Camp Nurse (14 page)

“How did you know?”

On another occasion, Wayne took me aside to tell me he was itchy.

“Where?” I asked quietly.

“Back there. You know, in the
anal
area.” He squirmed around as he spoke.

I nodded and asked him a few more questions, but he refused to be examined, so Kitch had to make a guess. “We could give him Vermox in case he has pinworms. It’s harmless,” Kitch reasoned.

This was another drug I was unfamiliar with. “Does it have any side effects?”

“Only one,” he said, his eyes twinkling. “It may cause camp-wide hysteria.”

Wayne came back on another day to show me a scratch on his leg. “Does this cut look infected?” He was wearing swim trunks and a towel around his neck.

“Are you supposed to be at swim class?”

“Yeah, but this cut is bad.”

“Wayne, how’s it going? Other than swimming, are you happy at camp?”

“Sort of. Sort of happy. Well, happy-ish.”

I sat there, waiting.

“My parents sacrifice a lot for me to come to camp. Please don’t call them.”

“I wasn’t planning to.”

“Great. Can I use your bathroom?”

After learning so much from Kitch and as I got to know the children better, I grew confident in treating them. I knew who needed a hug or a chat and who simply wanted to receive a comforting dose of some common over-the-counter product they were familiar with from home.

But Caitlin had a better connection than I did with many campers, especially the teenagers, who gravitated to her. They saw her as a friend, whereas I was more like a mother. With her banana-split-flavoured lip gloss, adorable figure, stylish clothes, and natural way of conversing in their language (casually using “phat” when it didn’t mean overweight and “way cool” as a complete sentence). They identified with her. I was coming to realize that I no longer spoke the language of the people around me. They understood
my
dialect, but it was an effort for me to grasp
theirs
.

For the most part, anyone could treat the minor, everyday things the kids came to see us about. By and large, the problems they arrived with on our doorstep were all the things parents treat their own kids for on a daily basis. And when they proffered their sore finger or cut knee, what they really wanted, more than anything, was attention. Once, when a girl came to me for something I considered trivial, I asked in annoyance, “If you were home, would you go to the doctor for this?”

“No, but I would go to my mother,” she answered, pouting.

Touché
. Okay, I got it. At camp I was everyone’s mom – except for my own kids, from whom I was expected to keep my distance. When it came to Max and Harry, I could look, but not touch. I threatened to start them on a four-times-a-day regimen of pills, just so they’d have to come for pill call and I’d get a chance to connect with them!

Happy campers came and went, but one camper who proved to have a persistent case of unhappiness was Alexa Rose. I kept an eye out for her around camp, and she seemed always to be with friends and enjoying her popularity. The other girls clearly admired her outfits, such as a pink Juicy Couture sweatshirt with camouflage cargo shorts, and designer sunglasses. But she continued to come to us every evening right before bed, asking for a few drops of Rescue Remedy. When I tried one night to get to the bottom of what was bothering her, the tears welled up instantly.

“I am soooo unhappy,” she said. “This is so not a fun camp. It’s more like boot camp.”

“But you seem to be having fun,” I countered, “at least during the day.”

“There are so many rules and I miss my parents. Camp is supposed to be a vacation from your parents, but I like my parents, my mom, especially.”

“What would your mom do if she were here?”

“She’d let me do whatever I want. She never makes me do anything I don’t want to do.”

“Anything else?”

“She’d make me feel better. She’d hug me.” Her counsellor was at her side, trying to do that very thing, but Alexa Rose pushed her away. “It’s not the same.”

“No, it’s not,” I admitted, “but your counsellor can help you while you’re here.”

She shook her head. “No, nothing will help me.”

Her counsellor, who’d been giving her lots of extra attention, was getting frustrated. “I don’t know what to do. I’ve tried everything,” she told me when we went aside to talk.

“You’re doing a great job,” I said. “It’s not easy.”

“I didn’t know it would be so hard to be a counsellor,” she whispered to me. “I can’t wait for my day off.”

We returned to Alexa Rose, who articulated her complaints only too well.

“I hate how they make us do activities all day. Why can’t we relax? It’s supposed to be our vacation.”

“Did you want to come to camp?”

