Doctor's on ship

[dealia]

Does anyone know if there is a policy that the doctor be on the ship before the passengers start to board? We had a situation last year right after we boarded the ship and we where told that the doctor still hadn't boarded the ship yet.The nurse who took care of my husband was very incompetent and was very arrogant. We were told that if my son's hadn't called 911 my husband may not be here right now. I would just feel safer if I knew the doctor was on the ship before us.

[PINEVIEW01]

The Doc would only have to be on the ship by the time crew has to be. about 30 to 60 minutes before boarding.

 

So, it would be hit or miss.

[themarm]

Does anyone know if there is a policy that the doctor be on the ship before the passengers start to board? We had a situation last year right after we boarded the ship and we where told that the doctor still hadn't boarded the ship yet.The nurse who took care of my husband was very incompetent and was very arrogant. We were told that if my son's hadn't called 911 my husband may not be here right now. I would just feel safer if I knew the doctor was on the ship before us.

 

be careful that you do not confuse incompetency with an acute awareness that she is not allowed to practice outside the realm of her lisensure.

[dealia]

be careful that you do not confuse incompetency with an acute awareness that she is not allowed to practice outside the realm of her lisensure.

 

It was a he not a she . My husband had a seizure right after we had boarded. As far as I know there wasn't much that would be out of the realm of his licensure .He acted as if he didn't know what to do and as if we were bothering him. He came into the room (after 5 calls down to the infirmary )threw his bag down on the floor with quite an attitude. I wasn't the only one to notice this several other people noticed it also. There was a couple in the hallway that came when I was screaming for help and they made the comment " what's his problem? "Then he had to audacity to yell at my son for calling 911, his exact words where" I hope you know that was a 1000.00 dollar call you made". It could have been a million for all I cared this is my husband we are talking about.

By the time the paramedics came on board my husband was down in the infirmary. One of the paramedics actually yelled at the nurse " Hey your patient is over here buddy" because he was writing something on a chalk board on the wall rather than paying any attention to my husband. At one point they lost my husband blood pressure. I was later told by a doctor at the hospital that if the paramedics had not been there at that moment the situation would have been very different.

[firefly333]

Since the ship had not taken off and you called regular 911 for regular emergency services, it makes sense to me that the doctor wouldnt be required to be on board when you had regular emergency services still available to you.

 

You could report the nurse, but sounds like you needed a doctor and good thing you called 911. You were still in port, so it makes sense to me.

 

I am sorry that the medical staff wasnt up to what you should have expected and the nurse wasnt very good. You could and maybe should have complained or reported him.

[dan40]

DEALIA,

 

Please keep in mind that ship's infirmaries are not big city trauma centers. Nor do they equal a small town ER. They are only first aid stations. Among the best equipped and manned first aid stations you'll find anywhere, but still, only first AID stations.

 

Dan

[gill_boo]

DEALIA,

 

Please keep in mind that ship's infirmaries are not big city trauma centers. Nor do they equal a small town ER. They are only first aid stations. Among the best equipped and manned first aid stations you'll find anywhere, but still, only first AID stations.

 

Dan

 

That I think is complete crap, if the ships want to offer the security of having the ability to promote and offer an infirmary staffed by a physician and nursing staff then those staff should be able to handle something as simple as a seizure. What kind of doctors are the cruise lines hiring? It is not difficult to deal with a seizure patient, even just a nurse should know what to do. Beside that fact was the poor bed side manner offered by the nurse. On one of my cruises a man collapsed in one of the restaurants and I was right there. Being a paramedic myself I was assisting him until the nurse arrived. This nurse seemed very competent and skilled, and I was impressed with their treatment plan and they thanked me for my assistance. Maybe it was just this specific experience but I think the cruise lines do have some responsibility to offer competency if they are going to offer this service.

[Border Granny]

I have been in healthcare for over 40 years, and there is never any excuse for any healthcare provider to be rude and not compassionate to a patient, period.

[jetskier]

Even in ports of call the doctor is not always onboard. In Roatan, I had a beer with the doctor. He had his family down with him.

 

When I was on the Fantasy a young lady cut a large slice of her big toe. I went over to help along with another passenger who was a paramedic. Security wanted her to walk from the Lido to the Infirmary. We could not get anyone from the infirmary to come up. I asked Security to call and get a wheel chair.

 

The paramedic kept pressure on the toe while I pushed the wheel chair to the infirmary. The nurse there could not stich it because of the way it lacerated it and ended up cutting off the slice. The poor lady's boyfriend had a problem with the sight of blood.

 

That is the only complaint that I have observed is getting someone to respond. Instead they want you to come to the infirmary. With the ships getting larger populations onboard, a first responder team would seem like a necessity.

