Medical Evacuation NCL SUN.....

[Nightengale212]

I am very sorry to hear about the situation your family member is in. As a nurse who is a case manager that coordinates palliative and hospice care for patients in the clinic attached to a hospital I work at, I would suggest your family member touch base with the ship's doctor prior to embarking on their cruise to discuss their potential care needs.

 

Providing quality end of life care is not that simple even in a hospital setting. Often times in hospitals that do not have hospice units such as the case with the one I work at, many patients whose death is imminent are transfered to inpatient hospice centers that have the staffing and all the other supports needed to provide this specialized care. The average length of admission to expiration in these hospice centers is one week, and these patients during that time are receiving pretty much continuous comfort care. My mother passed away in a hospice center, and having witnessed first hand the intense care she received at this center as she had a very difficult passing, I honestly doubt the ship's small medical staff could provide this level of end of life care considering all the other routine and urgent medical care they are required to provide to crew members and passengers.

 

I do not think the ship's doctor would force an air evac of a terminal actively dying patient, but I do think once the ship reached a port that they would likely insist on a transfer to a hospital where the patient can receive higher quality end of life care than what the ship's medical staff is able to provide.

[Karysa]

I am very sorry to hear about the situation your family member is in. As a nurse who is a case manager that coordinates palliative and hospice care for patients in the clinic attached to a hospital I work at, I would suggest your family member touch base with the ship's doctor prior to embarking on their cruise to discuss their potential care needs.

 

Providing quality end of life care is not that simple even in a hospital setting. Often times in hospitals that do not have hospice units such as the case with the one I work at, many patients whose death is imminent are transfered to inpatient hospice centers that have the staffing and all the other supports needed to provide this specialized care. The average length of admission to expiration in these hospice centers is one week, and these patients during that time are receiving pretty much continuous comfort care. My mother passed away in a hospice center, and having witnessed first hand the intense care she received at this center as she had a very difficult passing, I honestly doubt the ship's small medical staff could provide this level of end of life care considering all the other routine and urgent medical care they are required to provide to crew members and passengers.

 

I do not think the ship's doctor would force an air evac of a terminal actively dying patient, but I do think once the ship reached a port that they would likely insist on a transfer to a hospital where the patient can receive higher quality end of life care than what the ship's medical staff is able to provide.

 

Nice information for the rest of us but the OP's family member is already on the ship and that is why she posted. She is looking for advice primarily about medical evacuations and insurance. Not so sure she's going to feel comforted.

[cheshyrkat]

In the area where I live there are no specialty inpatient hospice centers. The patient requiring more care than is available in the home setting would be placed in a nursing home. At no point does the average hospice patient here receive care provided by a professional in the home for more than a few hours at a time. The family is instructed how to deal with symptoms and provided with a supply of medications that can be used to control distressing symptoms like agitation (Ativan), delirium (Haldol), excess secretions (atropine), and pain (morphine) and so on. They can call the hospice provider for guidance or more meds. It is like home health, but without the goal of curative treatment. It isn't perfect, but the alternative is worse.

I am confident that the ship's doctor would be able to provide support like that in such a situation.

[ksimpso3]

In the area where I live there are no specialty inpatient hospice centers. The patient requiring more care than is available in the home setting would be placed in a nursing home. At no point does the average hospice patient here receive care provided by a professional in the home for more than a few hours at a time. The family is instructed how to deal with symptoms and provided with a supply of medications that can be used to control distressing symptoms like agitation (Ativan), delirium (Haldol), excess secretions (atropine), and pain (morphine) and so on. They can call the hospice provider for guidance or more meds. It is like home health, but without the goal of curative treatment. It isn't perfect, but the alternative is worse.

I am confident that the ship's doctor would be able to provide support like that in such a situation.

As an oncology nurse who also worked on an in-patient unit of a hospital that cared for Hospice patients, I agree with you completely. I don't believe hospice patients need a higher level of care, and in fact in our area they are encouraged to stay in the home as long as possible (if that's what the patient and family want). I have no doubt that the ship doctor would be able to handle the needs of a terminal patient. The goal is comfort of the patient throughout the dying process, which usually includes pain meds, anxiety meds, maybe oxygen. I would think all would be available on the ship.

[Loucat]

Medical evac is usually only invoked in a situation where a person is actively dying. If your family member is in imminent danger of dying, I would highly recommend seeing the doctor. As someone has already mentioned, sick bay can handle most medical issues/emergencies, and it sounds like medical treatment should be sought.

 

A benefit of seeing the doctor is that if the medical condition is very serious but does not require evac, the captain may decide to speed up to reach Miami earlier than scheduled so that the patient can be treated as early as possible.

 

When it comes right down to it, if the condition is life-threatening, does the cost really matter??

