This person is expected to provide medical nursing services to all Guests and Crewmembers who need it. The Nurse shall assist the Staff Captain, Senior Doctor, Doctor and Chief Nurse in all shipboard health-related matters including outbreak prevention, and illness reporting as required by international, national and Company policies.
In order to consistently exceed guest expectations and provide the highest levels of product and services, additional duties and responsibilities may be assigned as needed.
The Nurse shall have an understanding of the Safety and Quality Management System (SQM) and carry out the policies and procedures appropriate for his/her position.
* Provide administrative assistance to the Doctor and Senior Doctor including completion of medical forms/reports and the medical inventory.
* Ensure confidentiality of medical information.
* Provide First-Aid instruction for crew members as directed by the Doctor, the Staff Captain and oversees the operation, good order and cleanliness of the Medical Center and Secondary Medical Space.
* Assist the Doctor in carrying out his professional responsibilities and duties.
* Provide nursing care for minor and major emergency situations for passengers and crew.
* The Nurses need to do a triage of every patient. It is the responsibility of the Nurse to immediately inform the Doctor when she finds or suspects that a patient has a life threatening condition or has any abnormality in the vital signs.
* In addition to assisting the Doctor with patient care, the Nurses have a variety of administrative responsibilities in relation to care of guests and crew and management of the Medical Facility and pharmacy.
* Generally, it is the responsibility of all Nurses to become fully versed with the policies and procedures of the ship as well as the particular requirements of the Doctor under whom the Nurse will serve. Each Nurse will serve at scheduled times on a medical "on call" roster each day. During this period, the Nurse will assist the Doctor on duty.
* When any member of the medical staff receives a telephone call or otherwise becomes aware of a potentially serious guest or crew medical issue outside established office hours, that contact or telephone call should be followed-up by an "in person" visit with the patient by a member of the medical staff, which should then be documented accordingly in medical records.
* The Nurse must participate in all lifeboat and emergency drills held on board unless excused by the Staff Captain.
* The Nurse will have responsibility for the preparation and maintenance of medical logs, crew medical records and reports. On each voyage, the Nurse must prepare for the Doctor's review and signature the following:
- Daily Illness Log - Crew and guest Sick Lists;
- Log of Shoreside Medical Referrals;
- Infectious Disease and Diarrhea Log;
- Narcotic Count Log; and,
- Medical Supplies Usage/Consumption Report.
* The Nurse must also assist in maintaining a proper inventory level of pharmaceutical and medical supplies, and prepare requisitions as needed for the Doctor's signature. The inventory of pharmaceuticals aboard the ship must be conducted on a weekly basis as well as whenever there is a change in medical personnel aboard ship. Risk Management and the Director or Medical Operations should be advised of any substantial missing items or supplies.
* The Nurse must follow the Doctor's instruction with respect to inspection of equipment and supplies. He/she must follow the Doctor's orders for weekly inspection of diagnostic and life support equipment for proper working order and for emergency code kits at the emergency stations throughout the vessel to be certain the equipment is properly stocked, that medications are within current date and that oxygen bottles are full.
* The Nurse must ensure that all expired medications are removed from the shelves and are disposed of according to environmental policies or, if applicable, return them to the vendor in case that a medication has any refund value.
* The Doctor will require daily inspection and testing of all battery operated equipment in the Medical Facility including the EKG, defibrillation equipment, resuscitator and the like. The Nurse will be instructed to discharge the capacitors of the defibrillator on a daily basis to assure proper working order. The Nurse will maintain a log of all weekly and daily equipment inspections. Sample checklists are in Chapter 8.
* Test the water samples delivered to the medical facility for this purpose using the method designated by Public Health (such as Colisure) and maintain a log of test results. The Nurse must report any positive and negative findings immediately to the Doctor and the Staff Captain.
