Second Nature
Duchesne, UT

Dear Friends in the IECA Community:

We have recently been asked by a number of Educational Consultants to provide specific information on some of Second Nature's standard safety protocols.

At Second Nature, all incoming clients (meaning adolescents and adults and will otherwise be noted if not both) receive an Intake Physical before entering the wilderness that includes a physical exam and interview. The physical exam includes a stress test where heart rate, breathing patterns and physical abilities are observed. The doctor determines the client's ability to perform the expected exercise while at Second Nature and also considers the need for detoxification. When the need for "detox" is determined, the doctor will dictate the client's necessary treatment, i.e. specialized detox facilities, supervised rest out of the wilderness, restricted hiking in wilderness for first week, etc. Lab work (CBC Panel, Metabolic Panel, drug test, etc) is also completed during the physical exam to determine overall health and nutrition by testing for levels of hemoglobin, electrolytes, glucose, protein, potassium, sodium, and carbon dioxide to name a few. These and other factors help to determine a client's capacity for exertion. Some clients are given additional tests (EKG's, MRI's, etc.) to confirm their appropriateness for Second Nature. Clients are drug tested to screen for: Amphetamines, Cocaine, Marijuana, Benzodizepines, Tricyclic Anti-Depressants, Barbiturates, Methylenedioxy and Methamphetamine, Opiates, Phencyclidine, Oxycodone, and Propoxyphene.

The interview process includes clients being asked about their drug history, diet, fitness level, if they smoke, and any other concerns they may have about their health. All information is relayed to the staff team working with the client in the wilderness. Some examples include physical abilities, mental state, current illnesses, asthma, details on medications, anaphylactic reactions to meds/ foods/ bees, and dietary restrictions or requests so 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 depending upon a client's current status in the field. If the concern warrants a need for a visit to a clinic or emergency room then an evacuation is immediately put into place. Adolescents receive medical checks in the field every 14-21-days (depending upon location) by a medical practitioner.

Recently, during the admission process, Second Nature has begun asking parents/potential adult clients if the potential client has had any flu vaccines. If the client did not get any vaccines before arriving at Second Nature, the client will receive vaccinations during the Intake Physical (with parent/adult client approval) and when/where appropriate vaccines are available. Also, during the Intake Physical interview clients are questioned if they've been exposed to any type of flu recently and the doctor decides if prescribing Tamiflu is necessary as a prophylaxis. In weekly staff trainings staff are educated on hallmark signs and symptoms. Staff are trained to immediately call the medical coordinator and report any signs of the illness where quarantining and/or evacuation is determined necessary.

During Earth Phase, all Second Nature clients participate in an acclimation curriculum in which they are closely supervised and observed by an appointed staff. During this period, minimal hiking takes place. At Second Nature, clients never participate in extended hikes with lower food intake. Second Nature strongly believes that such practices are unsafe, and further; do not enhance the impact of placement in a wilderness program. From day one, staff members begin building rapport with clients, opening up the lines of communication and offering continuous support as the client begins to consider why they are at Second Nature and what they hope to get out of the program.

During the transport to the field office, clients 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, a jar of peanut butter, tuna 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 their discretion. During meal times, staff supervises each client's intake of food provided. 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, staff contacts the Second Nature Medical Coordinator to address concerns expeditiously.

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. Staff are 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 any responses to therapeutic concerns are addressed secondarily at a later time. Second Nature staff avoids engaging in power struggles with clients and approach issues related to safety conservatively through established best practices.

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 food, water or nutrition to create a therapeutic change. 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 ensures the safety and well being of all clients in our care. All Second Nature staff are certified in CPR and First Aid. Each group of participants is supervised by at least one Wilderness First Responder certified staff or 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 remote backcountry situations.

Second Nature staffs receive continual training from a medical professional on pertinent medical issues. In the field all Second Nature staff has 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.

Second Nature honors requests by our clients to be evaluated by a medical professional. There is no consequence 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. Staff 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 staffs operate under the mission of safety first. Our clients' physical health and safety is our priority above any other goals. Our staff are flexible with their daily routine and hiking plans in order to address any medical concerns. It is our policy to only hike as fast as the slowest member of the group at all times. 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 struggling with the weight of their backpack. Second Nature will also adjust the diet to provide extra calories and/or electrolytes if needed. For example, we provide extra fruit in the summer and extra protein during the winter.

Please feel free to contact Co-Founder, Dr. Brad Reedy or any of our admissions team members with questions and or concerns. We welcome the opportunity to address this issue further with you.

Second Nature Wilderness Programs

Dr. Brad Reedy: 801 201-8196
brad@snwp.com

Admissions Team: 866 205-2500
loria@snwp.com