Humanitarian Nursing
Performing humanitarian work in either the domestic or international field is a dream of many healthcare professionals. An emergency nursing background lays a firm foundation for this rewarding career choice. This may be chosen as a part-time job or a once-a-year event, or you may choose to seek out a full-time position that lasts from 6 months to several years. Many organizations await your application to fill a needed role.
A history of emergency or critical care nursing is important in the hiring process for this role. Anything that can walk through the doors of an ED can walk through the doors of the ship infirmary. Learning to take X-rays, perform laboratory testing, and deal with the disembarkation of a passenger or crew member with an acute, life-threatening illness or injury are just a few of the many items to check off the orientation list.
Do not expect the pay to be exceptional. Many nurses take full-time contracts and do this for their full-time employment. Others may work part time, which for some cruise lines is 2 weeks at a time. You can’t take this job thinking it’ll be a vacation. If you enter this voca- tion with that thought in mind, your contract will not be pleasant.
For employment in the cruise ship industry, go to the individual cruise ship website and look for the employment section.
Questions that should be considered when choosing a cruise line to work with:
■What is the complement of medical officers onboard? ■What kind of intensive care area is onboard? ■What medications are available?
■What equipment is used?
■Do all the medical officers onboard speak the same language? ■Does the cruise line provide thrombolytics onboard?
■What kind of backup assistance is available via phone?
■What kind of training should I expect?
■Do they allow me to bring my spouse or other person onboard with me?
WARNING:
WARNING: Cruise ship nursing is Cruise ship nursing is not like the old television show like the old television show The Love Boat or the movie or the movie Out to Sea ! But it is fun and interesting.! But it is fun and interesting.
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When considering work in the developing world, consider the impact it will make on not only yourself, but on your family as well. Having a loved one gone for a considerable amount of time, without being able to contact home, can take a toll on those left behind. Make sure that both sides of your personal relationship can handle the absence.
Some trips are physically challenging, while others can be more fixed (in that although you are in a developing country and working in harsh conditions, one-stop unpacking is avail- able, and a bed and a shower are available each night). On some teams, constant movement from village to village may be the norm, requiring constant packing, unpacking, and carry- ing your personal backpack each day. There may be long hikes while transporting supplies or rivers to ford. You may be transported in tightly packed trucks, in the back of a pickup, in a ramshackle bus, in a long boat, or on a crude raft. Days may pass with no real beds or showers; when showers are present, they may be a cold trickle of water. Other trips may be held in one location, thus not requiring the constant travel. You may reside in a hotel or compound and be transported each day to the location of the clinic.
The clinics can be a challenge all on their own. You may find yourself struggling to deter- mine how to teach people to mix rehydration fluid, but unsure as to how they are going to acquire clean water to use with it. There are often few or no hospitals nearby, and it can become a quandary as to how to deal with an individual with potential appendicitis, a severe burn, or acute cholecystitis in remote areas of the world. There are also issues with diagnosing some of the endemic infectious processes such as leishmaniosis, dengue fever, or leprosy. It is always helpful to have local physicians or nurses as part of the medical team. Critical thinking is the most important skill needed for this type of nursing.
Make sure before you leave that you have a clear image of what the mission is for the par- ticular group that you choose. Emergency nurses usually want to provide medical care. Not all groups do this. Make sure you ask and are provided with an unmistakable answer as to the vision and purpose of the trip. Is there a religious affiliation with the group? Some groups require attendance at church services or, at the least, prayer before medications are provided. Just make sure that you fit in with the group that you choose to join.
Be aware that when on a mission trip, again either domestic or international, you may not see “the big things.” Most patients that come to the clinics are there for simple processes such as upper respiratory infections, urinary tract infections, yeast infections, and the occa- sional abdominal pain. Some trips have their share of more acute illnesses and injuries, but the norm is to care for the less acute and more chronic issues. However, for the people who come to the clinic for care, the medical team is seen as a gift to them. Simple interventions such as Tylenol or ibuprofen for constant back pain, antacids for chronic reflux, or an anti- biotic for a UTI are welcome relief from long-standing problems. Of course, you must be prepared for catastrophic events such as extensive burns or patients in need of surgical
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intervention. The rewards are seen in the smiles you receive when you take the time to lis- ten and treat patients like they count. Because, of course, they do.
Education should be a large part of the process of caring for individuals who do not have regular access to care. Talk to the team leader to determine what percentage of time should be devoted to educating the patients and their families. Whether formal or more informal, education will guide them in the future, because the clinic will not always be there, and it is difficult for them to find even the minimal type of medications that are provided by the medical team. Teaching proper lifting techniques, hand washing, brushing teeth, access to clean water, and simple first-aid techniques can be the best thing that is left behind. See Table 3.1 for a list of some organizations that organize humanitarian trips that nurses may participate in.
Table 3.1
Table 3.1 Organizations WhosOrganizations Whose Humanitarian Misse Humanitarian Missions Include Nuions Include Nursesrses
Organization Website
Doctors Without Borders www.doctorswithoutborders.org
Project Helping Hands www.projecthelpinghands.org
Convoy of Hope www.convoyofhope.com
Big Creek Missions www.bigcreekmissions.com
Samaritan’s Purse www.samaritanspurse.org
Project Hope www.projecthope.org
International Medical Relief www.internationalmedicalrelief.org
AmeriCares www.americares.org
Go to www.missionfinder.org/medical-dental-doctor-relief to see a listing of multiple organiza- Go to www.missionfinder.org/medical-dental-doctor-relief to see a listing of multiple organiza- tions that offer medical care in both domestic and international venues. Another website that tions that offer medical care in both domestic and international venues. Another website that deals with this type of nursing is www.onenurseatatime.org. This site not only provides a directory deals with this type of nursing is www.onenurseatatime.org. This site not only provides a directory of organizations but also offers financial scholarships to help nurses to participate in mission of organizations but also offers financial scholarships to help nurses to participate in mission trips, networking, and educational opportunities.
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Disaster Nursing
Disaster Nursing
Disaster nursing is another aspect of humanitarian work, but it carries with it a different set of tools and needs. For those interested in this venue of nursing, you must be ready to leave within a very short time period; disasters don’t happen on a schedule. This is a very intense type of nursing and requires someone who can handle harsh conditions and severe situations. When approaching a disaster site, no words can totally prepare you. The area may be strewn with bodies of injured individuals. There may not be a true “medical clinic,” and making the most of what is available is a quintessential characteristic for these nurses.
When faced with disasters, the impact of the surrounding devastation, loss of family connec- tions for those injured, and the fact that severely injured people must be cared for with a minimum of supplies, diagnostics, and treatment options prevail. It may be difficult to adjust your mentality if your usual environment is a hospital ED setting where you’re used to resus- citating everyone; you may have to get used to leaving the most injured who require intensive resuscitation to concentrate on those you can quickly help. It’s a nursing role that provides deep satisfaction and fills a demanding need, but the reality of the destruction may take a toll on you physically, psychologically, emotionally, and spiritually.
For those interested, contact organizations such as the Red Cross and DMAT (Disaster Medi- cal Assistance Team) teams in your area. DMAT teams are deployed by the federal govern- ment to crisis situations and have required meetings and education throughout the year. A stipend is provided for those who respond to these team deployments (Public Health Emer- gency, 2014, 2015).
To join a DMAT team, search for the DMAT in your state. Each state has its own website and To join a DMAT team, search for the DMAT in your state. Each state has its own website and should provide information regarding how to join. Be prepared to be deployed on short notice to should provide information regarding how to join. Be prepared to be deployed on short notice to disaster areas.
disaster areas.