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ACN Association of Camp Nurses

ACN Practice Guidelines for Camp Nurses in the U.S.

Note: Practice Guidelines are culture-bound, hence these are labeled for nurses who practice in the U.S. A Canadian version is in development and will be posted when ready.

Health Screening at Day and Resident Camps
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Documentation in Day and Resident Camps
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Medication Management for Day and Resident Camps
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Communicable Disease Control in the Camp Setting
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Nursing Delegation to Unlicensed Assistive Personnel in Day and Resident Camps
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What Are Practice Guidelines?

ACN’s Practice Guidelines are designed to guide – not define – camp nursing practice. They are written for nurses and more fully describe aspects of camp nursing around which nurses typically have questions. The Guidelines compliment the Scope and Standards of Camp Nursing Practice (ACN, 2005).

While the Guidelines are designed for camp nurses, some aspects of each guideline will have impact on the camp in which the nurse functions. For this reason, ACN recommends that camp nurses bring the Guidelines to the attention of their camp director and/or other appropriate personnel. Talk through each statement and collaboratively determine how the Guideline might be implemented in a way that complements that particular camp.

Some statements are straightforward. For example, #12 of the Documentation Guideline simply states that documentation “Is legible and uses appropriate grammar and spelling.” Such a statement needs little support from a camp director. But other statements need director input. #5 of the Documentation Guideline is such an example. It directs that documentation “Is retained for the legally appropriate duration of time.” Since the camp has the responsibility of document retention, the camp nurse will need direction as to where and in what format his/her documentation should go.

The Practice Guidelines are sensitive to but not defined by ACA Standards. This is an important distinction. ACA Standards direct practices that are linked to a given camp’s ACA accreditation. ACN’s Practice Guidelines direct nursing action. For example, ACA Standard HW.7 describes the health screening done within 24 hours of an individual’s arrival at camp. ACN’s Practice Guidelines support this buts direct the nurse to document when a person leaves camp with an unresolved health problem (see Documentation Guideline, #3c). This compliments traditional nursing practices but, in this case, goes beyond what ACA Standards direct. Indeed, ACA Standards don’t address closing a person’s health record, something that is standard operating procedure for nursing practice (e.g., exit charting).

The Practice Guidelines are culture-bound. There’s a reason why these Guidelines are labeled for use by nurses practicing at U.S. camps. ACN recognizes that nursing practice varies from country to country. Thus, cultural-bound materials produced by the Association are appropriately labeled. A Canadian (Ontario) version is being developed by the Ontario Camp Association’s Healthcare Committee under leadership of Board member Cheryl Bernknopf.

The Practice Guidelines are subject to change and/or revision. Nursing practice is a dynamic practice; it evolves over time. Consequently, ACN will periodically review and update each Guideline as need arises. Some changes may be driven by a change in law, others by a need that arises, and still others by new developments in the camp community. Users of the Practice Guidelines are thus encouraged to consistently check ACN’s website ( for the most current versions.

Why Should a Camp Director Know about the Guidelines?

The camp nurse is typically supervised by the camp director. Often, the director is not a nurse nor, necessarily, aware of what parameters might be used to determine if the camp nurse is practicing appropriately. This is where the Practice Guidelines can be helpful. Each describes aspects of camp nursing practice in a way that allows individual camps to provide descriptive, evaluative statements for the camp nurse’s performance appraisal process. Camp professionals are encouraged to use the Guidelines to contribute to that process.

In addition, Schultz’s research (Schultz, 2014) indicated that nurses not affiliated with ACN typically do not know about ACN. By virtue of extension, they’d then likely not be aware of the Practice Guidelines nor The Scope and Standards of Camp Nursing Practice (ACN, 2005). Camp directors can help bridge this gap by providing access to resources for their camp nurse(s). Like any other employee, the nurse should be oriented. The Guidelines help provide that orientation while also informing the nurse about practice parameters.

What are Some Highlights of the Practice Guidelines?

  • Health Screening at Day and Resident Camps:
    • Describes “pre-screening” as a review of individual health information that occurs before Opening Day, thus minimizing the potential for surprises and reducing time on Opening Day for one-on-one conversations.
    • Directs that screening parameters be defined – what is acceptable? – and a procedure in place when an individual’s parameters fall outside those expected parameters.
    • Directs the nurse to share personal health information about campers with appropriate camp personnel on a need-to-know basis.
  • Documentation in Day and Resident Camps:
    • Recognizes that camp nursing documentation often includes a variety of forms, some of which may be managed by people other than the nurse (e.g., incident reports).
    • Emphasizes that the camp nurse must satisfy the elements of nursing documentation (e.g., the nursing process), including the incorporation of evaluation statements, regardless of what tool is used for documenting (paper vs software).
    • Directs that attempts to communicate with stakeholders (e.g., parents) are documented as well as successful communication.
    • Describes nursing documentation using the acronym SMART (specific, measurable, appropriate, realistic, timely).
  • Medication Management for Day and Resident Camps:
    • Directs that clients – especially parents and staff – are informed about the scope of medication services provided by the camp and the credential of the individual(s) providing these services.
    • Describes the elements that should be in the camp’s written medication policies and practices. This includes how the camp defines “medication” and articulating a protocol when a medication error occurs.
    • Recognizes that medication is the domain of physicians. To utilize medication, including over-the-counter meds, the camp nurse needs and must practice within the parameters of written and annually signed medical protocols.
  • Communicable Disease Control in the Camp Setting:
    • Emphasizes a collaborative stance between the camp nurse and camp director. Neither person can be successful in communicable disease control without the participation of the other.
    • Lists a minimum set of protective behaviors for camp implementation.
    • Describes a camp’s Communicable Disease Response Plan, including the need to define the camp’s “tipping point,” the point at which communicable disease outbreak is suspected and the Plan is triggered.
    • Makes a distinction between the camp nurse’s need to focus on care-giving during an outbreak while the camp director focuses on managing the overall situation.
    • This is the only Practice Guideline currently supported by a white paper, Communicable Disease Management in the Camp Setting (available online at
  • Nursing Delegation to Unlicensed Assistive Personnel in Day and Resident Camps:
    • Describes the parameters of a nurse’s (RNs) delegation authority and scope of that authority.
    • Recognizes that RNs may direct an appropriately trained individual to collect health data (e.g., take a temperature) but the nurse retains the responsibility for interpreting that data.
    • Directs the camp nurse to determine if the individual to whom a task is delegated is, indeed, capable of doing that task appropriately. This has impact upon camp programs such as tripping.


  • Association of Camp Nurses (2005). The scope and standards of camp nursing practice. Bemidji, MN:
    Association of Camp Nurses.