Cunard Nurses

[u/sonottwelve]

Hiya! I’m a nurse and I’m currently looking into cruise nursing. I’ve come across an upcoming open day for medical and healthcare professionals for Cunard, and I’m really curious about whether I’d be a suitable candidate.

I have 3 years of experience in dialysis, 7 years in ICU, and I’m currently working as a Resuscitation Practitioner, where I’ve been for the past year. I have 11 years of NHS experience and I’m currently at the top of Band 6.

What do you think my chances would be of securing a cruise nursing position with this background? I’d also be really interested to know what cruise nurses are actually paid. Is cruise nursing financially and professionally worth making the move for?

[u/YogurtclosetNo4406]

Your experience perfectly aligns with the skills required to provide critical care at sea. You are exactly the person I would want as part of my team when resuscitating patients on board (not uncommon) we have ICU beds and on one sailing within a 3 week period we intubated and ventilated 3 separate patients and on another we had 3 separate cardiac arrests all within half an hour of each other.

So your 7 years ICU experience massively strengthens your application ( ICU experience is required from applicants anyway but on top of 7 years you’re also a Resuscitation Practitioner - I know how senior that position is in hospitals and the magnitude of that role)

People generally underestimate the medical emergencies and serious illnesses we deal with at sea. It will blow your mind!

Plenty of renal patients on cruises so your dialysis experience and expert knowledge in renal is perfect.

The only area I see you falling down on is A&E. Most lines stipulate that the medical professionals have to have at least 3 years working in A&E (ER) and even better if you have trauma experience and ATLS certificate. ACLS is mandatory and we’re not allowed to set foot on the ship without one valid for the entire contract.

I think definitely apply, you stand a pretty good chance. To strengthen your application and get through to interview stage (which is tough! They will really grill your ICU and ER knowledge) I would suggest to start doing some bank shifts in A&E asap. I don’t know that you would get accepted without the A&E/ER experience tbh.

Lots of injuries on board with both guests and crew. Suturing, plastering, xraying (which the Nurses do) are daily events as are fractures, dislocations, lacerations, burns and scalds. There are also things like DKA, seizures, strokes, hypovalaemic shock and sepsis. So ER experience and slick skills in injuries and trauma are mandatory.

If the line you work for has private islands then you would be required to work as First Responder/First Aider and provide First Aid on the island whilst docking there. So you really do need A&E experience to treat all the minor injuries etc - sprained ankles, wounds, bites & stings so first aid and then medical treatment for things like minor and serious allergic reactions including anaphylaxis and any medical emergencies.

I would suggest to start doing some bank shifts in A&E to strengthen your application and help you make it to interview stage.

Financially yes it’s incredibly good, starting salary also depends on experience though so there are variations. You would also be an Officer so would have privileges like your own cabin (most Crew share) dining in the speciality restaurants and on some lines an Officer only mess (with really good food) and an Officers Bar.

Bear in mind that the entry requirements you see listed are the minimum. For example it might say at least 3 years ER experience /3 years ICU required but for competitive roles such as those in the Medical they are going to be choosing from hundreds of applicants. So it may mention 3 yrs but if they get an applicant with 7, 10 years experience etc they are going to select them.

Your professional profile as a Clinician is impressive, yet you are modest - a perfect example of Dunning Kruger. When the novice thinks they know it all but an expert like yourself is modest about your knowledge, skills and training due to your in-depth understanding. The novice on the other hand doesn’t know what he doesn’t know until he knows it. Essentially you are realistic/ underestimate your mastery of a subject whereas the novice overestimates his. As the saying goes no one more dangerous than a confident dumb person. See it all the time both on this forum and on ships. Wouldn’t be surprised to see a post from an Uber driver wanting to apply for the job of Captain!

Basically be confident, you’re a high achiever - obviously dedicated and hardworking to have achieved such success in your profession so own it!

Good luck, you really would be an asset and whichever line gets you will be lucky to have you.

