Textbook of Maritime Medicine

There are no international rules demanding nurse(s) working on cruise ships. The ACEP guidelines only states that a ship’s nurse should have a current ‘registered nurse licensure’, have ‘competent skill level in advanced life support and cardiac care’ and be ‘fluent in the official language of the cruise line, the ship and that of most passengers’. The guidelines can also be interpreted to recommend that nurses should have three years of post-graduate / post-registration clinical practice in general and emergency medicine (see Appendix 1).

However, most ships have one or more nurses, and where there is more than one, there will always be a nurse on call aboard. Therefore, the nurses should not share cabins, otherwise the off-duty nurse will be disturbed every time the nurse on duty is called and may not be able to sufficiently ‘recharge her batteries’ before next shift.

Hence, the nurses’ main duty is to assist the doctor so he can carry out his responsibilities and duties. They report to the doctor and they are not to diagnose or treat passengers and crew without the doctor’s consent.

In case of a disagreement with the doctor in medical or administrative matters, the nurses report to the MCA and to the Medical and/or Risk Management Department of the company.

The nurses are to be considered ‘Two-Stripe-Officers”.  On ships with two or more nurses, one is usually appointed chief / senior / head nurse. She will have 2.5 stripes, and in addition to responsibilities of the nurse she is to supervise and/or perform the administrative tasks necessary for the operation of the MC.

For a more detailed overview of the nurses’ responsibilities and duties, as well as tasks that the nurses may be expected to perform on behalf of the doctor, please see: Appendix 3 - A modified Job Description for Ship’s Nurses.