Cruise Nurse Life

We’ve currently had three sea days in a row cruising the Chilean fjords, so no new travel log updates at the moment. One of the most common inquiries we receive is asking for information about the realities of cruise nurse life. What is it really like to work on a cruise ship as an RN? When we set out on this adventure we did a lot of research to try to find out what we could. There wasn’t a lot of tangible, real life, useful information to be found. We had so many questions and found it hard to get answers. Hopefully this post will help to answer some of your questions. We’ll try to touch on a little of everything, including basics of the nursing work itself, what its like living onboard, and what perks and opportunities that come with the job. Cruise nurse life is unique, challenging, interesting, different, and rewarding.

Cruise Nursing

What Type Of Nursing Is It

Cruise ship nursing is primarily urgent care with occasional times of ER and ICU. Recent critical care experience is required for that reason. The most common complaints tend to be respiratory and GI related, for example acute gastroenteritis, flu, and Covid. Close behind those are falls, bumps, cuts, aches, and pains. There are some protocols in place to allow for a certain level of autonomy.

Of course there are more serious care events beyond urgent care. Perhaps a fall with broken bones. Maybe a cardiac arrest, respiratory failure in a COPD patient, emergent AAA. Like the ER in a hospital, it could be anything. Sometimes there may be a patient that requires ICU care for multiple days. Ideally you won’t be too far from port and the patient can be disembarked to a hospital, but in the meantime the medical team will provide care on the ship.

What Is The Team Structure

Team structure depends on the size of the ship or total number of people on board. It can also vary by company. Cruise ship medical teams start with a certain number of doctors and nurses. Some ships may also employ paramedics and/or a healthcare assistant, essentially a unit secretary or tech. On Dragon’s first assignment there were two doctors, three nurses, and an HCA. On her current contract there are two doctors and three nurses. The basic structure is the same with slight variations.

What Are The Hours

There are generally two clinics every day, morning and afternoon. Clinic hours vary depending on whether the ship is in port, at sea, or on turnaround day. Turnaround day is when one voyage ends and another begins. For instance:

• Port day clinic hours: 0800-1000 and 1600-1800
• Sea day clinic hours: 0900-1200 and 1500-1800
• Turnaround clinic hours: 0800-0900 and 1500-1700

Responsibility for the safety of those on board doesn’t end when clinic is closed. Someone is on call for the medical team at all times. That means the nurses have to rotate call for anything that comes in outside clinic hours. Depending on the preference of the lead nurse the call rotation may vary slightly. A common call rotation on a ship with three nurses is day call, night call, off call. In the event of a true medical response team emergency, the entire team responds.

Who Are The Clientele

This may seem obvious, but the medical team supports both the guests and the crew. There are hundreds of crew on board supporting the hundreds to thousands of guests. Everyone has access to the clinic and medical support team. You will be providing nursing care to guests and fellow crew members.

How Is The Nursing Different

You will have multiple job duties and learn new skills that you may not have needed on land. Cruise ship nurses do their own labs, respiratory care, take x-rays, IV’s, catheters, dispense medications, etc… While there is a lab, a ventilator, and x-ray on the ship, there aren’t lab techs, RTs, x-ray techs, or pharmacists. As a cruise nurse you will learn to process your samples in the lab, take the x-ray images and mix, administer and dispense medications yourself.

What Does Training and Orientation Look Like

Training for new skills is done on the job after joining. There are online learning modules to reinforce training. You may have basic orientation to the unit, protocols, standards, and rules. Beyond that, orientation is typically short and you are expected to hit the ground running. Dragon had 10 days of orientation.

You will also learn to be a member of a crew at sea. Crew drills are a regular component of cruise nurse life. Often run on port days, there are routine drills that teach the crew how to respond in an emergency. Drills cover a variety of potential situations, anything from a medical response team to a fire to a general evacuation. The medical team plays a critical role in emergencies at sea and regular practice is required for the hundreds of crew on a cruise ship.

Nurses Also Lead Training

Stretcher Team Training- The nurses lead a team of crew members that assist with medical response when a patient needs transport via a stretcher. There is regular training necessary to ensure all team members know their role and function.

Ship Life

Naval Structure

Life at sea is governed by a naval structure that establishes a hierarchy on the ship. There is a ranking structure from crew to officers all the way up to the Captain. As a registered nurse you enter the naval structure as a two stripe officer. Officers are afforded a variety of perks that are a benefit of their rank, things that effect your living arrangements, dining opportunities, etc. As we mentioned earlier some things vary by brand and ship size, but there is typically a hierarchical structure that governs life at sea.

Living Quarters

As a two stripe officer a cruise ship nurse will have their own room on the ship. While the room is small, you will typically have your own bed, bathroom, closet, and desk. The medical team rooms are usually located in close proximity to the medical center. You live and work in the same area. Having a room right next to the clinic means your commute is a few steps. It is imperative to be close to the clinic given the need to cover call 24/7.

Dining

In addition to room, your board is covered too. All your food is covered throughout your contract. Nurses have multiple dining options. Most ships have an officer mess. That means there is a dining hall for the officers to eat in breakfast, lunch, and dinner. Nurse’s also have the ability to eat in the guest dining areas. Part of the naval structure mentioned earlier governs dining in guest areas. Officer uniform is required to dine in the guest areas, which means you’ll have to change out of your scrubs or personal clothes whenever you want to eat at one of the guest restaurants. The option is there though. You can even eat at the fine dining restaurants onboard if you choose to, but this may come with a cost.