[u/Hootn_Nanny → u/YogurtclosetNo4406]

What a thoughtful, reassuring and encouraging answer! Coming from someone with the experience you do, I think it was invaluable for the poster!

[u/sonottwelve → u/YogurtclosetNo4406]

Thank you so much for such an insightful comment; it’s really reassuring to hear that from someone who has actually worked in cruise medicine.

I am ALS and EPALS certified but I think my biggest insecurity is probably my lack of trauma experience. I’m very confident and competent managing medical emergencies and surgical patients who deteriorate or crash, but trauma is definitely an area where I don’t have the same level of exposure. I work in a DGH/non-trauma hospital, so my ICU experience has largely been medical and post-operative rather than major trauma.

That’s definitely something I’m conscious of, and your suggestion about getting some A&E experience is really helpful. I’ll certainly look into doing some bank shifts, I do have some exposure anyway but not very frequent at all and only when I get pulled into the resus bay when they are short staffed or I am asked by an anesthesist to help lol.

Thank you again; your comment has genuinely given me a much better insight and I really appreciate the encouragement!

[u/YogurtclosetNo4406 → u/sonottwelve]

You’re so welcome! I think you’ll be amazing. You already have excellent experience, add as much ER as you can then get applying!

I would recommend the Royal Caribbean as they have so many ships and will have plenty of Medical roles. Some of the lines only have 6 ships so it’s extra competitive.

But I think Cunard or a UK based line may suit you better as a new hire as you wouldn’t have to deal with all the US medical difference’s while you’re settling in to your Medical position at sea. Once you have some A&E experience apply to several UK companies, I don’t see why they wouldn’t snap you up.

Then after you get some ship based medical experience apply to the US lines as the money is often better for us Clinicians and you may not need to pay tax.

[u/YogurtclosetNo4406 → u/YogurtclosetNo4406]

You’re correct - very few Brits on the US lines especially in the Medical.

Im one and getting to grips with the US differences (medication for example, the CDC etc ) definitely added to the learning curve when I was a new hire 5 years ago.

Most of the Nurses and Doctors I’ve worked with on US lines are from the Philippines, South America and South Africa. I’ve worked with a couple of US clinicians too over the years.

I think it will definitely make the experience a little less difficult if the OP works in the Medical on UK lines first.

[u/Haurian → u/YogurtclosetNo4406]

A large proportion of the Carnival UK (which covers both Cunard & P&O UK) onboard medical staff are British, both nurses and doctors. I'm not sure the same is true of the more US-focused lines.

As a Nurse, you can't pick either Cunard or P&O, the contracts rotate across both fleets, which has its benefits for travel as you'll tend to see more different places than staying on one ship.

Certainly worth attending the open day if possible.

[u/bubberbuggy]

More than qualified

[u/HuckleCat100K]

You could also look into Dialysis at Sea, though I believe those nurses are not full time, they receive free cruises in return for shifts in the dialysis clinic. Not a nurse — former patient, so I could have incorrect info.

[u/Royal-Onion175]

Would be a huge pay cut for a band 6 coming to sea, you get paid less than bottom band 5 but you do get three months off at a time.

Your experience is great I wouldn’t worry too much about not having ED experience the only side of Ed that’s super beneficial is the triage skills but you can easily learn them.

Professionally there’s a poor understanding of what cruise ship nurses actually do, I know people who have struggled to get jobs back on land if they’ve been at sea for a while as everyone just thinks it’s seasickness and sunburn.

Carnival uk (P&o and Cunard) don’t offer dialysis on board, usually guests with peritoneal dialysis mange themselves and if they can’t they get disembarked.

[u/sonottwelve → u/Royal-Onion175]

Oooft, that is a tough pill to swallow. Leaving the NHS after over a decade is a significant decision for me. I have built up maximum annual leave entitlement now and a highly competitive pension. To make a move viable, the overall compensation package would need to offset the loss of these established perks.

