Medical Staff for Encampments

[mikeylikey]

The Medical Officer for my Wing's  Encampment/ RCLS, has stepped down.  Is it a requirement that the Medical Officer be a Senior Member or could it be a Cadet.  I have looked everywhere for guidance, and unless I just overlooked it, I have no clue.  I have been told that Cadets can not perform this function, and that Cadets can perform this function.  Is there another publication I am just not aware of?  Any help would be great.  Also, what is the basic level of education training the medical officer should have?  THANKS FOR YOUR HELP!!

[PA Guy]

As a start read CAPR 160-1.

[Capt.karl]

I have been a Cadet Medic for the last 3 encampments that I have been too. One year we had one SM as a Medical Officer and last year we had 4 SM Medical Officers. The SM Medical Officer position is mainly a Mentorship position for their cadet counterpart. However there is NO requirement for a SM Medical Officer, only a requirement for qualified personel. If you have a Cadet Medic who is a NREMT-B and a SM who is First Aid, CPR. Then the cadet could just be the Medic for the encampment. I have only seen this once in my CAP career and probably will never see it again. A medical officer of the encampment has more authority then the Encampment Commander since this is CAP. If the Medical Officer believes that for safety reasons he/she must suspend the encampment they CAN do that. Even if the Encampment CC disagrees, the Medical Officer can go right to Wing CC, Reg CC, Natl. CC and have them suspend the encampment, if they disagree then the next step would be for the Medical Officer to resign and have CAP get sued over a blister on a cadets toe!

[mikeylikey]

^  A year later........anyway, I used Army Physicians and the Post medical clinic and it's personell for all my CAP Encampment needs.  I would also like to get rid of the  cadet medics that seem to be at every activity.  They are not allowed to provide MEDS, or anything more than a band-aid.

[PA Guy]

A medical officer of the encampment has more authority then the Encampment Commander since this is CAP. If the Medical Officer believes that for safety reasons he/she must suspend the encampment they CAN do that. Even if the Encampment CC disagrees, the Medical Officer can go right to Wing CC, Reg CC, Natl. CC and have them suspend the encampment, if they disagree then the next step would be for the Medical Officer to resign and have CAP get sued over a blister on a cadets toe!

Do you happen to have a cite for that, CAPR or....?

[PA Guy]

^  A year later........anyway, I used Army Physicians and the Post medical clinic and it's personell for all my CAP Encampment needs.  I would also like to get rid of the  cadet medics that seem to be at every activity.  They are not allowed to provide MEDS, or anything more than a band-aid.

A great solution, if it is available, to a difficult prob.  My wing does not utilize cadet medics.

[RiverAux]

I really HATE that term when used in association with any CAP activity as it just gives everybody the wrong impression and especially with cadets.  Start calling a cadet a "medic" and I'm really worried they're going to be attempting to perform a field tracheotomy on me that they saw on a MASH re-run if I stub mytoe.  It goes straight to their heads. 

[mikeylikey]

I really HATE that term when used in association with any CAP activity as it just gives everybody the wrong impression and especially with cadets.  Start calling a cadet a "medic" and I'm really worried they're going to be attempting to perform a field tracheotomy on me that they saw on a MASH re-run if I stub my toe.  It goes straight to their heads. 

Agreed.  I have had cadets in the past at special activities and Encampments break the rules, and try to cite medical reasoning for doing so.  One Cadet actually said he could stay int eh female Barracks overnight, because they had no medical person assigned to them.  So the next morning, I disbanded all Cadet Medics.....sent them to the DIFAC (Dining Facility) to wash posts and pans.  I can be a really ass sometimes, but when a CAP Cadet tries to tell his Commander (who Happened to also be an AD Army CPT) rules derived from military instructions and regulations........  Please, I am the REGULATION GURU.

[ZigZag911]

Agreed.  I have had cadets in the past at special activities and Encampments break the rules, and try to cite medical reasoning for doing so.  One Cadet actually said he could stay int eh female Barracks overnight, because they had no medical person assigned to them. 

That actually has a refreshing ring of originality about it!

However, I gather the cadet was not simply kidding verbally....it's a shame we don't allow keelhauling, although i guess then we'd need to get some keels!

Seriously, the only time I've ever seen cadet health services assistants (or EMTs....we NEVER called them 'medics'!) was in circumstances in which we had well-trained, reasonably mature cadet EMTs and an SM medical officer to supervise them.

