Dialysis Nurse, Holidays

Dialysis Nurse on the High Seas

January 1, 1991 – Caribbean Sea

10-9-8-7-6-5-4-3-2-1-  “HAPPY NEW YEAR” blared the loudspeaker.

I shot out of bed and stood in the middle of the pitch black room with my heart racing. Where was I? What was happening? Oh yes. I signed up to work as a dialysis nurse on this nine-story ship for the week with payment of a free cruise. I went to bed early because I took a Dramamine tablet for my motion sickness. I climbed back under my covers until my alarm clock woke me at 5:30 a.m.

At 6 a.m. I joined my cabin mate and two other nurses in the dialysis room in the lowest level of the ship. We looked at the three recliners and ancient dialysis machines along with gallons of dialysis fluid the company loaded on to the ship the day before. In addition to their cruise fee, nine patients had each paid the company $1200 to dialyze them three times so they could see some places outside the USA. Because their kidneys no longer worked, they needed these treatments to survive. When we were in ports, both patients and nurses saw the sights in Key West, Jamaica, Grand Cayman, and Cancun, Mexico over the next seven days.

Our charge nurse divided us into two teams so we worked only while at sea. The other nurses and I qualified with at least two years of experience. But we quickly discovered one of the nurses had lied and had no dialysis experience. Frustrated, the charge nurse could only let her check blood pressures the rest of the week and the rest of us worked an extra shift.

As my stomach rolled, I prayed God would calm the ocean like I read in Psalm 107:29-31.

He calms the storm, so that its waves are still. Then they are glad because they are quiet; so He guides them to their desired haven. (NKJV)

I thanked Him for the opportunity to meet new people,  see new places, and relax in between dialysis sessions. One nurse who also cruised last week said the seas were so rough that she had to go to the ship’s clinic to get a shot to stop her vomiting. She had her sea legs now. Terra firma felt fantastic when I stepped ashore at the different ports.

Picturesque Key West, Florida.
I parasailed in Grand Cayman.
Pam with one of her patients using the old dialysis machine
Pam with one of her patients using the old dialysis machine

A nurse showed me how to prime the old machines with saline and enter the amount of fluid to remove for each patient. The new computerized machines that I was familiar with didn’t work because the rolling motion of the ship made the alarms go off too often.

Our three patients arrived at 6:30 a.m. Since our supervising doctor, Dr. C., was also a patient, he gave me his own orders. After he weighed in and we calculated the amount of fluid to remove over the next 3 hours, he asked me to take an extra half pound off so he could eat and drink more. I reluctantly entered the amount. I took a deep breath as the ship and my stomach rolled and inserted two large needles into his fistula in his arm. We checked each patient’s blood pressure every 15 minutes and recorded it. Patients and staff chatted together in the small windowless room as the hours ticked by.

I checked Dr. C’s blood pressure. Too low at 70/50! Noting his pale face, I quickly tipped his recliner back and stopped the machine from removing any more fluid from his body.

“Dr. C, I know you wanted to get the extra fluid off, but I really want you to be with us on this cruise the entire week, so I am giving you 100 cc of fluid now (about 1/2 cup) to raise your blood pressure.”

“No argument here, Pam.”

He completed the treatment and left with his blood pressure at his baseline of 110/80.

That was my first and last cruise due to my severe seasickness. Even to this day, when I recall that long week, I still become nauseated. I now take prescription medicine to prevent nausea (Zofran) 30 minutes before a plane or short boat ride and wear over-the-counter Sea Bands (acupressure bracelets).

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