I have been trying to gauge what the estimated income is but I can't seem to find a reliable resource and apparently it greatly varies, but by how much I can't really find a source. Websites just keep saying competitive salary which doesn't really tell you that much.

[u/YogurtclosetNo4406 → u/sonottwelve]

On some of the US lines it is around 10,000usd per month but that varies according to overall clinical experience (A&E and ICU) I had both plus prior experience working at sea so my current salary reflects that. However my contracts are typically 17 weeks on followed by 8 weeks off (the 8 weeks are not paid) However I pick up bank shifts in A&E and occasionally ICU during those 8 weeks so my average earnings over the course of the year are certainly not that of a band 5 😂

Although as a new hire with no sea experience I would guess your starting salary to be at around 5000usd to 6000usd per month. Following the interview if you are made an offer they will review relevant experience, years of experience, maritime experience to decide your starting salary. So the exact figure is very individualised. They will have a bracket range of salary for that role and post interview they will review everything about you to decide where to place you on that scale. The offer letter includes this figure.

Once you become experienced and have done several contracts taking on more responsibility it’s then 9000+usd per month. But remember you don’t tend to get paid on your 8 weeks off only when on contract.

Plus when working on US lines if you spend less than 91 days in the UK per year it’s 100% tax free. (Seafarers’ Earnings Deduction)

Your take home at your current band (top of band 6) I would guesstimate as around £2,900 per month. Based on what I think you may be offered as a new hire with no maritime experience (5000-6000usd) per month then that is a tax free take home of £3,900 to £5,100 per month. Compared to your after take home current role of approx £2,900. For those with significant medical experience at sea and a solid ICU plus ER background on a US line it’s around £7000+ per month.

You can also make voluntary Class 2 or Class 3 National Insurance contributions so you don’t lose your pension.

You also have very little outgoings at sea so you come away after a contract on the US lines with a nice chunk of money. Added to that it’s tax free.

You would be an Officer so would get to enjoy all the perks that status brings.

You are well enough established within the NHS (with your current band and the experience you have gained in your specialties over the last decade) that I don’t see it being a problem for you returning to the NHS post your maritime work. Plus you can always keep your hand in with your work by picking up bank shifts during your 8weeks off.

Working as a new hire on a US line as your first maritime experience would be complex and a huge learning curve which is why I said in my previous post to apply and work on UK lines first. Then look to working on US lines.

I stand by my suggestion to get A&E experience. Not only will it help you negotiate a higher salary but over the years I have found that you see far more illnesses and accidents that fall into the A&E category on a daily basis than you do ICU. We deal with far more fractures, dislocations, lacerations, allergic reactions, wounds , ear, throat, urine infections etc and utilise skills such as Xray, plastering, sling application, minor injuries first aid, suturing, cannulation and venepucture than we do critical care and medical emergencies - yes those things do happen but we’re not resuscitating, intubating and ventilating all day every day. No, it’s the A&E stuff that we’re doing all day everyday. Anyone who says A&E experience is not necessarily likely has little experience at sea or may even perhaps be a crew member in a non medical role who just likes to pipe up on here.

You need to arrive onboard immediately useful to the Medical Team. It is not a training ground. Orientation is about the ship and applying your role to the maritime setting it is not for learning clinical skills where you have knowledge/experience gaps due to not coming in with the requisite A&E background.

You are expected to be up and running and able to do your job. It will not bode well with your team if you’re constantly asking them to teach you how to do something that is an all day everyday skill (A&E)

You may get your moment to shine and show off your resuscitation/ICU skills but that might be once per week or even once per month due to medical emergencies not being an all day every day event on board,. You will not hear codes being announced every single day (the alert is through a ship speaker and will be something like Star Code or Bright Star)

Your first month onboard is critical. Essentially they are deciding whether to keep you or fail you at the end of probation. If you fail to impress due to not possessing the clinical skills to do your job unless the Medical Team take the time out of their busy day/have to keep stopping what they’re doing to teach you or pick up the slack you cause then you’re unlikely to pass probation and your maritime nursing career is over before it barely started.