“I thought so, but not any more. Every minute here feels like an hour. I want it to go by like that!” She snapped her fingers to show just how fast. “At first, I thought the tuck shop would be good, but it’s a joke. It’s a hut with a few candy bars and potato chips – what is that? Like, hello! There’s nothing to buy. At my other camp, there was a vending machine. And there’s only three sinks for twelve girls and four counsellors. Don’t you agree something’s wrong with that? If I don’t get there first, do you know how long it takes? Oh, how am I going to get through the next twenty-two days? I want to be in my own bed, in my clean house.”

I gave up. Talking to me only gave her more opportunity to dwell on her problems.

One day I received a message from her mother.

“How’s my baby doing?” she gushed into the answering machine. “I’m so worried! Alexa Rose is very sensitive and it’s been so hard for me, too, because, well, we’re best friends. She and I, we’re practically attached at the hip, and I miss her so much, but I do think it’s good for her to stay at camp. Of course, both my kids are
numero uno
in my life, but Alexa Rose is … she’s special. I just want her to feel good about herself, but her letters are breaking my heart.”

“Did you speak to my mom?” Alexa Rose asked the next time I saw her. “Did she say I can come home?”

“She said she wants you to stay and that … you’re …
special
.”

“My mom always says I’m special, but at camp, I don’t feel special. Here, I feel just like everyone else.” She looked dejected but ran off to join her friends.

Just like at Camp Na-Gee-La, it was not only campers who needed attention. The counsellors also got colds, sore throats, and headaches, and could be just as miserable and needy. Sometimes, the counsellors needed counselling, like the girl who returned from a day off sporting a new tattoo, a black and white Chinese yin and yang symbol, on her backside. It was inflamed and swollen, and she had a low-grade fever.

“Does it hurt?” I asked, touching it gently. “It looks sore.”

“No, I don’t feel a thing,” she said with an odd giggle.

“Is your hepatitis vaccine up to date?” Kitch asked her.

“I don’t know. Can you call my mother and find out?”

“Did you get this tattoo in a reputable place? Was it clean?” Kitch inquired, ever so sharply.

“I think so … The guy seemed to know what he was doing. My friend got hers there.” She hiccuped loudly.

“Do your parents know about it?” Kitch asked.

“I
am
seventeen,” she said, “but yeah, they know and they’re cool with it, anyway. Hey, your questions are majorly freaking me out.”

Kitch and I went into his office to talk privately. He told me that a tattoo in that place was called a tramp stamp, and that it was a dangerous practice. “If these girls ever require an epidural anaesthetic, during childbirth, for example, the ink can track right up the spinal column and cause serious complications. But they won’t listen to reason about these things and besides, legally, they don’t require parental consent. I just know that if she were my daughter, I wouldn’t be too pleased.”

The counsellor agreed to let me take a blood sample to send off to test for
HIV
and a hepatitis screen. Afterward, as I applied anti biotic ointment to the reddened area, I asked her why she got a tattoo back there where she can’t see it.

“I can’t, but my boyfriend can.” She grinned. “He thinks it’s a real turn-on.”

As she got off the examining table, she stumbled, and as I reached over to steady her, I caught a whiff of alcohol on her breath. She looked at me sheepishly. She was drunk and she knew I knew it. I had to tell Coach Carson and he fired her later that day. She packed up and stormed out of camp, upset only about losing the six-hundred-dollar bonus Coach Carson gave every counsellor who completed the summer.

I would rarely treat a counsellor before a camper, but I made an exception one evening for a young woman in genuine distress. It was just after pill call and suddenly the waiting room inexplicably filled up with campers, all with minor complaints. In the midst of that, the female counsellor arrived, clearly upset and fighting back tears. I went to her right away; however, it wasn’t me she wanted.

“Is Caitlin here?” She looked around.

“No, it’s her day off. She’ll be back tomorrow.”

Face it, Caitlin is younger, prettier. Who wants the wise and witty nurse when they can get the cool and phat one?

“That sucks … but I can’t wait.”

“What’s the problem?” I was all business, pen poised over the clipboard.

“Can I talk to you? Privately?”

“Of course.” I invited her into the examining room and closed the door.

She faced me down. “You
have
to keep this one-hundred-percent under your hat. Not a word! If Coach Carson finds out, I’ll be fired. You know the rule, no sex at camp.”

