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Marie:
Great question. We hope that camps are not trying to run without a credentialed healthcare provider (RN, NP, MD) at least available and preferably onsite. The key is that camps can ask just about anyone to perform a “task” like bandaids, hand out pills, and restock first aid kits. What cannot be done by an untrained individual is assessment, judgment, and decision-making. These are critical activities at camp to help minimize risk.
The risk for camps is not that things happen for the most part. The risk is how the camp responds to those injuries, illnesses, and other behavioral issues. If the camp does not respond in a “reasonable and prudent” way, then there could be real legal risks.
Most state nurse practice acts will not be specific. They will be more general to help cover all types of practice areas. They are not site specific regulations. The key is to know that the requirements outlined around assessment applies in all clinical sites and locations.
Therefore, if you have camp leadership who doesn’t want to pay for a licensed/credentialed healthcare provider or they don’t see the value, consider asking these questions:
1. What is the process for when something unplanned happens (lost medication, significant injury, several folks with same illness symptoms)? Who makes decisions or judgments about the next steps?
2. Who is identifying and managing behavioral concerns? Are you creating behavioral health plans to support youth as they navigate a camp experience?
3. Who is making a decision about over-the-counter medications – what do you give? when do you give it? What do you need to be asking/assessing when someone presents will symptoms requesting treatment? What is the camp documenting related to care provided.
4. what is the care/management processed for significant events (e.g. concussion, major fracture, self-harm, suicidal ideation)?
At camp we have to plan for the unplanned. If everything were to run perfectly (and it never does), then that would be great. However, we have to be prepared for potential injury, illness, behavior that may present during camp. Camp directors can usually understand the concept of risk mitigation and arranging policy/procedure and staffing that minimizes risk.
What is your highest risk area? Your health center. How we respond to illness and injury are the critical steps that keep a camp out of legal situations.
I hope this helps.
Tracey Gaslin