* While on duty, the Nurse must answer the telephone in the Medical Facility. Personnel should always answer the telephone politely: "Medical center, Nurse (name), speaking." During office hours, on Royal Caribbean ships, the Nurse must remain in the Medical Facility at all times except for: meals, official errands and emergency cabin calls. On Celebrity ships, two Nurses must be present at the medical facility during office hours. The Nurse should use the walkie-talkie, the beeper and taped phone messages when out of the office during duty hours.
* The Nurse is involved in the provision of medical care to crew members who are injured or ill while in service of the ship. The Nurse will request appointments for shoreside referrals via the Crew Medical Department, notify the pertinent department heads and prepare a list of referral appointments to forward to the Chief Purser and Customs Official.
* The Nurse will maintain a log of all shoreside medical referrals and file shoreside referral medical reports in each crew member's files after the Doctor has viewed them.
* Maintain current medical records for all crew members.
* Schedule appointments for the regular shipboard medical examinations of crew members, and notify the appropriate department head of the appointment date and time.
* Under circumstances where the Nurse learns of accidents involving guests or crew, report the matter to the Staff Captain immediately verbally and in writing.
* The Nurse's daily work schedule is determined by the Doctor. The duties may include the following:
- Seeing patients (guests and crew) as necessary.
- Conducting water tests throughout the ship on a rotational basis.
- Ordering medication, supplies and stationery.
- Checking and cleaning equipment.
- Preparing daily, weekly and monthly logs, reports and forms as necessary.
- Submitting necessary completed forms to shoreside.
- Triage/Evaluate patients in order to help the Doctor to establish eventual emergencies needing immediate treatment during crowded office hours.
* Fill the nursing assessment/intervention part of the crew medical examination paper.
* Maintains Guest illness logs and medical notes. Completes all paperwork associated with various medical situations.
* Maintain Crewmember illness logs and Crewmember medical files. Such files shall accompany Crewmembers from ship to ship in accordance with company policy.
* Maintains injury logs and fill out accident reports.
* Maintains current Crewmember physical examinations.
* Maintains Acute Gastroenteritis log for U.S.P.H. or any port health authorities and reports as required.
* Prepares and maintains records of Medical Center charges.
* Executes Code Alpha / Star Code procedures regardless of being on duty or not.
* Executes air and land evacuation procedures.
* Trains and leads stretcher teams in Fire and Lifeboat drills, and first-aid training for Crewmembers.
* Obtain and tests water samples and cultures for growth of Coliform organisms.
* Performs weekly checks of emergency equipment and maintenance of all Medical Center equipment.
* Sterilizes surgical instruments.
* Orders medical supplies and equipment. Maintains proper levels of inventory through us of the AMOS ordering system.
* Maintains current medications in lifeboat canisters once yearly.
* Provides first aid supplies for first aid boxes.
* Makes and distributes Medical Center on call schedules.
* Properly disposes of hazardous wastes and used sharps (needles, syringes).
* Oversees and maintains cleanliness of the Medical Center in a clean and orderly fashion.
* Actively participants in Crewmember education and training programs.
* Maintains records and narcotic counts.
* Ensures confidentiality of medical information.
* Properly fills out and distributes all forms associated with the medical department.
* Prepares and submits a list of accidents/injuries by department for the monthly Crew Safety and Environmental Committee meetings.
* The Nurse assists in mandatory random drug testing when required.
* Executes and has a good working knowledge of all paperwork associated with the operations of the Medical Center.
* The Nurse needs to be available at all times in order to assist the Doctor or Senior Doctor with any medical cases.
* Performs other related duties as assigned or as directed. The omission of specific duties does not preclude the supervisor from assigning duties that are logically related to the position.
* Nurses respond to all codes even when they are off duty.
* Nurses will advise the Doctor when the patient waiting times are increasing or there are higher than usual patients waiting to be seen. She may decide to call another Doctor to help with the clinic. This will reduce patient waiting times and increase patient satisfaction.
Dimensions
Nurse needs to be available at all time in order to assist the Doctor or Senior Doctor with any medical cases.