Essentially they did what the MO told them (i.e., escorting a sick cadet to medical tent, helping someone apply an Ace bandage, and so forth)

[John Bryan]

Ok.....first please remember CAP Medical Officers, Nurse Officers and Health Services Officers are very limited in what we can do in the first place. What any health care professional (adult officer or cadet) can do while on CAP's time is a much larger issue.....we can maybe address that later.

As for the question of cadets serving in health services. CAP has a major problem in that most adult officers think that the word cadet = child.....that is not always the case. This also could be another debate.

We have cadets who are health care professionals. I have known cadets who have been Emergency Medical Techs, 1st Responders, Certified Nurses Aides, and Pharmacy Techs.....these are young adults who are all state licensed or certified in different health care professions and based on some state laws might be in greater positions of authority then most adult officers would think.

If for example a cadet ground team member is an EMT and the adult officer on the team is only 1st aid trained , then under Indiana (and many other states) law the cadet would be in charge of the scene and the victims and if the adult officer tried to block or override the EMT(Cadet) then the adult officer could be arrested. It is late so I have not looked up the IC (Indiana Code) number but it is on line.

Another thing.....although I have never met one....it would be possible for a cadet to be a nurse.....here's how. You finish High School at 17 , 1 year later your an LPN or 2 years later an RN and still under 21.

So whats my point.....only that a cadet who happens to be a health care professional is an asset to CAP just like an adult officer.

[mikeylikey]

^ No doubt, My gripe is with those cadets who have no healthcare experiance and work as an "Encampment Medic", carrying around band-aids, and a notebook. 

[flyguy06]

Ok.....first please remember CAP Medical Officers, Nurse Officers and Health Services Officers are very limited in what we can do in the first place. What any health care professional (adult officer or cadet) can do while on CAP's time is a much larger issue.....we can maybe address that later.

As for the question of cadets serving in health services. CAP has a major problem in that most adult officers think that the word cadet = child.....that is not always the case. This also could be another debate.

We have cadets who are health care professionals. I have known cadets who have been Emergency Medical Techs, 1st Responders, Certified Nurses Aides, and Pharmacy Techs.....these are young adults who are all state licensed or certified in different health care professions and based on some state laws might be in greater positions of authority then most adult officers would think.

But that is NOT the norm. And you are right, when people here the word "cadet", they think of teenagers. And I am sure parents who pay and send their children in our care for a week wouldnt be too comfortable knowing that their childs health is being monitored by a teeneager. You have to look at liabilities.

First off when I think of a medical officer, I think of a Doctor or a Nurse. i do not think of an EMT, Paramedic, or LPN.

They can do limited things and I guess wouldnt be a bad asset. But I would want someone of adult age and experience to be working on teenegaers that arent my own.

[Ned]

A brief review is in order:

We had a pretty good discussion about the role of Health Services Officers in CAP here.

Another good resource is CAPR 160-1.

Basically, no one in CAP is authorized to perform "routine medical care" at encampments for things like sprained knees, tummyaches, colds or fevers.

As in NO ONE.  Not CAP doctors, nurses, EMTs, CNAs, DCs, veternarians, or "medics".

I repeat -- it is a violation of our regulations for anyone -- including CAP medical folks -- to hold a "sick call" or treat anything other than a true life-or-limb threatening emergency at encampment or anywhere else.

And for good reason.  CAP, Inc. is not covered by any sort of medical malpractice insurance.  So any mistake (or even just a "bad outcome') by a CAP medical person performing routine care could literally mean the end of the corporation.

Our HSOs have an important role to play in educating our members, advising commanders on health-related policies, and screening applications and similar adminstrative support.  They are terrific folks who donate their professional skills to the CAP and deserve our respect and appreciation.

But they simply cannot put hands on a patient for anything other than a genuine emergency.

Really, really.


"Friends don't let friends endanger CAP by performing or allowing routine medical care to occur."

Ned Lee
Director of Cadet Programs, Pacific Region
Former CAP Legal Officer

[Major Lord]

Do I understand correctly then, that a cadet suffering from blisters ( at encampment) should either provide self-care with no senior member involvement, contact a parental-unit to arrange transportation to the family doctor, Doc-In-The-Box, or hospital, or just tough it out? Why then the emphasis on foot checks by Tac officers? Is there a regulatory exemption for blisters? It must be somewhere in the back of the reg book.....Perhaps we have expanded the threat of blisters to life threatening....

Major Lord

[Eclipse]

Thank you, Ned - I don't know why we have to keep saying this over and over, but if we do, we do.
I will say it as well, just so it keeps echoing:

THERE
IS
NO
SUCH
THING
AS
A
"CAP Medic"

(being an EMT, MD, RN, etc., who is also a member of CAP is >not< the same thing. Be prepared to quote the reg, pamphlet, and authorization before you take exception to this statement.)