“Yes,” I nodded, “it’ll stay confidential unless it involves health or safety.”

She didn’t look too pleased with that proviso but continued. “My boyfriend …” She twisted her hands in her lap. “He pulled out … too late. We were in the middle of it, you know … and he’d told me he was an expert in withdrawal. He said he knew
what he was doing … so then I stood up right away, but …”

Together, we figured out where she was in her cycle and I convinced her to talk to Kitch, which she did, but only after swearing him to secrecy, too. He promised to obtain the morning-after pill for her, but only on condition that she and her boyfriend would come in for counselling on birth control and safe sex. “This is a one-time rescue,” he warned her. “You have to make a contraceptive choice.”

“No worries,” she said. “We’ve broken up. I dumped him.”

Most afternoons, Kitch took a break. “Don’t hesitate to call,” he always said. I didn’t want to interrupt his rest, but that wasn’t the only reason I didn’t like to call. I had worked with doctors in hospitals for many years and was all too familiar with the nurse-doctor game. For a nurse, there’s always a certain pride in figuring things out by yourself and using your own judgment. However, doctors varied hugely in the way they regarded the nurse’s role. Some freely collaborated with nurses and relied upon their judgment and initiative, especially at night or during their off-hours when a capable nurse could keep them from being disturbed. Others wanted complete control and expected to be woken up for every little thing. But in many cases a nurse’s hands are tied: we know what the patient needs – sometimes it may be something very basic, like a laxative – but we can’t give it without a doctor’s order. If I were to call the doctor in such a situation, the doctor might get annoyed with what he saw as my lack of initiative or judgment. Nurses have to be able to accurately read the doctors they are dealing with and know the degree of mutual trust and respect. They have to be confident, have excellent assessment skills, and know their own abilities and limitations. All of these are factors that go into a decision to call the doctor.

One afternoon, there was a true emergency – though it didn’t appear to be one at first – for which I had to take independent, immediate action
and
call the doctor. In order to give the best care to this serious situation, we had to work together. An effective response required teamwork between Kitch and me, and luckily, by then, I had won his respect enough that we could collaborate as equals, with our separate, but interdependent roles.

It all started very quietly. I’d been sitting in the mc enjoying the air-conditioning when Jared, the water ski instructor, showed up at the door. He stood there, dazed and disoriented. He told me only a few details about what had happened.

“I was doing tricks … skiing for … to show the kids,” Jared had said slowly, haltingly. “A back flip … and a tantrum, I think that’s what … and went down. I wiped out and hit the water hard.”

I knew immediately that this was a serious situation. I called for Kitch and then got straight to work.

“What hit the water, Jared?”

“My head.” He rubbed his neck. “My back, too.”

As I ran to get the spinal board from the examining room, I heard him mumble that his arms were tingling. He lifted his chin slowly. “My neck is sore.”

I laid the board down on the floor and strapped him in, careful to stabilize his head and neck with the collar. Then Kitch was there and I told him what had happened and what I’d done so far. We were both thinking the same thing: spinal cord injury and possibly head injury, too.

Kitch examined Jared while I called for an ambulance. Kitch said Jared would need an emergency neurosurgical consult and a ct scan of his head and spine to rule out spinal cord compression, bruising, or even a rupture. Kitch was worried, but angry, too. “Jared, you should have known better! We’ve gone over emergency procedures with a waterfront injury. Would you have
let a kid get up and walk after an accident like this? Don’t you realize how serious this could be?”

Jared closed his eyes, wearily. He had no explanation for why he hadn’t taken the proper action. Maybe he’d been stunned by the blow to his head. However, even if he’d had his wits about him, when it comes to treating ourselves, most of us lack the clinical objectivity needed to make rational decisions.

I took his vital signs frequently, including neurological checks that involved assessing the reaction of his pupils to light and the strength of his hand grips. I knew that he was at risk for “spine shock,” a rapid worsening of his situation that could be fatal. It would start with a sudden drop in heart rate and other vital sign disturbances. It can lead to cardiac arrest. I stayed near and observed him closely. He remained in stable condition. Soon, the ambulance arrived and Jared was taken to the local hospital and then air-lifted from there by helicopter to a Toronto trauma centre, a hospital that specialized in treating accident victims with head and spinal cord injuries.