Medical staff members are officers and crew members and must therefore pass a pre-employment medical examination for crew to be declared fit for duty on board. The medical fitness certificate must be renewed every two years.
Expectations, service and attitude
One of the most important parts of the cruising experience for the passengers is the positive attitude and friendliness of the crew, including the medical staff members. They should always maintain a clean and neat appearance and show appropriate bedside manner while providing medical services. As officers, the medical staff members are the company’s representatives and must adhere to the uniform code. They must conduct themselves in a congenial and professional manner and be friendly, but respectful during all contact with the passengers and crew, not only on board, but also in port. This friendliness and concern for well-being of all on board will assist the company in fostering a positive public relations image and in general help reduce any apprehension the patients may have in being treated away from home.
By obtaining a ticket, the passengers have paid for and rightfully expect a high level of service. The slightest discomfort may make them unable to enjoy the promised cruise experience and should be dealt with promptly by the medical staff whenever requested. The MC staff must keep in mind that they are there for their patients (passengers and crew), and not vice versa. Thus, any delay in medical service just for the convenience of a medical staff member is unacceptable.
Crewmembers should always be treated with the same respect and level of care as passengers. Good health care increases morale and high crew morale is essential for proper ship operation. Without a healthy crew it is not possible to maintain a high standard of service.
Both passengers and crew come from all over the world with various therapy traditions. Hence, it is important to listen to each patient’s explanation for his or her illness, and the medical staff is well advised to always explain the reason for a particular treatment. The best way to avoid future conflicts and possible unfavorable comments from passengers and crew is to establish a favorable and pleasant rapport with them during the first visit. All patients should receive service at least at - and if possible above - the level they expect, and one way to ensure that is frequent and interested follow-up by the MC staff. Satisfied patients also give positive feed-back to fellow cruisers and crew, which will further ease and enhance the cruise experience for the medical staff members.
The medical staff should consider themselves an integrated part of the shipboard team. By working together and actively pursuing a good relationship with all departments, all aspects of the MC activities become easy easier and more pleasant. Goodwill is an essential component of crew life at sea.
The doctors and nurses must adhere strictly to the company’s ‘Alcohol and Drug Policy’. Whenever on board, they must at all times be in a position - mentally and physically - to take care of emergencies that may suddenly arise.To appear intoxicated in public or in the MC is reason for immediate dismissal on any ship.
A confidential relationship between the medical staff and their patients regarding medical matters must be observed at all times. The doctor is not expected to disclose medical information except when he has knowledge of a serious medical or sanitation problem that involves the safety of the ship or may threaten the health of others on board. In such cases, he must immediately inform the Master and / or the MCA.
The nurses are only to discuss confidential medical matters with the doctor. Requests to the nurse for medical information about patients (passengers or crew) should always be referred to him.
Availability of medical staff
On ships with two or more nurses, one nurse is always on call, and she is always on board the vessel.
The doctor is obligated to the request of a patient seeking care (at any hour), even though the problem may be minor by all medical standards. The term “medical emergency” is aboard ship defined by the patient. If a passenger or crew wants to see the doctor for what he or she considers a medical emergency, the nurse on duty is to establish the desired contact as soon as possible.
The MC is usually open every day with regular consultation hours both in the morning and the evening for both passengers and crew. The exact opening hours will vary from ship to ship and may be different on sea days, port days and ‘turn-around-days’. The nurse on call is usually not to leave the MC during opening hours except for emergencies.
As a rule, a patient must never be left alone in the MC. If a patient is admitted to a ward in the MC, the nurse off duty must be standby and take over monitoring if the nurse on call has to leave the premises. Furthermore if a patient, in the doctor’s opinion, should be accompanied by the nurse on call to a medical facility ashore, an off-duty nurse will have to take over her duties until she is back and ready to be in charge.
Emergencies have always priority regardless of passenger or crew status.
Availability at sea
All medical staff must wear beepers or deck phones at all times and be in a position to take care of any kind of emergency. Whenever an extra hand is needed in the MC, i.e. to reduce waiting time for patients during rush hours, the nurse off duty is expected to assist.
Availability at anchor
A doctor should always be on board as tender operation is considered a high risk maneuver. Permission to leave the ship is usually only to be given by the Master or MCA.
Availability in port
On ships with two or more doctors, one doctor will always remain on board and be on call.
On ships with only one doctor, he may usually go ashore outside office hours if his services are not required. However, before going ashore, the doctor should make all necessary arrangements for the implementation of emergency procedures in his absence, including such standing orders as he deems necessary to enable the nurse to carry them out.While ashore he should (if available) carry a cell phone in the event he must be summoned for advice or assistance during an emergency. The nurse should also consider immediately contacting local port medical assistance (e.g. #911[jc1] in USA; # 113 in Norway)which, in many cases, may arrive at the ship before the ship’s physician can return to assist.
The off-duty nurse may usually also go ashore in port ifher services are not required. However, if a patient is admitted to the MC on board or a patient is scheduled to go to a medical facility ashore, she must obtain permission from the doctor, or in his absence the nurse on call, before leaving the ship. It should be noted that many ships now require a minimum of two medical professionals to remain on board at all times.