On a hot summer evening during my recent postdoctoral dream cruise, I was preparing to relax and enjoy a show in the beautiful lounge when, above the excitement and din, I heard the unmistakable sound of a human body hitting the marble floor. In fact, the dull thud of a head making contact with an immovable object is a sound any nurse would recognize. It was immediately followed by the sickening sound of a young child’s cry that quickly grew from a whimper into a pitiful scream.
I instinctively jumped from my seat and ran in cartoonish fashion to the back of the lounge—my legs seemed to be moving faster than my body. As if in slow motion, however, I noted the bewildered stares of my traveling companions in the seats around me. Before the first “where are you going?” reached my ears, I was already at the back of the lounge and at the side of a very young boy who was now holding his head and staggering to get to his feet. “Please don’t move. I’m a registered nurse,” I told him and the small group of people standing around him.
Before I could react further, a firm hand gripped my shoulder and two crew members authoritatively said, “Step aside.” One of them leaned down, quickly helped the boy to his feet, patted him on the head and simply said, “You’re all right, son. Now be a good boy and run along.”
“No, no,” I said and once again asserted, “I’m a registered nurse. He shouldn’t be moved yet…might need a cervical collar…an X-ray and evaluation…at least!” The crew quickly turned their attention to me and delivered the same, but slightly revised and more mature version, of the “now run along” message and concluded with, “Go have some fun and relax! Don’t worry about it. That’s what we’re here for.”
Although it seemed to last an eternity, the whole incident from start to finish lasted less than 30 seconds. I stood in stunned silence until two friends in my party retrieved me. Needless to say, I discovered that it was far easier to be instantly transported from vacation mode to nurse mode than vice versa. All I could think about was the boy. A patient…er…a passenger fall? Where was the incident report? Follow-up? Then I thought, “Should I follow the staff’s advice, stop being such a nurse, and just enjoy myself?”
The answer was ultimately no. I couldn’t stop being a nurse for that one moment, that evening, the duration of the cruise, and, I expect, even a lifetime. Needless to say, based on the crew’s less than robust response to the incident, I had a different perspective of myself, the passengers, crew, and surroundings. For the remainder of the trip I noticed things I might not have before.
For example, every time I reported to the gym for an early morning workout, I noted that there were no staff members on duty. I looked around the large workout area that hugged the ship’s stern. Just a few people, most of whom appeared quite overweight, very sweaty, and breathing heavily, were using the treadmills. I wondered if they were trying to work off some diner’s remorse from the previous night’s 4,000-calorie dinner. Was it safe for them to be engaged in such strenuous exercise? Were they instructed in the proper use of the equipment? Was their heart rate in their ideal workout range or should they stop and take a break? But, Oh, stop worrying… just relax and enjoy yourself.
Although I ultimately managed to take my own advice, I have to pass along a few recommendations. I’m sure that any group of nurses who got together over coffee could come up with more, but here are mine:
• If you or a member of your party experiences a fall or other injury while on a cruise or at a resort, insist on an incident report and a medical evaluation. Your chances of receiving appropriate—and deserved—follow-up care substantially diminish if you leave the scene of an incident without insisting on both.
• Don’t leave medications or valuables sitting on bathroom counters. Noting the frequent occurrence of open doors and un-attended staterooms all over the ship, and given that bathrooms were located just inside each stateroom’s entrance, I envisioned someone stepping into the bathroom and stealing valuables or medications in hopes of making a quick score or obtaining narcotics.
• Take an economy-sized container of antibacterial wipes. When you arrive at your stateroom, use them to sanitize all surfaces in the bathroom as well as the TV remote, credenza, and door handles.
• If you choose to use exercise equipment while on board, read the warning signs and disclaimers carefully. Let someone know you’re going to work out and ask him or her to check on you if you don’t return by a certain time. Exercise sensibly, and keep in mind that working out at sea isn’t like your basement or local gym. For example, even in relatively calm seas, you may need to hang on to the treadmill to avoid falling.
• Avoid eating leftovers or recycled food. Hot foods should be prepared, stored, and served hot, and cold foods should be prepared, stored, and served cold. Although we can’t observe all three processes, we can certainly check the temperature of soups, salads, entrees, and cold desserts right before eating. When in doubt, don’t eat it.
• Pack sunblock with a minimum 30 SPF. Common sense? If so, then why did I see so many passengers walking around with second-degree sunburn by day two?
• Stay hydrated throughout the cruise, especially during shore excursions, where the ship’s amenities aren’t readily available.
Will I ever develop the ability to leave my nursing identity behind on vacations? I don’t think so. Nursing is what I do and a huge part of who I am. I don’t know about you, but I just can’t help myself. I do intend, however, to arrive for my next dream vacation better prepared and more self-sufficient. Only then will I be able to nurse my vacation less and instead nurse my own need to engage in well-deserved self-care through rest and relaxation.
Editor’s note: Read more about Foley’s adventures on our Insights blog.
David Foley is an assistant professor of nursing at Cleveland State University in Cleveland, Ohio.