 

Dave

[luckycruzer]

are contract..My visit was to a cutie from New Jersey..that's all he does, is cruise ship gigs. $148 for a "Z" pak, and for me to tell him I had a sinus/sore throat infection.. The meds I was given was for "STD's"..so I was NOT allowed to have sex for 2 weeks :eek: ..traveling solo, and not a date-er..that was okey dokey by me. The MD in the Lido, and several other pals from the DR took better care of me than "Dr. Blonde" did. they checked on me at meal times, and during the day, etc..and offered to bring a dinner from the DR to my cabin, and made me hot tea for medicinal purposes:) .makes

[luckycruzer]

are contract..My visit was to a cutie from New Jersey..that's all he does, is cruise ship gigs. $148 for a "Z" pak, and for me to tell him I had a sinus/sore throat infection.. The meds I was given was for "STD's"..so I was NOT allowed to have sex for 2 weeks :eek: ..traveling solo, and not a date-er..that was okey dokey by me. The MD in the Lido, and several other pals from the DR took better care of me than "Dr. Blonde" did. they checked on me at meal times, and during the day, etc..and offered to bring a dinner from the DR to my cabin, and made me hot tea for medicinal purposes:) .makes one wonder why a Doc like that sosent have an office???.anywhere 'cept at sea

[Flip2cruise]

Does anyone know if there is a policy that the doctor be on the ship before the passengers start to board? We had a situation last year right after we boarded the ship and we where told that the doctor still hadn't boarded the ship yet.The nurse who took care of my husband was very incompetent and was very arrogant. We were told that if my son's hadn't called 911 my husband may not be here right now. I would just feel safer if I knew the doctor was on the ship before us.

 

Sorry to hear about your hubby, I hope he is doing much better now.

 

Here is the info about the medical services offered. It sounds like as was mentioned its hit or miss when the doctor will be on the ship and able to render service.

 

http://www.carnival.com/CMS/FAQs/Medical_Services.aspx

 

Should a guest require medical attention while aboard one of our vessels, the Infirmary staff is available to assist 24 hours a day. The Infirmary is equipped to treat minor non-emergency matters. Physicians are available to render services at a customary fee. While at sea or in port, the availability of medical care may be limited.

Medical Infirmary Hours

The Medical Infirmary on board has daily office hours which are listed in the Carnival Capers. The medical staff is on call 24 hours a day for emergencies. The hours may vary from ship to ship and whether the ship is in port or at sea:

Infirmary Hours: 8:00am - 8:00pm

Doctor's Hours : 9:00am - 11:00am; 3:00pm - 6:00pm

Medical Service Fees

A charge for medical services will be billed to the guest's Sail and Sign Account and a receipt will be provided for the guest to submit to their insurance company upon return for possible reimbursement.

The physicians on board are independent contractors and are entitled to render services at a customary fee which may vary from ship to ship based on the time of day. The basic fee does NOT include medication, tests or treatment.

 

 

 

Medication

Motion Sickness: complimentary Meclizine (Bonine) is available from the Infirmary, Room Service or the Information Desk, free of charge. A motion sickness shot can be administered to those who are actively vomiting, but not as preventive medicine; there is a fee for the shot. The Infirmary does not have motion sickness patches nor wristbands.

 

 

 

Over-the-Counter medications for cold, cough, upset stomach or other minor illnesses can be purchased at the Infirmary from 8:00am-8:00pm. In addition, the shops on board may carry some of these items.

Prescription drugs and vitamins may not be readily available either on board the ship or in the ports-of-call.

 

 

 

Medical Staffing and Equipment

In order to maintain a safe and comfortable environment for our guests, our infirmaries meet or exceed the standards established by the International Council of Cruise Lines and the American College of Emergency Physicians.

Our infirmaries are staffed by qualified physicians and nurses who are committed to providing the highest quality of shipboard medical care. Each ship in the fleet carries one doctor and three nurses; the Destiny, Triumph and Victory each carry two doctors and four nurses.

Doctors on our ships are required to have a current and valid medical license from the USA, one of its territories, or Canada, Australia, New Zealand or South Africa, or have full registration with the British General Medical Counsel of the United Kingdom or current full registration with the British General Medical Council of the United Kingdom, or current full registration with the medical council of a member country of the European Union. In addition, doctors must demonstrate competent skill levels and hold current certification in basic and advanced cardiac life support and cardiac care, have experience in general medicine or general practice including emergency or critical care, and have one to three years clinical experience and minor surgical skills, and board or similar international certification is preferred. The doctors on board are independent contractors.

