Calliope and I spent our second weekend at camp this past weekend. The previous weekend was pretty easy because it was just staff orientation, and we camp nurses are generally exempt from attending most activities. We are always welcome, but never required. This works well for me. I like doing my own thing.
But this Sunday was opening day.
When I worked here in 2008 and 2009, I was the only nurse. It was fine most of the time, but dispensing medications twice a day was always stressful -- these kids take a lot of medications despite it being a regular population of kids (apart from a small cohort of campers on the autism spectrum who participate in the Mitzvah Corps program... "mitzvah" means good deed in Hebrew. The rest of the campers have the choice to choose the mitzvah corps major, where they work with the ASD campers.) However, my second summer there, we witnessed an H1N1 outbreak, with 75 campers having fever (almost all within a few days of each other), then the director, Melissa, got MRSA, then we had a lice outbreak. So I was exhausted by the end of that summer.
So I'm very grateful that the camp now hires two medical staff. The second nurse, Francesca, is great. Very, very laid back. I am struggling not to naturally take over. She's totally competent and while there are some areas of being a camp nurse where I am clearly experienced and she is not, there are a lot of times where I naturally speak up and take charge because that's what I am used to do in my solo practice. She's very graceful about the whole thing and never seems to take offence but I don't like this tendency in myself. And I'm trying to work on it.
Opening day was brutally long. We had Saturday to prepare, and Calliope did beautifully in her two hour "practice" with the new babysitter. But being away from her for nearly 11 hours on Sunday was hard. I felt physical pangs towards the end of the day, and suddenly just couldn't be in the infirmary any more -- the longing to see my girl was intense.
Saturday night, the night before opening day, we were at an outdoor picnic dinner -- way past Calliope's bedtime -- and she tripped and fell on the pavement. Her mouth immediately had a rivulet of blood spilling down her lip. I grabbed her up and swabbed her mouth and immediately scanned her wailing mouth for dental damage -- I'm terrified of her breaking a tooth, or jamming one up into her gums -- and luckily couldn't find any sign of injury beyond a small laceration to her lower lip. Phew.
Her cries of fear and pain changed to screams of outrage as I attempted to hold an ice pack to her lip -- Francesca, well prepared nurse that she is, was carrying cotton balls to sop up the blood as well as disposable instant "ice" packs. I gave up after about three minutes, figuring that she got some benefit even from brief icing. And carried her off to a very late bedtime. Unfortunately, the next morning, jumping (from a kneeling position), she bumped her lip again, barely, and it bled profusely all over again.
The schedule at camp is stressing me out. Well, we've only had one day of actual camp, plus training days. But the schedule seems to always be in flux. There's a lot of hurry-up-and-wait. I need to be available to distribute medications prior to meals. And it's also important to me to be fairly consistent with Calliope's schedule. So if I know dinner is going to be late, I can take Calliope to the cabin and feed her ahead of time. And either put her to bed, or not, depending on the timing. But last night, we were ready to distribute meds from 6:15. A half an hour later, we still hadn't seen any sign of the campers, so I lugged Calliope -- who was done with hanging out with the babysitter -- to the camper orientation session. The assistant director whispered that the director had forgotten about "med call" and was going to postpone the medications, but changed her mind, and would, after all, be sending camper for meds before dinner, in just a couple of minutes.
So I scurried back to the infirmary with Calliope, handed her extremely "reluctant" self over to the babysitter once again, and waited. Soon after, a number of campers showed up. Maybe one third of the number we expected. As this was our first time dispensing meds, we had some snafus with things being in the wrong place. Finally we were done and everything was safely locked away. Then a new camper arrived to be medically cleared. With an apologetic wave to Francesca, I scrambled to the dining hall and found Calliope sitting in a high chair at a table with the assistant counselors, two of whom are her babysitters -- everyone eating. Except maybe not Calliope. On her plate was a whole (unripe) pear, 95% of an apple (the rest was sliced off and shaved into pieces on her plate), some olives, cucumbers, and raw broccoli. The size of the fruit made me laugh. Bless their good intentions.
After dinner -- I made Francesca a plate so there was food for her when she finally arrived, though I didn't have enough foresight to make it until the meatball supply was limited -- I very deliberately and a bit resentfully did not return to the infirmary until I had taken Calliope back to our cabin for a bath and to read some books. I felt like she had been neglected long enough, opening day or not.
Once Calliope was in bed -- at the shockingly late hour of nearly 8:30 (normally it's 6:30-7) -- I returned to the infirmary. Francesca reported that another one third of campers had come after dinner to pick up their medications while I was gone. Leaving a fair number of medications still unclaimed. Two hours after they were due.
