Camp Akeela Nurse Reference Form

A candidate has applied for a nursing position on our summer staff at Camp Akeela and has listed you as a reference. We would appreciate your assistance in evaluating the applicant’s candidacy. Camp work is challenging and all staff must be able to relate effectively to children and teens, adult supervisors, and their peers. A staff member must be a great role model for our children and teens and be able to live within community standards, such as a nightly curfew. We are looking for mature individuals who love children, are spirited and fun, and who approach their responsibilities seriously.

Camp Akeela offers a traditional sleepaway experience to campers aged 9-16 who struggle socially with their peers. Our campers are bright, creative and “quirky” kids who have difficulty forming and maintaining friendships. Many have been diagnosed with Autism Spectrum Disorder Level I (formerly called Asperger’s) or a similar neurodivergent profile. However, Akeela is not a therapeutic camp. While our counselors will receive training and on-going support in helping campers make connections, their primary responsibility is support our effort to provide campers with a life changing and fun summer camp experience. The role of our healthcare team, which includes registered nurses and nursing students, is to support to health and well being of our campers and staff. Primary responsibilities include medication administration, triage/assessment, parent communication, and ensuring the health center is a welcoming environment for teens to come for healthcare.

Please do not hesitate to call us at 802-333-4843 with any questions or additional comments.

Applicant Name: *

First

Last

Reference Name: *

First

Last

Reference Email: *

Reference Phone:

How long have you known the applicant? *

In what capacity do you know the applicant? *

What are a few words you would use to describe the applicant's personality?

How would you rate your confidence in the applicant for the following clinical skills:

(Rate on a scale of 1-5, with 5 being Extremely Confident, and 1 being Not Confident.)

you (eg. illegal

Medication Administration

Selected Value: 0

Triage & Assessment

Selected Value: 0

Patient Care & Follow Up

Selected Value: 0

How would you describe the applicant's communication skills related to patient care? *

How would you describe their ability to work on a team? *

How would you describe the applicant's work ethic? *

How would you describe the applicant's ability to handle stress? Conflict? *

Have you seen the applicant respond to an emergency situation? If so, how do they respond to emergencies? *

What is one area in which you would like to see some growth or development? *

Do you have any concerns at all (eg. history of illegal behavior, drugs, alcohol, judgment issues, safety around children, etc) with the applicant working in a children's residential community? This is the most important question we can ask you, and please know that your response will be held in the strictest confidence. *

Custom Captcha *

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