Entertainment

There is always some form of entertainment on cruise ships. As with dining, any time you want to venture into guest areas you are expected to be in uniform. That means you can go to shows, concerts, etc. You also have access to the gym, in which case you can wear your workout clothes of course. There is usually a library on the ship as well as a multitude of movies available to watch in your room. Beyond scheduled cruise ship events there always seem to be fun events for the crew. Whether that is get togethers in the officer bar or karaoke in the crew lounge, there is usually some type of fun activity happening somewhere.

Laundry

There are multiple laundries available. Usually there is an officer laundry, but also multiple crew laundries. You can do your laundry for free or you can send your clothes to be laundered for you. Your scrubs are laundered for you regardless of what you do with your personal clothes.

House Keeping

A frequently overlooked perk is having your room cleaned. While the schedules may differ by brand and ship, there is generally a room steward who comes to clean your room while you are working. That’s right, you never have to clean your room, cook, do laundry, or do dishes. Who can’t get used to that?

Other Benefits

Exploring the World

Maybe the most obvious benefit of working as a cruise ship nurse is the ability to go ashore in ports of call around the world. There are times you can’t get off the ship, for instance when you are on day call and the ship is in port. When you aren’t on call you will have plenty of opportunities to go explore the port cities the ship visits. Occasionally there are opportunities to act as a crew escort on an excursion as well. If there is room and you have time you could find yourself on an excursion to some amazing locations.

Relative Travel Benefit

One amazing benefit of being an officer with your own room is the capability to have a family member on board with you. Usually a nurse will have to complete their first contract before they are allowed to bring family on the ship. It is not uncommon for officers to have spouses on board, living in their room on the ship. In fact, this is the current situation that we find ourselves in. Dog lives on the ship while Dragon is working her contract.

Friends and Family Discounts

Another perk of working for the cruise line is having access to a friend’s and family cruise discount. Usually there is a 10-20% discount that you can share. The discount varies according to the voyage, but the perk is available.

Global Friendships

One of the amazing things we’ve discovered has been having the opportunity to make friends from around the globe. We’ve made friends from all over Europe, Africa, Asia, and the Americas. We even used part of our last vacation time to see friends and have incredible experiences in South Africa.

Challenges

Travelling To Your Assignment

The company arranges your travel to and from your assignment. While having that expense covered is great, be prepared for the possibility of inconvenient travel arrangements. You may get flights seemingly going out of the way, multiple layovers, and red eyes that you wouldn’t normally book for yourself. That is just one of the things you’ll have to get used to.

Tiny House Living

While it is great having your own room on the ship, it is also a change for many people to live in such a small environment. Unless you’ve recently been living in a dorm, you may have to adjust to minimalist, tiny house living.

Working Every Day

The significance of working every single day for four months cannot be overstated. Four months is a long time without a day off. 120 days in a row. Coming from nursing careers in the U.S. we were used to working 3, 4, or 5 days in a row, usually with a couple of days off in between. Just know that you are going to work every single day of your contract. It is one of the biggest challenges that every new cruise employee faces. The perk of course, is a 2 month holiday between contracts. Every role and rank have different contract and holiday timeline structures.

Isolation and Loneliness

It may go without saying, but you will be gone from your family and friends for months. While you can keep in touch on the phone, messaging on WhatsApp, or via social media, there is a very real potential for loneliness. We recommend avoiding isolation by making and embracing new friendships. Your fellow officers and crew are often experiencing the same challenges you are.

Constantly Changing Team

Due to the nature of assignments on ships the makeup of the medical team changes regularly. Your team will change during your contract. The other nurses, doctors, and team members will be on a different contract schedule. So you may lose your lead nurse a month in when her contract ends and a new nurse takes her place. One of the doctors will be replaced when her contract ends and be replaced by another provider. The constantly changing team can be a challenge.

Naval Hierarchy

That same naval hierarchy we talked about earlier can also be a challenge for people new to sea. There is a hierarchical ranking of individuals on the ship. As a two stripe officer you will have certain benefits and expectations that are different from the non-officer crew. There are also officers of higher rank who have different benefits and expectations than you. This system can be a surprise and a challenge to some.

Additional Costs

While I’ve mentioned many of the benefits that are free perks of working on the ship, there are some things you’ll still have to pay for yourself. Internet access is an extra cost. Like many things we’ve discussed the cost varies by brand. If you want to have an alcoholic beverage you’ll generally be expected to pay for it yourself. There is also a custom and expectation in certain circumstances to tip, for instance your room steward or the waiters in the dining room when you go for a nice meal. Relatives generally pay a daily fee to stay aboard, this varies by brand.

Conclusion

Cruise nurse life is a unique experience. It differs from nursing in the hospital in so many ways, but is ultimately still nursing. It has its own way of testing you with challenges that are very specific to sea life. Cruise nursing can also be super rewarding though. You’ll have the opportunity to make new friends from all over, visit new places around the world, discover an entirely different environment in life at sea, and learn a new set of skills.

Overall, Dragon has really enjoyed this nursing life at sea. If you have any questions or comments, please comment below or contact us.