I carried a box with remaining medications down the hill to the outdoor synagogue. The campers and staff were facing the large pond as it reflected the setting sun, their singing voices carrying beautifully across the open water. I squatted in the back and started popping open blister packs with my walkie talkie turned on low and tried to be unobtrusive. The other senior staff in the back were sympathetic.
Eventually the medications were all poured into little tiny envelopes and labeled with the appropriate names and cabins and handed off to the head counselor after a whispered consultation during the Mourner's Kaddish. Yikes.
Walking back across the property to the infirmary, I mused about this camp director. Melissa has unbelievable gifts. For one, when she's talking to you, she can make you feel like a million bucks. And this is true not only one on one, but also in large group settings. Shortly before the campers arrived, she had all the staff sit together and close our eyes, and instructed us, "Remember how you felt when you arrived at this place ten days ago, and how we've grown as a community. We are about to create a summer of magic for our campers. You are the keepers of that magic. And out of that magic comes the next generation of Reform Jews."
Even I, a (mostly) non-believer, was ever so slightly awed. And for the eighteen and nineteen and twenty year old staff, I'm sure they were completely enthralled.
That part is amazing.
The not so great part... is her organization. She likes to be involved with minutiae -- like being in charge of the grill at dinner -- making her unavailable when I have important questions. She plays fast and loose with the schedule. Often for unimportant reasons. She asked Francesca and I to wait for a meeting for five minutes for a meeting so she could say goodbye to a friend who was leaving... and kept us waiting for thirty minutes. She could have said, "I'll call/walkie/stop by when I'm ready" so we could've continued our preparations for the onslaught of opening day -- the infirmary is always the bottleneck on opening day and I wanted to maximize our organization and thus, efficacy -- but instead, we sat, unproductive, while she chatted.
Likewise, the evening activity, and not giving clear instructions to the camper regarding when to pick up their medications. Medication dispensation is not something I take lightly.
A previous summer, I was pretty sure a junior staff member had broken her leg, and needed an ambulance to bring her from her cabin to the local ER because she couldn't walk and her ankle had swollen to gross proportions. But the counselor's mother also worked at the camp, and didn't want me to call the ambulance until I confirmed that the camp would pay for it, because her child didn't have health insurance. But the director was in the midst of expelling two (favorite) campers who had been caught having sex. And was having a long and drawn out conversation with each of the expelled campers, in turn. I sat on the floor outside the director's office for forty-five minutes while the worried mother paced. The assistant director sat on the floor beside me, powerless to interrupt as the director had specifically demanded no interruptions. Both of us frustrated, though he was diplomatic enough not to say anything critical about his boss.
Finally, finally, I was able to talk to the director. I had just slid into one of the chairs in her office when the increasingly panicked mother bounced into the door and announced angrily, "I couldn't wait any longer! I had to call 911!"
And then the two of them got into an argument. The director yelling that the mother had no right to do so since it wasn't a true emergency, and the mother shouting back that the director had taken too long to talk to me.
Of course, this happened five years ago. Maybe a lot has changed. But the disorganization of last night, especially, worries me, and makes me doubt it.
And as a side note, I still don't know if I did the right thing by waiting to talk to her, or if I should have interrupted. I so rarely have a non-medical person question my authority to interrupt a meeting that I was wholly inexperienced in this situation. The principals in my school -- a building of 1350 children -- have never questioned my right to call an ambulance or make any other medical decision. Was a broken leg an actual emergency? I thought not, since it wasn't life threatening, especially since the patient had waited overnight to even report the problem. On the other hand, she was in a lot of pain and I was enraged that I was told by the assistant director, on her orders, not to interrupt, even to help my suffering patient. He sat beside me on the floor, clearly frustrated also, both of us feeling powerless. (I suppose I want her approval and positive feedback, as we all do, or else I would've interrupted any way. I mean, who cares if she gets mad at me, right?)
Compromising Calliope's day so much was the most frustrating of all for me. So much time spent waiting, when I could've fed her and put her to bed, but was waiting to be available. If I just decide that past a certain time, I'm going to leave and put her to bed, I'm not being fair to Francesca and the campers. If I make Calliope wait (and wait and wait), I'm not being fair to her, and it's not her fault that the schedule is so disorganized. I could ask her babysitter to feed her early, I suppose, though I prefer to assume that responisibility myself. And I hate to use a babysitter (no cost to me, but still) when I am not actually doing any work besides waiting.
The money is helpful, for sure, but I'd love to find a way to not be frustrated by this situation. I know, as is true in life, that I can't change her. So how can I find a way to provide appropriate care for my daughter (and by extension, myself) and also make peace with camp, and Melissa, being who she is.
I know that I can't change her, and I can't change camp. How can I change my myself and my thinking so that I'm not frustrated by the realities there. And how can I get to a place where I don't care about her approval?