If each area a nurse works leaves its mark on the nurse identity, then I have amassed a dozen identities over the years; my favorite was Camp Nurse. You haven't lived until you've managed health care for 125 Girl Scouts and a score of adult staff for a full week. I agreed to my first week of camp nursing because I could bring my girls for free, and I was promised the only cabin in camp with air conditioning. (I’m a real wuss when it comes to camping out.) What a week it was! Homesick campers, asthmatics, international staffers with allergies, hyperventilating adolescents, dehydration, and Camper's Complaint (constipation-induced stomach ache) filled my camp nurse days with drama.
As I recall, this is an outline of camp nurse duty: the week begins with Sunday afternoon intake, an event that fills my Infirmary wall-to-wall with excited campers and nervous parents. I and a helper wade among them, taking temps, checking medical forms, and examining for head lice. I organize camper medications and write out MAR’s before supper and prepare for the week's routine.
Medicine call begins with before breakfast ac meds (which the sensible nurse administers clad in bathrobe and slippers) and ends after evening meds at bed time...if the campers show up on time. Be aware that the camper with the heaviest hs meds always signs up for Night Owl Stargazing.
A camp nurse learns to say things and make them stick. "No, you can't have a nurse excuse to avoid diving practice." Not even if you pretend to have the following: the 45-minute flu, excruciating pain related to a microscopic cut, unnatural dread of horseflies/menstrual cramps/garter snakes, or you think you might have poison ivy. Homesick campers are gently but firmly denied a tearful phone call home to be picked up . The remedy for most homesickness is getting involved in activities; campers are encouraged to pair with a counselor "buddy" for moral support, write distraught notes to the camp mascot if they like, and check in with the nurse twice a day. The goal is to stick it out for three days, after which the director will phone home, but by Wednesday it seldom comes to that.
Campers at risk of dehydration and heat prostration must be taken seriously. "You may spend 60 minutes in the air-conditioned nurse's office; I want you to drink a glass of Gatorade and then plain water, and sit quietly. After that, you'll (almost always) return to your unit," (not lie here in a bunk and quiz the nurse.) “Counselor, while it's this hot, make sure you have extra fluids for campers to drink, and watch everybody drink a glassful every 2 hours.”
The change to a new diet is enough to throw some campers’ digestive tracts off. Remember root dietary causes when dealing with "homesick stomachache" which is constipation that manifests as generalized stomachache and homesick feeling. During assessment the nurse should ask, "Did you poop today? Yesterday? Not sure?” and after ruling out something more serious, “Eat this apple and drink a glass of water. Counselor, remind her to eat fruit at lunch and drink fluid every time it's offered. Feeling a bit better? No, lying in the nurse's office will not help, but exercise will. Come tell me how you're feeling at lunch. Bye!"
There are serious issues in camp, as I learned when an intractably homesick camper was picked up by her (at least verbally) abusive father. In the absence of abuse evidence we had to let her go with him and her totally cowed mother, but I regretted having to do it. I watched racial conflict play out before my eyes, between a white camp staffer and the family of a black camper who had acted out and was going to be sent home. As camp nurse it was my job to second the director in cases of campers or staff who needed to be disciplined; many discussions took place with me as observer. I was the second line of emotional support for staff as well. One quiet afternoon I was working at the Infirmary, Rimsky-Korsakov's "Scheherezade" on the stereo when the director came in, shut the door, and blurted, "Take my blood pressure; and turn down that music, it sounds way too much like my life right now."
Then there are the things you will learn nowhere else. Camp nurses learn to announce at the weekly dance, "Campers who insist on head-banging to 'Bohemian Rhapsody' will NOT receive Tylenol for headache after the dance!" then make a show of watching the campers dance for awhile. This should be continued at least until the first emergency sprain draws you away. In anticipation of minor emergencies, I found that a military surplus medic's pack makes a fine nurse kit, if stocked with band-aids, thermometer, adhesive tape, ace wrap, bandage scissors, and so on. I also figured out how to sweet-talk the grounds keeper into handing out replacement shower curtains, a thing he was inexplicably reluctant to do.
The camp nurse is relied on for advice on all things medical. Utter annoyance compelled me to tell staff at a week's end meeting not to hover over the girls so much. The campers in question, aged 11-13, had been doing glass art all week and a few of them had suffered minor cuts. Staff was concerned that the activity was too risky; should staff handle the glass for campers to prevent future lacerations? Having observed activity in the craft house, it seemed a controlled risk to me and I said so. "When DO we let the girls take risks, if not here under supervision? Let's empower them to get cut occasionally, if that's what it takes to help them explore new things."
Bear in mind that camp life is not quite real compared with everyday standards and those who survive it get a sense of proportion and humor right quick. I didn't have a sense of humor when I started out, but I began to develop one after my friend Maureen insisted I participate in Costume Night. She fixed me up with an over-sized, deflated, mylar fish balloon (in shocking pink) which she affixed to dangle from my bandaged forearm...and called me a shark bite victim.
Camp life can also be a grind—long stretches of wet weather or heat bring on health problems and snappish tempers. Even in good weather, mental health among campers and staff can go awry, and since our reason for being there is all about girls under the age of 18, staffers need a firm grip on themselves. Everyday camp survival for me involved carrying a travel mug, learning the hours at which dining hall coffee would be fresh, and cultivating what I considered a MASH-casual look. T-shirt, shorts, stethoscope, and a pink name badge. Regardless of the badge, someone jestingly called me "Nursie" and it stuck like super glue. In the end I resigned myself to being called Nursie and gamely answered the phone in my cabin, "Infirmary, Nursie here." Whatever you’re doing at camp, you just can’t be too careful; one morning I entered the bathroom to find gigantic cockroaches climbing the mirror. They were no less horrific for being plastic! Another morning I was arrested by the Fashion Police and cited for passing meds in my unfashionable bedroom slippers. So much for the dignity of the adult.
Somehow, I enjoyed the unpredictable quirkiness of camp nursing. Girls who started out as strangers and argued over caper duties all week became the closest of friends by the end of Friday night campfire. Over time I watched girls grow into young ladies; I was amused at their squabbles, and touched by the way they'd come to the Infirmary in a noisy, untidy flock, bringing an injured or ailing friend and watch over my shoulder with terrible concern as I went about the examination. I wasn't so much treating a camper as treating the lot of them and educating them as I went. We had many daft-but-serious talks at evening meds and treatment time. Life is never so glorious or so crisis-filled as it is for teen aged girls who feel they are among friends. For obvious reasons, camp nursing is not for the faint of heart, but in many ways it’s the opportunity of a lifetime.