At Second Nature, all incoming adolescents and adult clients receive a physical exam including a complete CBC panel to determine overall level of health and hemoglobin counts. In addition, they are administered a metabolic panel to determine basic nutrition including the levels of glucose, protein, potassium, sodium, and carbon dioxide. These and other factors help to determine an individual’s fitness for exertion. During the physical exam, adolescents/adults are asked their drug history, diet, fitness level, smoking history, and are drug tested to screen for recreational or prescription drugs.
In addition to extensive information provided by parents on the application for admission, Second Nature staff interview each incoming client. Clients are asked about their drug history, diet, fitness level, smoking history and any other concerns they may have about their health. All information is documented and relayed to the staff team working with the client in the wilderness. Important information relayed to the staff includes physical abilities, mental state, current illnesses, asthma, and details on medications, anaphylactic reactions to meds/ foods/ bees, and dietary restrictions or requests to ensure food is palatable to the client.
All Second Nature locations have a Medical Coordinator (advanced practice clinicians, i.e., medical doctor, Physician's Assistant, Nurse Practitioner) on call at all times for field staff to contact regarding medical concerns, questions and/or updates regarding a client's current status in the field. If the concern warrants a visit to a clinic or emergency room then evacuation is immediately initiated. Additionally, clients receive medical checks in the field every 14-21-days by a medical practitioner.
Upon arrival, as clients travel to the field office, they are offered a meal and beverage as standard protocol. Once the client arrives at base, he/she is provided a supply of personal food that contains a large bag of trail mix, fresh fruit, string cheese, peanut butter, tuna and/or chicken packets, a bag of tortillas, and four quarts of water. Staples are replenished as appropriate (at least twice a week) and are accessible to the client to eat at his/her discretion. The logistical support staff delivers fresh fruit and meat to each group throughout the week. During meal times, staff supervises each client's intake of food and water. Clients must consume at least 8 oz. of food per meal and four quarts of water each day. Food and water intake is monitored and documented. If a client doesn't consume the required food or water intake, the Second Nature Medical Coordinator and the client’s therapist are contacted to address concerns expeditiously.
During Earth Phase (initial phase), all Second Nature clients participate in an acclimation curriculum in which they are closely supervised and observed by a staff. From day one, staff members begin building rapport with participants, establishing open communication and offering continuous support as they begin to consider why they are at Second Nature and what they hope to get out of the program. During this period hiking is kept to a minimum and the group hikes at the pace of the slowest member of the group. At Second Nature clients never participate in extended hikes with lower food intake. Second Nature strongly believes that such practices are unadvisable, and do not enhance the impact of participation in a wilderness program.
Second Nature conducts ongoing and mandatory staff training for all levels of Field Instructors, Drivers, Logistic Coordinators, Therapists and Administrators. While Second Nature’s safety protocols meet or exceed industry standards, protocols address other vital relational aspects of safety. Second Nature staff never hikes or “pushes” when an adolescent or adult client exhibits any sign(s) of possible duress. Staff is trained to respond to all complaints even when there is reason to suspect manipulation. If a client attempts to manipulate by “crying wolf” with complaints relating to his/her health, he/she is assessed and treated medically first and responded to therapeutically in the next therapy session. Second Nature does not engage in power struggles with clients; our instructor and medical staff must, by company protocol, always rule out medical risk first.
In addition, Second Nature has always taken the stance that clients are not engaged in an overly strenuous curriculum. Second Nature never uses deprivation of water or nutrition to create stress or dependence, as an access for therapeutic change. To illustrate, Second Nature offers more than 3,000 calories per day and utilizes internal frame backpacks for comfort.
Second Nature continually maintains a very high staff to student ratio that helps ensure the safety and well being of all clients in our care. All Second Nature field instructors are certified in CPR and First Aid and each group of participants is supervised by at least one Wilderness First Responder certified staff or (wilderness) Emergency Medical Technician. The Wilderness First Responder program (and WEMT) is a nationally recognized certification that certifies our staff to respond to emergency medical situations in backcountry situations.
Second Nature staff receives continuous training from a medical professional on pertinent medical issues. In the field all Second Nature staff have access to medical resources and information including but not limited to a Wilderness First Responder handbook, information about the potential side effects of psychotropic medications administered in the field, and Second Nature policies and procedures regarding the health and safety of our clients, along with 24/7 phone access to the Medical Director.
Second Nature honors requests by our clients to be evaluated by a medical professional. There are no negative consequences for asking to be seen by a medical professional or for anything said to a medical professional. It is Second Nature's policy to address any medical concern that cannot be handled in the field by transporting the client to a medical facility as quickly as possible. Status reports are routinely communicated to the base logistical staff at morning and evening call-in. If the group does not call in during this time, logistical staff make a visit to the group. Staff members have two-way radios, cell phones, and satellite phones and are directed to contact EMS directly for evacuation or consultation in an emergency situation if they cannot immediately access Second Nature medical personnel.
Finally, all Second Nature employees operate under the mission of safety first. Our clients' physical health and safety is our #1 priority above any other goal or treatment objective. Our staff is flexible with their daily routine and hiking plans in order to address any medical concerns. If for any reason, a group member cannot continue the hike, the group will stop. Second Nature will transport any extra or unnecessary gear (extra layers of clothing or extra food) for any participant unable to carry the full weight of their backpack. Second Nature will also adjust the diet to provide extra calories and electrolytes if needed. For example, we provide extra fruit in the summer and extra protein during the winter.
Second Nature strives daily to maintain an impeccable safety record. Our admissions team is happy to speak with you at any time to further discuss our established safety protocols.
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