As to the blister argument - I'd say it falls into the abyss of the gray area that is CAP health operations.

Common sense would say that treating a blister could fall within the basic first aid we are authorized to administer (if trained) within the team.

However, an argument could be easily made that we should not even do this - if an Encampment HSO
decides a blister is "minor", when in fact it winds up with an infection that costs a cadet his football career, or worse his foot, that cadet's parents could have an action against the HSO, since CAP would likely be held harmless because it could be shown the HSO acted against regs.

Common sense and goodwill mean little in a court of law with the right lawyer and the wrong jury.

Its also a vast chasm or regulations and risk between having someone who is an EMT or MD tracking meds and being the decider between "encampmentitis" and "dial 911", and staffing a full medical detachment with  a triage area and cadets running around with stethoscopes around their neck.
The former IMHO/IANAL would stand up much better within our regs and guideline than the latter.

This is a difficult situation for me to argue, because while I don't like or agree with the current situation, I have to do what I can, with reasonable judgment, to protect my members >and< the organization.

[Major Lord]

Ned's reply seemed emphatic enough to me:

"But they simply cannot put hands on a patient for anything other than a genuine emergency.

Really, really."

Given this emphatic and certainly legally correct interpretation, it seems to me that we have no room for "gray areas" or any reasonable belief that acting in good faith is any protection. Presumably, we should file IG grievances for the routine pre-or post- shower blister check.... We'll get right on that...right....

Is the blister check the CAP version of the "short-arm" inspection?

Major Lord

[mikeylikey]

I would also like to add that it is inappropriate for CAP members to interview cadets on what medical conditions they may have without a guardian present.  There are no psychologist, psychiatrist positions in CAP.  I have always hated when an activity sets time aside so that the "medical section" can do pre-admission interviews with cadets.

It is one thing to dump out cadets bags and search for illegal prescriptions, but to know a complete medical history and ask "are you depressed" is going way beyond the line.

I will back any parent who decides to sue the CAP because their child was precluded from activities because of "possible mental health disorders".  I had a huge problem with PAWG for the past 3 years for the very same reason.  (not me, I am some-what sane!)  If you get a chance check out PAWGS encampment and CLS websites.  The medical sections are the driving force behind both activities.  Terrible shame! 

[Eclipse]

I agree here, too. (With Lord).

If you've read "I, Robot", you'd understand why this is the kind of situation that would short out
a positronic brain - two opposing viewpoints which are equally correct.

Do you do what you know is the "Right thing to do", or the "right thing to do"?

[PHall]

Do I understand correctly then, that a cadet suffering from blisters ( at encampment) should either provide self-care with no senior member involvement, contact a parental-unit to arrange transportation to the family doctor, Doc-In-The-Box, or hospital, or just tough it out? Why then the emphasis on foot checks by Tac officers? Is there a regulatory exemption for blisters? It must be somewhere in the back of the reg book.....Perhaps we have expanded the threat of blisters to life threatening....

Major Lord

Paraphrasing for Ned:

Alan, Tac Officers are acting in loco parentus, i.e. subtitute parents while the cadet is at encampment.
And as such can do stuff like look at a cadet's feet and give them a band aid or some moleskin.
And that's about all we do. Anything worse and it's Doc-in-a-box time.

[Eclipse]

Do I understand correctly then, that a cadet suffering from blisters ( at encampment) should either provide self-care with no senior member involvement, contact a parental-unit to arrange transportation to the family doctor, Doc-In-The-Box, or hospital, or just tough it out? Why then the emphasis on foot checks by Tac officers? Is there a regulatory exemption for blisters? It must be somewhere in the back of the reg book.....Perhaps we have expanded the threat of blisters to life threatening....

Major Lord

Paraphrasing for Ned:

Alan, Tac Officers are acting in loco parentus, i.e. subtitute parents while the cadet is at encampment.
And as such can do stuff like look at a cadet's feet and give them a band aid or some moleskin.
And that's about all we do. Anything worse and it's Doc-in-a-box time.

It's "In loco parentis": http://en.wikipedia.org/wiki/In_loco_parentis
("loco parent us" is how most people with children feel"  )


And >maybe<, we say that they are, in fact all senior members are, certainly encampment staff, but I don't know if that trumps the legal issues of medical care, though I'm right with you on the attitude.

Its a legal mess, which is why most members do what they think is right and cross their fingers.

Its also why I continue to be stymied by activities which allow situations which are obviously way over the line.