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Caring for Patients in a Different Light: Pharmacists’ Experience at Indian Summer Camp for Kids with Cancer

Sarah T. Mitchell, PharmD
PGY-2 Oncology Pharmacy Resident
Norton Children’s Hospital
Louisville, KY

Savannah L. Gulley, PharmD
PGY-1 Pharmacy Resident
Norton Children’s Hospital
Louisville, KY

For 36 years, Indian Summer Camp has provided children with cancer in Kentucky and southern Indiana a reprieve from fighting cancer and a place where they can just be kids. It began as a summer camp but has now been expanded as part of the Kids Cancer Alliance, an organization that provides more than 50 programs for these children and their families each year. However, the main event remains Indian Summer Camp for Kids with Cancer, a weeklong camp dedicated to serving local children who have battled or are currently battling cancer.

To an outsider, camp may appear to run smoothly, but this amazing experience takes a small army of volunteers to function seamlessly. Volunteers range from students to previous campers and include a full medical staff of physicians, nurses, and pharmacists. Unless a child is hospitalized, none is ever too sick to come to camp, and the medical staff works to accommodate all children regardless of their medical needs. When given the chance to serve as part of the medical staff, our immediate response was “yes.” The opportunity to see our patients experience a normal childhood, even for just a week, was something we could not pass up.

The first day of camp is the busiest for all staff members, but especially for the pharmacy staff. We work with campers and families to perform a thorough medication reconciliation, develop medication administration records (MARs) for each camper, and fill individualized medication boxes for the week. Each camper’s medications are unit-dosed and divided into four administration times: breakfast, lunch, dinner, and bedtime. Because roughly 60% of our 100-plus campers receive at least one scheduled medication, we have to recruit local pharmacy students as additional volunteers to complete the filling of all campers’ medication boxes by dinnertime. After all campers have arrived and their medications are accounted for, the pharmacy team gets to enjoy the waterslides and jump houses and take part in the joy of camp.

Before each meal, we review all campers’ MARs and gather medication boxes to ensure that all children receive the appropriate medications at the proper time. As campers enter the dining hall, they stop by the medication table to receive their scheduled doses and then rejoin their cabin mates to hear updates on the Polar Bear Swim and Davy Crockett camp awards. After all campers have received their medications, a final MAR review is conducted to ensure that no child missed a medication administration. This process is repeated four times a day, every day, until the end of camp.

Outside the regular medication administration times, the pharmacy staff also provides around-the-clock pharmacy services. We manage campers’ as-needed medications and maintain a small supply of over-the-counter and emergency medications for common concerns that may arise at camp, ranging from bug bites and rashes to headaches and swimmer’s ear. We even keep a small supply of intravenous antibiotics in case of unexplained fever. Where the medical management of campers is concerned, there is never a dull moment. This experience helped prepare us to manage a variety of conditions in this patient population, including febrile neutropenia, in the more traditional setting of our residency site.

This experience was a great jump start to our residency year. We had the opportunity to get to know some patients and their families early on and start building relationships with them, which allowed us to better understand our patients’ needs and become their advocates early in the residency year. Camp also introduced us to a variety of malignancies, common medications prescribed to these patients, and some effects of treatment, including avascular necrosis, posterior fossa syndrome, and growth factor deficiencies. It allowed us to put faces to different disease states that came up in discussions throughout the year and opened our eyes to the survivorship aspect of these patients’ care.

Managing medications for all the campers comes with challenges, but the joy and liveliness of camp are strong enough to outweigh any amount of stress or fatigue. When not administering medications, we spent time with the campers having fun and making memories. Water-gun fights are a constant amusement, and no one is safe within 100 feet of the pool. The campers may say their favorite activities are building with Legos, playing bazooka ball, or preparing for the end-of-camp dance, but for the medical staff the favorite activity is Hug-and-Tuck. Every evening before the campers fall asleep, we tuck each child into bed and wish each one a good night.

These kids look forward to Indian Summer Camp all year long. These 6 days help them through their fight with cancer, but the energy provided by camp also has a rejuvenating effect for the staff. When caring for these pediatric patients becomes challenging, we can think back to all our memories of caring for them in a different light over the summer. Indian Summer Camp will forever hold a place in our hearts, and we are already looking forward to this year’s camp.