sick campers to rest; secure, limited-access storage of medication; and even private living quarters for the medical staff.

Keeping camper and staff medical records confidential and easily available is a true balancing act. Nowhere is this more apparent than at a medical-based camp. Years of refinement at Camp Hamwi--a residential camp for youth ages 7-17 with diabetes, run by the Central Ohio Diabetes Association--has resulted in a system where each camper receives an individual medical log sheet at the start of the week. Medical staff documents each and every medical-related interaction, from insulin doses to food given as treatment for low blood sugars to blood glucose levels to be taken at pre-determined intervals. The carbon-copy log sheets, kept in binders by cabin group, stay with the cabin nurse at all times. When campers go off-site for activities, log sheets are reassigned to the supervising or student nurse delegated to that activity, then returned to the cabin binder upon return. Prior to each meal, the doctors review the records and determine insulin dosages based on the accumulation of medical information--made easy by thorough documentation on one central sheet.

Medical centers often bustle with activity--comings and goings, minor emergencies and major crises--making quiet recuperation difficult for those with orders to rest. Darlene Honigford, director of Camp Hamwi, notes that a properly created sick bay should be a separate room isolated from the general medical-center traffic, but easily observable by medical staff. Keep in mind, too, that supplies kept in sick-bay areas should be non-medicinal in nature if a camper or staff member needs to be alone in the room.

Even if your camp is not actively seeking or in the process of maintaining accreditation, the standard of locking up all medications--including over-the-counter ones--and limiting access to only a few people is a wise one. Anything used for treatment of ailments needs to be under lock and key at all times, with the key in the hands of charge physicians or nurses. And don’t forget the refrigerator--medicines aren’t just for cabinets. Install a padlock on one refrigerator designated for medical-center use only, and allow only charge medical staff access. Limiting key access to medications lessens the likelihood of tampering or improper use.

Finally, you may want to delineate specific areas in the medical center as “staff only” and “camper only.” At Camp Hamwi, the majority of the medical-center area inside the front door is for campers and staff seeking medical attention, but a closed door separates the service area from the staff sleeping area. Regular program and counseling staff members know this area, and the sleeping quarters of the medical staff are off-limits unless one is explicitly invited.

B: Basic Medical Considerations
Medical buildings can have long lulls of solitude to bouts of frenzied activity in an instant. Impromptu social gatherings, intense medical meetings and doctor/patient interactions keep the atmosphere dynamic. For this reason, it’s important to keep in mind that the camp’s medical center is a service center. Rules and regulations in conjunction with solid procedures taught by the top members of the medical chain-of-command guarantee a safe, orderly experience. Addressing general housekeeping issues and consideration of the flow of incoming patients before campers arrive sets the stage for a successful, positive medical-center image and experience.

Ill campers and staff seek out a medical center for treatment as well as comfort. The familiarity of set rules and procedures transcends physical setup. Clearly stated rules for various types of patient calamities need to be established and communicated to medical staff. It can be helpful if non-medical program staff know these basics as well, in case help is needed. Having the charge medical staff lead training and/or orientation in the center itself improves knowledge-retention, especially in the case of high staff turnover from year to year.  Labeling equipment, supplies and even areas of the medical center (i.e., “doctors only,” “waiting area,” “trash”) so everyone has a general idea of their surroundings goes a long way in lowering uncertainty.

In the same vein, accountability is a major component in any medical undertaking. Tracking medication--both incoming and outgoing--is essential. With the use of the carbon-copy log sheet, medical documentation is comprehensive and easy.

Housekeeping is a mundane reality in medical centers. Establishing a routine maintenance plan through assignment or designation of staff members will keep things running smoothly. Upkeep, refills, supply organization and records maintenance can be done in off hours and during non-peak time. A rotating chart of medical staff, updated daily for these tasks, ensures everyone is equally responsible for smooth operations.

At a diabetes camp, medical staff takes into account the placement of supplies within the center in relation to other supplies used to treat similar ailments. “You want a logistical flow for treating related symptoms,” shares Honigford. “For example, it makes sense that in the area where we keep blood-glucose meters for testing, we also keep Band-Aids, lancets, cotton balls, testing strips and alcohol pads.”

C: Community
If you’ve experienced a camp medical center as a patient or staff member, you know there’s much more to the building than four walls and cotton balls. The medical center at Camp Hamwi is not only a treatment facility but an integral part of the camp community. More than dispensing medicine, the center offers comfort in a positive, supportive environment.

Some campers might visit the medical center for a minor complaint but, in reality, are homesick or need some extra attention. Since staff is on duty around the clock, campers know they can find someone to help or just listen. In case of an emergency elsewhere on camp grounds during regular activity sessions, staff members can be found quickly with a look at the menu board inside the front door listing their activity whereabouts. Staff members also give diabetes-related information to campers through engaging activities designed to help students learn while lessening the fear of the medical end of camp.

Organizing a camp medical center can be a daunting task. The needs of each camp vary as greatly as the patient needs themselves. But with forethought, targeted planning, common sense and a back-to-basics approach, establishing your camp medical center and integrating it into the overall fabric of the camp experience will benefit everyone.

Beth Morrow is a freelance author, educator and a member of the Central Ohio Diabetes Association’s Youth Committee and Camp Leadership teams. She has served as Senior Week program director for Camp Hamwi, a residential, age-based, week-long residential camp for diabetic youth for sixteen years. Reach her via e-mail at: beth@bethmorrow.com.