The demand on clinical facilities by a variety of programs has resulted in some clinical placements being negotiated several years in advance. Increases in enrollment, changes in faculty composition, and shorter hospital stays make finding adequate pediatric clinical experiences increasingly difficult. Planning for a summer clinical experience in the nursing care of children should include the consideration of camp for children with chronic conditions as a possible site.
To establish a camp nursing experience, faculty need to find camps in the local area. National organizations associated with camping can be a starting point. The American Camping Association (ACA) publishes the annual Guide to Accredited Camps, available in public libraries, as well as standards that govern all aspects of the camp experience. Based in Bemidji, Minnesota, the Association of Camp Nurses (ACN) is also an excellent resource that provides professional support and information about camp nursing.*
Many camps for children with special needs use an ACA-accredited camp facility for a week of summer camp, but may not be listed in the national directory. Calling area children's hospitals can get you in touch with clinical nurse specialists to identify local and regional camps for children with special needs. Besides hospitals, many nonprofit organizations whose mission is to serve children and their health care issues also sponsor camps. After a week, the author was able to identify over 20 different camps for a pediatric experience, all within 85 miles of the school of nursing.
Selecting a Camp
Choosing a camp depends on a number of professional, educational, and logistic factors including timing, expectations, available opportunities, on-site support, distance, and accommodations. Camps range from day camps for children with multiple handicaps requiring total care (i.e., feeding, elimination, and transfer) to residential camps where the common health factor is a chronic condition but the emphasis is on recreation. While some camps have no health professionals for 100 children, others have as many as six nurses, six physicians, and three dietitians on site during the entire camp experience for approximately 60 children. Camps that are planned by an ongoing team of professionals offer a well-organized and thorough camp experience for both campers and nursing students. Residential camps for children with special needs typically last from 4 to 6 nights with anywhere from 64 to 96 clinical contact hours, assuming a 16-hour clinical day and an 8-hour sleeping period. Ongoing nursing care, however, requires round-the-clock accessibility, and a full night of sleep may not be a realistic expectation in understaffed camps.
The criteria for selecting a camp should be based on a sound match between the course objectives and camp opportunities. Examining the daily schedule, job descriptions, available facilities, and decision-making at camp can help faculty decide if the camp learning experience will be consistent with the course objectives. For example, one diabetes residential camp has night rounds, routine blood sugar testing, and individualized insulin administration in the cabins four times a day, meal plans in a family style dining environment, daily educational sessions, and supervision during physical activities. Consultation and collaboration are available around the clock with a staff of physicians, nurses, dietitians, and outdoor education specialists. In addition, students can provide acute diabetes care, first aid, and routine medication administration in the clinic with nurse and physician supervision. This camp met the criteria of having ample opportunities for meeting course objectives including those related to the nursing process, medication administration, decision-making, ethical and legal aspects, growth and development, family dynamics, professional role relationships, and group process.
Confirming the Clinical Site
Once a camp has been selected, it is important to enlist the support and enthusiasm of faculty peers in order to obtain administrative approval for the new clinical site. Pictures, pamphlets, and daily schedules can confirm that the camp learning experiences are consistent with the curriculum and course objectives. Frequent contact between the agency and faculty during the camp planning process helps to negotiate skill opportunities for the students which range from supervision of the activities of daily living to total care for the campers. All of the camps that were contacted prefer the student nurse/counselor role, which means that students reside with and supervise the daily life of an assigned group of campers while also providing for their health care needs. An additional aspect of confirmation should include the role of the faculty while at camp. One camp requested that the faculty be the camp nurse and the students the camp counselors while another camp assumed that students would be coming unsupervised. Clarification was critical in both situations. This author resided at camp with the students and provided direct supervision throughout the clinical experience. Clinical evaluations were conducted in the same manner as the rest of our clinical courses.
Interest and support can be developed for the experience with a notice on the student bulletin board or a brief handout in classes to explain the possibility of a clinical rotation at summer camp. Students want to know about the camp experience: how long they will be gone from home and campus; what to pack; what meals are provided; what camp life will be like; and what professional materials they need to bring. For example, accommodations at one camp were small rustic cabins with one fight bulb and screened windows; down the path from baths and toilets, while another camp had modern air-conditioned lodges designed to accommodate individuals with a wide range of disabilities. Students at the first camp needed to bring fans, flashlights, and plenty of bug repellent which weren't needed at the other camp.
In addition to anticipating concerns regarding camp, faculty need to make it easy for students to be involved in a camp learning experience. Arranging for campus absence by taping classes and negotiating any deadlines for assignments should be done well in advance.
An orientation session helps familiarize nursing students with camp expectations, protocols, medications, profiles of the children they will be supervising, as well as any assignments they are expected to complete. Meeting with other camp staff and seeing pictures of camp from previous years helps student enthusiasm and readiness for camp. Finally, providing students with a map and a phone number for their families to call in case of emergency can help alleviate some of the anxiety of being away from home for several days.
Students in our institution were given the option of summer camp or a traditional pediatric hospital experience. Although contact hours at camp were higher and more concentrated, students chose to participate in week-long camps for elementary school-aged children with diabetes, adolescents with diabetes, children with seizure disorders, and a long weekend camp for children and young adults with myelomeningocele, cerebral palsy, and traumatic brain injury. Student, camper, and camp staff feedback from these camp experiences was extremely positive. Being with campers around the clock enabled students to fully concentrate on their clinical experience and learn what it is like to live with a chronic condition. In addition, students developed skills in providing technological care for clients outside of the acute care setting. Not only were students pleased with their experience, parents were relieved to know that their children were being supervised by nursing students instead of non-professional volunteers. Campers agreed with their parents that camp was better organized and that it was fun to have counselors who worked so well to assure them a good camp experience. Even the camp directors reported that camps ran more smoothly with the addition of student nurses. The camps have requested ongoing relationships and students are eagerly awaiting information about future camps. Since the camp clinical experience first began, our college has also used camps for community health and service learning courses with equally successful results.
As resources become scarce, providing adequate pediatric clinical experiences can be a challenge for nurse educators. Camps for children with special needs provide an opportunity to practice nursing care for the whole child in a natural environment. Using these steps to establish a camp nursing experience proved to be a successful curricular innovation for clinical teaching.