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Anonymous.
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June 21, 2023 at 9:44 pm #50109
Ronda Shorter
ParticipantHello all
I am new to camp nursing. RN for 30 years with school nurse experience and this is my second week at camp. The “Health Officer” is training in Wilderness training and she was the person working in the health clinic administering medication. The camp allows her to take medications out of the original labeled container and place in a coin envelope for easier dispensing, but what I saw was more opportunities for error. I saw her make a few ( I corrected it). My question is since we are working the same role am, I am not delegating duties to her, but if there is a problem I can see receiving the penalty. I just obtained my MSN-PMHNP, I have not taken boards yet, but I don’t want a problem before I get started in a new area. What are suggestions for handling this delicate situation.
Pickled and policies shades of gray 🙂Ronda
June 24, 2023 at 9:22 pm #50154Mary Marugg
MemberHi Ronda, Great questions!
States have different regulations so please be sure to check your state nursing practice act and your state pharmacy regulations. In most cases, it is Ok for the RN to put medications in different containers if the same RN is also administering the medications directly to the camper. It is more challenging if one RN is pulling medications and expecting another RN to administer. According to RN practice acts, the nurse is responsible for knowing exactly what they are giving and confirming the 5 rights of administration beforehand. If medications are placed in a secondary container (if allowed in your state), then the container should be labeled with the 5 rights (person name, drug name, dose, route, and time) to prevent medication errors. An unlicensed person can’t legally administer meds without the delegation piece. (Wilderness First Aid/First Responders are not licensed.) On the ACH website page dedicated to Medications you’ll find good documentation about the various roles of healthcare providers, as well as guidance for medication administration. Specifically the Medication Administration Practice Guidelines will give you some language to use with your camp director/leadership about the system currently in place at your camp.
https://www.allianceforcamphealth.org/wp-content/uploads/2019/08/Medication-Management-PG-2020-ACH.pdfPlease feel free to reach out to ACH at the office should you like to have additional conversation! 820.830.8393.
Best,
Mary
Mary Marugg, RN
Operations Director
Alliance for Camp HealthJuly 12, 2023 at 8:11 am #50711Anonymous
InactiveRonda,
If this helps, I will share. We use the healthcare assistant role in our camp to expand the function of the RN. In Texas, that would mean that your Wilderness First Aid person would be administering meds under my license. In the past, our med admin was “interesting” as well so I feel your desire and concern related to this. How we addressed it this year is all the HCA’s completed the Alliance for Camp Health med admin online training and then I checked them all off. We talked through all the big considerations the nurse would consider with giving meds (allergy to peanuts, don’t give that med). I made it fun and we used candy in the med cups to talk through potential common situations. Then, each week when the RN arrives (we switch weekly), I encourage her to watch the med set up process with the HCAs and reiterate they are under her license so she has to decide her comfort level. Within our delegation policy, they can administer meds per their training. This has worked so well and it empowers the nurses to participate in the med set up and ensure they feel safe with delegating this aspect of care. Overall, the team and I feel really comfortable with how this process is going. Good luck!
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