I have to disagree with you on evacuation only if someone is dying. I am an RN with ER and ICU experience. On our last Dawn cruise, DH was almost put off in Belize for respiratory problems and for sure he was not dying, another man had an auto immune reaction and needed treatment the clinic does not provide and a third man was put off in Cozumel for a diagnostic cardiac procedure. Both returned to the ship after treatment in a Mexican hospital. None were dying. It is a tough call for the physician and staff whenever they have to evacuate someone and each situation is based on the individual; what the clinic can provide and what is in the best interest of the patients.

Given the choice, I would rather take my chances on the care provided on the ship than in a third world hospital.

It does make me think carefully about where we are going, and what type of care is available in ports.

[cheshyrkat]

The recommended course of action depends on a lot of things. The ship doctor asked my mom and dad if they wanted to be evacuated to a hospital. They chose not to do that. It wasn't a big issue. They weren't on Dawn, but she also told me that the ship they were on could make the medical center onboard operate as an ICU if necessary. I just hope the OP's family member is more comfortable.

[Packedready]

I have a friend that was on a NCL cruise and the first port was Cabo. She had a blood condition and went to the ships doctor. He drew blood and at the first port they came to their door early in the morning, told them to pack and that they would be dropped at the port.

 

They were forced to leave the ship and didn't have air to fly them home. It cost them a lot of $$ to get a flight.

 

She lived for another 3 years after the incident. They had been on many cruises and traveled a lot before and after NCL threw them off the ship.

 

They had no love for NCL after that.

[lanceholt]

NCL had no responsibility to get them a flight or transportation home. Whatever her blood condition, the doctor must have determined that it was not safe for her to remain on the cruise. I can understand that they were angry at the situation, and at the cost and their lack of insurance. Everyone should buy trip insurance, but is especially necessary if you have a medical condition already.

 

We always buy insurance that includes pre-existing conditions, evacuation, the works. Yes it is expensive but then there are no worries if something happens. We've been on two ships out of five that had medical emergencies. The last was a man with a heart attack that was transferred to a waiting ambulance in Corfu. The ship had docked there for just a few minutes to transfer him as it was not on our itinerary till later in the cruise.

 

We had to use the insurance once two years ago when my husband was told he needed surgery two weeks before our Med cruise and that no he couldn't wait till he went and got home. We were reimbursed every penny with no problems....all we had to do was to get the dr. to fill out a form.

[cheshyrkat]

Everyone should buy trip insurance, but is especially necessary if you have a medical condition already.

 

 

I agree. My parents had insurance and they were reimbursed for every penny they had to pay for attention from the ship's doctor. They bought it when they paid for the cruise and all the preexisting condition limitations were waived. It was expensive, but both of them were above 65 and my dad had been diagnosed with cancer. Had they chosen not to get insurance, the amount they would have had to cover would have been thousands (the doctor bill) rather than hundreds (the cost of the policy) in the end.

 

Of course there are people who feel otherwise about insurance. In the end it's a personal decision but if it's a decision made with all the relevant issues in mind, those who elect not to get it should already be aware of what the consequences could be. They should also be ready to experience the consequences if they chose to gamble.

[Loucat]

I want to add that having worked in the ED and ICU, I was so impressed with the doctor and nurses. They were outstanding and so competent. This has not been our first trip to medical clinics on ships:o

Dawn had an outstanding doctor who was not only caring, he was good!

We had to call off hours and when I told the nurse who answered that my husband had a respiratory emergency, she said we will be there in less than 5 minutes; it was about two.

I give all of these medical crews credit for taking on so many with unknown illness and it is just them. We have always had excellent care. I also will never sail without evacuation insurance again, which we did not have on this cruise.

[dlynn0366]

Thanks for all the kind words and assistance.

 

I hope everything turned out as best as it could for your family member. One of the things my Mom wanted to do when she was told her cancer was terminal was go for a hot air balloon ride but unfortunately she almost over night became oxygen dependent. After she passed I made my 2 sisters who are both afraid of heights go with me in her memory :)

[camz]

Boowa - Very sorry to learn of the situation surrounding your family. It is very sad, scary stuff. Please keep us posted with regard to the medical assistance NCL offered your family.

[meggie711]

I'm so sorry to hear that you & your family are going through this. I hope that the cruise has been enjoyable for the family in such a difficult time. I sat with my dad when he took his last breath last year. What a wonderful thing that your family was able to have this trip together.

[blindrid]

Ours is a yearly policy that covers us for as many trips out of the country as we would like to take up to 15 days per trip. Pre-existing conditions in this policy only include ones that you see a doctor for within 3 months before you need to use the insurance.

Our DD broke her arm 6 months prior to a trip and since her last check- up was 2 1/2 months prior to our trip we were told that her arm was essentially not covered.

Insurance is all so different and you really need to read the fine print.

 

Agree 100%. It's all in the policy......