 

 

 

Shipboard medical facilities are set up to provide reasonable emergency medical care for guests and crew. In cases of extreme emergency where more comprehensive facilities are required, patients are referred to shoreside facilities.

 

 

 

In addition to standard lifesaving equipment such as defibrillators and external pacemakers, our infirmaries carry some of the latest in medical technology including thrombolytic therapy, electrocardiograph machines, lab equipment, pulse oxymeters and x-ray machines on many of our ships.

[PINEVIEW01]

Glad everything worked out ok for your DH.

[dbrucern]

are contract..My visit was to a cutie from New Jersey..that's all he does, is cruise ship gigs. $148 for a "Z" pak, and for me to tell him I had a sinus/sore throat infection.. The meds I was given was for "STD's"..so I was NOT allowed to have sex for 2 weeks :eek: ..traveling solo, and not a date-er..that was okey dokey by me. The MD in the Lido, and several other pals from the DR took better care of me than "Dr. Blonde" did. they checked on me at meal times, and during the day, etc..and offered to bring a dinner from the DR to my cabin, and made me hot tea for medicinal purposes:) .makes one wonder why a Doc like that sosent have an office???.anywhere 'cept at sea

 

Just to correct something Z-Pac is an antibiotic that is widely used for respiratory infections, sore throats etc. I my 32 years we have never used a Z-pak for STD's.

[salty dingo]

If you are still at the dock, it would be the same as being at a hotel - you dial 911 and the EMTs respond to the ship. Would you expect a doctor to be resident in a hotel at all times?

 

If I were to have a problem on a ship, I'd be FAR better off if it happened before I sailed.

 

If it was not an emergency, then it could probably wait until the doctor arrived.

[jayesouthworth]

Whenever we have used the infirmary on board the ship, we have always received good medical advice and care. This sounded like a desperate situation and calling 911 while still in port was a wise thing to do. Luckily, you were still in port and not half way out to sea or stuck in a foreign country.

[dan40]

That I think is complete crap, if the ships want to offer the security of having the ability to promote and offer an infirmary staffed by a physician and nursing staff then those staff should be able to handle something as simple as a seizure. What kind of doctors are the cruise lines hiring? It is not difficult to deal with a seizure patient, even just a nurse should know what to do. Beside that fact was the poor bed side manner offered by the nurse. On one of my cruises a man collapsed in one of the restaurants and I was right there. Being a paramedic myself I was assisting him until the nurse arrived. This nurse seemed very competent and skilled, and I was impressed with their treatment plan and they thanked me for my assistance. Maybe it was just this specific experience but I think the cruise lines do have some responsibility to offer competency if they are going to offer this service.

 

The OP posted a version of an event. The true version in her point of view. But AS ALWAYS not the only version. You are a paramedic, you say. Have you never seen a situation where the patients friends, family, loved ones, were on a completely different page than you, the medic or the doc? Her version might be exactly right but more likely its only somewhat right and the nurse might have a favorable version too.

Doesn't change the fact that its only a first aid station, not an ER.

 

And I say this knowing full well that my own health problems could spell curtains for me if I had a problem on a cruise ship. I've got a heart that might be equal parts scar tissue and muscle. Out at sea, they probably couldn't do much for me. So be it.

 

Dan

[dealia]

DEALIA,

 

Please keep in mind that ship's infirmaries are not big city trauma centers. Nor do they equal a small town ER. They are only first aid stations. Among the best equipped and manned first aid stations you'll find anywhere, but still, only first AID stations.

 

Dan

 

I realize that the infirmary is not equal to an ER dept. I am not sure what type of equipment the infirmary had as the paramedics were there very quickly and took charge of the situations.It was the fact that we had to make several calls to the infirmary before we even got an answer and then the attitude that the nurse gave us. I was under the impression that the doctor's were supposed to be on the ship , but now I realize that is not the case.

My husband had never been sick a day in his life and we don't know what caused the seizure . He has been seizure free for a year now and doing great! I did report the incident to Carnival and they assured me that they would look into it.

Carnival actually gave us a credit for the cruise . (We hadn't bought any cancellation insurance and we learned a lesson.) You never know when something is going to happen. This time around we purchased insurance.

 

We leave for our next cruise on May 1st out of New York.:D

[Marie51]

There must be more than one doctor on the cruise..........So if one is off the ship having a beer with you, the other must be on the ship for emergencies there.

[Chigirlcruzin]

There must be more than one doctor on the cruise..........So if one is off the ship having a beer with you, the other must be on the ship for emergencies there.

 

 

If there's more than one, the others are passengers. There's only one cruise ship doctor.

