Volunteering at Diabetes Camp: A Professional Experience with Personal Benefits

By Mary Pat King, MS, Catherine Marschilok, MSN, CDE, BC-ADM, and Janet Silverstein, MD

For kids, summer camp can be the highlight of the year. Six-year-old Keenon Hill would agree. He recently attended the American Diabetes Association’s Camp Victory for children with diabetes in Louisiana.

Diabetes camps were created to ensure that children with diabetes have the same opportunity to enjoy a fun, challenging camp experience that other children without diabetes enjoy each summer. Throughout the United States, there are residential and day camps for children with diabetes. These include special interest camps, such as sports camps or adventure camps, as well as camps specifically designed for targeted age ranges. While many diabetes camps are independently operated, the American Diabetes Association owns and operates 45 diabetes camps nationwide.

At all diabetes camps, children are cared for by volunteers who are trained in diabetes care, such as endocrinologists, nurses, diabetes educators, dietitians, psychologists, and other healthcare providers. These volunteers help campers to learn how to meet the demands of caring for diabetes in a camp setting, including:

• Evaluating blood glucose readings and adjusting insulin;
• Recognizing and treating hypoglycemia;
• Making provisions in treatment to account for increases in physical activity; and
• Checking for ketones when necessary.

School nurses play an important role in promoting diabetes camp to their students, as well as serving as camp volunteers.

Making a Difference at Camp

Tracy and Gregory Hill, of Gretna, La., were concerned that their 6-year-old son Keenon might be too young to go to an overnight diabetes camp on his own. But Kim Denesse, a school nurse at Belle Chasse Academy (in Belle Chasse, La.), convinced them otherwise. “Nurse Kim,” as Keenon calls her, offered to volunteer at ADA Camp Victory to ensure that Keenon would be safe and happy. “It reassured me that she was there because I knew that there was someone Keenon knew – and he wouldn’t be afraid because he had her,” Mrs. Hill said. “I really appreciate everything she does for Keenon and all the other students – when I’m not there, she’s like his second mom.” Winner of ADA Camp Victory’s “Most Lovable” Trophy, Keenon enjoyed seeing Nurse Kim at ADA’s Camp Victory. When asked about Nurse Kim, he paused thoughtfully and responded simply, “She helps me.”

Like Keenon, going to ADA Camp Victory is now the highlight of Nurse Kim’s year! “What really tugged at my heart was the closing ceremony...it was one of the most moving experiences I’ve ever had,” she said. “During the week, we saw some of the kids do their injections or test their own sugars for the first time — they had come full circle.”

Campers learn how to manage their diabetes while swimming, boating, playing basketball and doing other activities in the safe, supervised setting of camp. They also learn that their activities need not be limited by their disease. They are taught diabetes-related tasks, as developmentally appropriate for them. The younger children may learn to give their own injections, whereas the older adolescents participate actively in insulin dose adjustments. The mastery of diabetes management provides campers a sense of independence that persists after camp has ended. “It’s incredible to see the drastic change these kids go through,” Kim said. “At the beginning of the week, these children were not my own – but by the end of the week I felt like they were.”

Gaining Knowledge and Confidence as Providers of Diabetes Care

Immersion in the diabetes camp experience is an excellent way to teach medical students, nursing students, teachers, and school nurses about the intricacies of diabetes management. More important though, they learn that caring for a child with diabetes is more than dealing with blood glucose numbers.

When Karen Fenimore, school nurse at Rowlett Elementary School in Garland, Tex., had six students with diabetes, she knew there was much more she needed to know to care for all of them. “I wanted to have more of a comfort level and be more assured in the care I was providing,“ Karen said. “When I heard about camp, I thought it would be a perfect avenue for me to learn more about diabetes.” Eight years later, Karen continues to learn more about diabetes management as a nurse volunteer at ADA’s Camp New Horizons North. “At camp, there are all sorts of medical professionals — from doctors to pump specialists, to representatives from different diabetes companies, nutritionists and certified diabetes educators — everyone who would touch a child with diabetes,” she said. “And when they see me, they probably say, ‘Here comes Karen with more questions.’”

