Cruise Nursing

Among the many different avenues from which registered nurses can choose, being a ship’s nurse gives them a chance to see fascinating new places, meet people from all over the world, and experience many wonderful things.

Twice now, I have sailed for Holland America Lines, once to Alaska and once to the Eastern Caribbean. Both cruises were unforgettable experiences.

A cruise nurse’s job, besides the clinical aspect, is basically public relations. The ship’s nurse must be helpful, professional and courteous, and go the extra mile. Passengers, and crew especially, look up to the ship’s nurse. With the crew, who are away from home for months at a time, you are their friend, sister, mother and nurse.

Aboard a Holland America Line ship, there are 3 nurses, a doctor and a dentist. The medical department provides medical treatment for passengers and crew during clinic hours, and other times for emergencies and medical needs. The physician sees those who require or request medical consultation, performs crew medical exams, orders and performs diagnostic tests, and prescribes treatments and medications. Many times the medication or a legitimate substitute will be in stock. Otherwise the passenger will have to purchase it in port.

The physician also makes decisions regarding admission of passengers and crew members to the ship’s infirmary, and on whether or not a crew member or passenger should disembark for medical care on land. The dentist provides treatment for the crew and on an emergency basis for passengers.

DUTIES AND RESPONSIBILITIES
The lead nurse onboard is responsible for running the infirmary. She is usually the nurse with the most experience and is on full-time contract with the cruise line. She makes the rotating call schedule and maintains inventory control. She is also your mentor during the assignment.

The second, or crew nurse, is responsible for checking that newly embarked crew members have up-to-date physicals. She reviews charts to ascertain any medical problems needing follow-up. She requests crew consults for onshore medical treatment and has the sealed medical chart updated and ready for pickup for disembarking crew.

The third, or dental nurse, is responsible for scheduling and notifying crew members of dental appointments. She also completes the voyage report for each cruise to send to the medical department at the company headquarters in Seattle.

JUST LIKE HOME: ON CALL
All three nurses are on a rotating call schedule. The first call nurse is the first to respond to medical emergencies during a 24-hour period. She coordinates clinic hours in the morning from 8 a.m.-12 p.m. and again from 2-4 p.m. The second call nurse relieves the first call nurse from 4-6 p.m., and is available for backup in case of a medical emergency or if the first call nurse needs backup during clinic hours. The third call nurse is off for that particular 24-hour period whether in port or at sea.

All three nurses carry a beeper. Should around-the-clock care be needed for a patient admitted to the infirmary, the nurses share rotating 4-hour shifts.

MEDICAL EMERGENCIES
Passengers depend on the medical department personnel for most of their health needs. Illnesses vary. For instance, in Alaska, we treated chest colds and upper respiratory infections. On most ships, you will also treat seasickness, especially during the first few days at sea.

There typically are a handful of passengers who have forgotten their prescription medications. In this situation, they will see the physician and it will be up to him to prescribe the medication. The medical department also supplies sharps containers for passengers with diabetes.

Although Holland America ships are equipped for medical emergencies, with an X-ray machine, lab equipment and defibrillators, several times there were cases in which the patient was either sent to a hospital in port, or airlifted to the closest American hospital, if we were at sea.

All shipboard personnel are required to wear uniforms. For nurses, this includes white blouse, blue or white skirt, blue or white jacket, white shoes and natural color pantyhose. The nurses onboard Holland America Line ships are considered officers and enjoy the perks of that position. There are three cabins behind the infirmary for the nurses, which are basic accommodations. After the first contract, a nurse can have her spouse aboard with her at no charge. Holland America Lines pays for all nurses’ travel costs to and from the ship, but the spouse is responsible for his/her costs. The pay varies based on your position, full or part time.

AWE-INSPIRING SIGHTS
We also had adequate time off, both on the ship and in port. In Alaska, I was able to see some of the most awe-inspiring sights snow-capped mountain peaks towering above glacial valleys, humpback whales, ice caves and a sun that doesn’t set until midnight. In Sitka, a city rich in Russian influences, sits St. Michael’s Russian Orthodox Cathedral, first built in 1816. Sitka was the former Russian capital of Alaska.

In the Eastern Caribbean, we visited Old San Juan, which features an Old World flavor. Very interesting was the walk through San Felipe del Morro Fortress and Military Museum. San Juan has many great examples of Spanish heritage, like the legendary Cristo Chapel that houses a silver altar and famous paintings. Hundreds of years ago, the waters off Puerto Rico were filled with pirate ships, captained by men such as Sir Francis Drake. La Casa Blanca was built in 1501 for the island’s first governor, Ponce de Leon.

Being a ship’s nurse, part- or full-time, is only one of the many career choices a registered nurse can make. For those who hold a full-time position, cruise nursing once or twice a year could be a welcome change. It is an economical and diverse way to combine travel and career. n

Resources
Allen, L. (2001). Medically speaking: What the cruise passenger should know. Retrieved Aug. 20, 2001 from the World Wide Web: http://www.cybercruises.com/medicspeak.htm

Frantz, D. (1999, Oct. 31). Cruise lines found unprepared for medical emergencies. Retrieved Aug. 20, 2001 from the World Wide Web: http://www.dallasnews.com/national/1031nat4cruise.htm

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