[Marie51]

There has to be more than one cruise ship doctor and here I why I think this. Last year my daughter-in-law went to the infirmary and saw the doctor. Two days later she had to take my grandson to the infirmary with a cough/cold. Each time there was a different doctor, leading me to believe that there were 2 of them onboard.

What does everyone else think?

[themarm]

It was a he not a she .

 

whether a he or a she, it does not affect the standards required for lisensure.

 

My husband had a seizure right after we had boarded. As far as I know there wasn't much that would be out of the realm of his licensure .

 

here i disagree with you. what is and is not out of the scope of his lisensure could indeed be a complex matter. is he a RN? LPN? CNA? if he is an RN, then he *potentially* could be operating under the scope of his lisensure (depending on the state of issuance) depending on a number of factors which are at the discretion of that state, and are very dependant on the treatment you have in mind.

 

many states require that nurses are supervised and acting under established organization policies. being as carnival's infirmiry professes to be of help with MINOR non-emergency situations, i doubt they have procedures for rectal administrations of diazepam or for the vagus nerve stimulator on demand therapy. in this situation, i do not think many states would smile upon a RN who acted independently, even if it were heroically and correctly.

 

Then he had to audacity to yell at my son for calling 911, his exact words where" I hope you know that was a 1000.00 dollar call you made". It could have been a million for all I cared this is my husband we are talking about.

 

I was later told by a doctor at the hospital that if the paramedics had not been there at that moment the situation would have been very different.

 

without a doubt, your situation was a very difficult one. it sounds like your husband made it through - and bottom line, that is what is important.

 

while the nurse did not have the greatest bedside manner, nor did he work with the paramedics well, i do not see that he necessarily failed to act within his scope, and find strong evidence that it is highly unlikely to assume that he would have the speciallized training and supervision to independently attend to this emergency.

[gill_boo]

The OP posted a version of an event. The true version in her point of view. But AS ALWAYS not the only version. You are a paramedic, you say. Have you never seen a situation where the patients friends, family, loved ones, were on a completely different page than you, the medic or the doc? Her version might be exactly right but more likely its only somewhat right and the nurse might have a favorable version too.

Doesn't change the fact that its only a first aid station, not an ER.

 

And I say this knowing full well that my own health problems could spell curtains for me if I had a problem on a cruise ship. I've got a heart that might be equal parts scar tissue and muscle. Out at sea, they probably couldn't do much for me. So be it.

 

Dan

 

Regardless if we are hearing their "version" of the story, if a cruise line wants to advertise that they have ships doctors available for emergencies then they should be providing that service from the second you step on that ship until the second you get off. What if this had been a cardiac arrest, would this person have suffered a worse fate. Any properly trained RN should know that a seizure can be a life altering event and needs to be cared for quickly and efficently.

[themarm]

Regardless if we are hearing their "version" of the story, if a cruise line wants to advertise that they have ships doctors available for emergencies then they should be providing that service from the second you step on that ship until the second you get off. What if this had been a cardiac arrest, would this person have suffered a worse fate. Any properly trained RN should know that a seizure can be a life altering event and needs to be cared for quickly and efficently.

 

a properly trained RN knows that have to respect what the state will and will not let them do.

 

what that means is that they can monitor the seizure, ensure the person will not harm themselves during the seizure, not stick anything in their mouth, and not hold them down.

 

that is not a lot that they CAN do.

 

SOME RNs (not LPNs and certainly not CNAs) under the supervision of a physician, and within strict organizational policy can initiate SOME therapies (rectal goo and a nerve stimulator thingy). this is clearly not the case on carnival.

 

a nurse is a right handy person to have around, and Lord love them. i certainly do. but they cannot act outside the scope of their practice no matter how nifty they are, without risking their job and license. keep some degree of perspective in this -- some states deem that there are sutures that a RN cannot attend to, and some say that RNs cannot remove a suture. a frikkin suture! guess where that leaves your average cruise ship RN? LPN? CNA? in the scheme of independently determining treatment for a seizure victim?

[FamilyDoc]

Carnival advertises that they will have a doctor on board when the ship is at sail. Not necessarily while in port. They say they will have one doctor on most ships but 2 on a couple of the ships.

 

A seizure is scary for people to watch but truly, there is almost nothing you can do if you do have the authority to inject meds. I would not want a nurse deciding what to inject a new pt with no known history without having the supervision of a doc. I know it sucks, but most of the time, the seizure finishes on its own without help from medical personel. Very rarely does the seizure itself cause harm.

 

Zithromax is also used for STD's by the way--it's great for chlamydia and usually for gonorrhea too. (That's why teens will tell me they have pneumonia and want me to just call something in, ie Zmax :D )

 

OP-hope all is well, seizures are awfully frightening to watch.