Camp provides an opportunity for school nurses to see how diabetes affects children in their everyday activities. They witness first-hand the number of times that children with diabetes have to check their blood glucose levels, and then adjust food intake or insulin to stay in a target range. School nurses also learn that much of a child’s ability to handle his own diabetes is dependent on family support. This insight cannot be provided in a clinical setting.

Recently, Karen has been recognized among her peers as one of Garland Independent School District’s leaders in diabetes care. She was recommended by her supervisor to help implement the district’s non-medical staff training on diabetes care, which was mandated by Texas House Bill 984. “As an administrator responsible for implementing this new law, I wanted to ensure that all training done in the district was consistent, accurate, and presented in a format that could be easily understood by our new assistants,” said Maggie Willis, MSN, RN, FNP, Director of Health Services for Garland Independent School District. “Karen’s experience with volunteering at ADA diabetes camps made her an excellent choice to lead this training. Working in the informal camp setting gave Karen the opportunity to develop a holistic view of a child with diabetes. She was able to see what other challenges face these children in their activities of daily living. It also helped Karen to identify concerns that parents have for their children in every aspect of their children’s life, not just at school.

Karen’s camp experience helps her to anticipate questions the class may ask because she has a personal understanding of the physical, social and psychological aspects of living with diabetes, Willis explained. “The class participants come away feeling they are a true team member in helping these children have a safe experience while at school.” Now, Karen’s role as a camp volunteer includes recruiting other school nurses to volunteer at the week-long day camp. She’s also recruited many students to attend diabetes camp and conducts diabetes education programs at camp designed specifically for parents. “With everything a nurse has to do for kids, you have to lessen the fear factor by gaining more knowledge,” Karen said. “There is still so much to learn – and I just want to learn more!”

Building Relationships with Campers and Parents

Amy Boynton, school nurse at St. Charles North High School, Ill., has volunteered at ADA’s Diabetes Camps in Illinois for more than 10 years. She was inspired to volunteer at ADA Camp Triangle D by her own daughter, Lindsay, now 23, who has type 1 diabetes. “She really wanted to go to camp, but my husband and I felt uncomfortable allowing her to go because we were so involved in her care,” Amy said. Lindsay’s Certified Diabetes Educator convinced the family to let Lindsay try camp out – and if Lindsay could do it, so could her mother.

“I went the first year thinking that if I didn’t like it, I didn’t have to do it again,” Amy said. “And they were very clear – I was there as a nurse – I wasn’t Lindsay’s mom. I would have my own campers so that I didn’t interfere with Lindsay’s camp experience.”

That first year, Boynton had a cabin full of boys. “It was a marvelous experience for both of us – I obviously fell in love with going to diabetes camp,” said Amy. “And once I saw the wonderful care they have there, I wondered why I ever hesitated to send Lindsay in the first place.” At that point, Lindsay already had diabetes for several years so Boynton felt comfortable caring for a child with diabetes. “But I learned so much about the big picture. I saw all different kinds of management,” she said. “That was really good for me – it was very enlightening and helped me to adjust in the school setting.”

Camp continues to be a learning experience for Boynton and sometimes the campers are her greatest teachers. “It is an intensive week of diabetes education for staff and campers alike. I never walk away without learning oodles of things from the medical staff and kids,” said Amy. “Kids are fascinating sources of information. They know of snacks for treating lows I’ve never even heard of!” As a mother, Boynton appreciates the benefits for campers. “It’s so wonderful for the campers because having diabetes is normal there. No one is embarrassed about anything – everyone is willing to test because everybody else is doing it. They are no longer singled out.”

Boynton explained that when parents see school nurses at camp, they are reassured that school nurses are up to date and well-informed about diabetes management. “As a mom, I know how they feel. I entrusted my daughter to the teachers and school nurses every day and I counted on them to make sound judgments about her diabetes,” she said.

Many of her former campers have become Boynton’s students at her school. “It’s fun because I’ve met kids at camp when they were in grade school who are now my students in high school and their parents remember me!” Amy said. “It makes a real difference in how they feel about entrusting their child to me. They know I’m involved in camp and stay current in diabetes.”

Kim Bradner appreciates the role Amy Boynton plays in the life of her 17-year-old son, Jeremy. “I tease her that if I fell off the earth, I’d sign my kids over to her,” said Bradner. “I even asked her if I could pay her to go to college with him!” Bradner expressed that as Jeremy’s school nurse, Boynton is a critical part of Jeremy’s diabetes care team. “It’s a huge comfort to know that she works with him at camp and at school,” she said.

Sometimes, Jeremy and Mrs. Boynton learn things for the first time together. Last year, they learned about a new bloodborne pathogen container that makes it easier and safer to dispose of syringes. “It was a new style and I was teaching Jeremy how to use this container to take off his pen tip, rather than unscrewing it and poking himself.”

Jeremy recently expressed his gratitude to her by asking her to join him and his friends as their special guest at an invitation-only breakfast for faculty, prepared by students. Boynton keeps a photo of that special day posted on her bulletin board in the school nurse’s office.

Spreading the Word to Students and School Nurses

Although she started at ADA’s Triangle D Camp for younger children, Amy Boynton now volunteers at ADA’s Teen Camp in the Chicago area. She leads many of the educational sessions for teens and promotes the camp to her own students with diabetes. “I get the camp information from the American Diabetes Association and share it with all the students who have diabetes and attend North High School,” she says. “Not that I think camp is for everyone, but I think it’s something everyone should consider.” Many children with type 1 diabetes do not know anyone else with their disease. Diabetes camp offers an opportunity to meet others with the disease, sharing common experiences and supporting one another.

And she is spreading the word to other school nurses. “Camp is the best opportunity to learn about diabetes that a school nurse could ever have,” she said. “At camp, we get to see how diabetes affects a child’s whole day and life — not just lunch time or snack time. At school, we see such a small picture of what’s going on in a child’s diabetes management. Camp helps you to understand what an enormous issue these kids are dealing with. It’s easy to forget that when you only see them for 10 minutes a day.”

Learn More About Diabetes Camp

To learn more about volunteering at the many diabetes camps across the country or to share information about diabetes camp with one of your students, visit:

• ndep.nih.gov
  The National Diabetes Education Program is a federally funded program sponsored by the U.S. Department of Health and Human Services’ National Institutes of Health and the Centers for Disease Control and Prevention and includes over 200 partners at the federal, state, and local levels, working together to reduce the morbidity and mortality associated with diabetes. Through NDEP, you can download year-round resources for diabetes care.
• www.diabetes.org/camp
  The American Diabetes Association is the largest provider of diabetes camps in the United States with 45 camps nationwide.
• www.diabetescamps.org
  Diabetes Education & Camping Association is an organization made up of camping and youth leaders, and medical professionals who operate diabetes camps and youth programs around the world. There are more than 160 diabetes camps in North America and another 160 additional camps around the world.
• www.childrenwithdiabetes.com/camps
  Children with Diabetes offers a comprehensive list and review of Diabetes Camps nationwide.

ABOUT THE AUTHOR

Mary Pat King, MS, Director of National Youth Initiatives, American Diabetes Association, member of the NDEP Children and Adolescent Work Group

Catherine Marschilok, MSN, CDE, BC-ADM, Juvenile Diabetes Research Foundation, Albany Medical Center Pediatric Endocrinology Department, member of the NDEP Children and Adolescent Work Group

Janet Silverstein, MD, Professor, Department of Pediatrics, University of Florida, Chair of the NDEP Children and Adolescent Work Group

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