Injections on board

[brillohead]

The OP isn't going to get any information from Special Needs without knowing what the medication is and why it is being administered.  

The medical facility isn't going to just agree to give any old injection to anyone without knowing who / what / when / where / why.  

 

[Maverick61]

On 9/12/2019 at 2:54 PM, nathanb2 said:

What other detail do you need to know that I haven't already provided?

 

Well, I included this in a lengthier, earlier response to you sharing my experience and approach

 

"Without knowing the medication or condition, all people here can do is speculate. "

 

Perhaps you are uncomfortable sharing this info which is fine.  But it also limits how people can give advice on the subject because again, they have to speculate not knowing all the details.

[123funcruiser]

14 hours ago, Charles4515 said:

 

Second guessing and attributing ulterior motives to the health care provider is not helpful. You don’t know if the provider is paid per service or is salaried. OP explained that self injection is not allowed there for the condition. People here want to second guess cause they have nothing better to do. OP needs a direct answer from Royal Caribbean and then go from there. 

 

All this doesn´t matter to me. I was simply saying that there is no free Service. Those People do this for a Living whatever their payment plan is. Someone has to pay for it. 

[123funcruiser]

11 hours ago, wendychloecruiser said:

 

 

Yes, an IM injection is technically easy though you must know a little about anatomy to get the location correct.  You can do a lot of damage if you get it wrong.  

 

This is correct!

[123funcruiser]

On 9/11/2019 at 2:24 AM, nathanb2 said:

Thanks for the input everyone. The reason why I mention the jurisdiction is that she can't learn to self-administer (even if she wanted to) because self-administration is not allowed in our jurisdiction for this particular condition, so there are no classes for it and you can't buy the materials (needles, etc.).

 

I will send an email to the special needs department.

 

Worst case she can go without the injection for one week and/or plan the previous and next injections right before we leave and get back. Telling someone to not cruise because of this seems a little excessive.

 

Whatever the answer from Special Needs is, you should have a plan B. The ships dr´s and nurses are not RCI employees. So RCI´s Special Needs Department is not in a Position to have an ultimate answer. As I´ve said before in this thread a responsible Health care professional will not inject a drug without knowing what it is and why it is prescribed. As we all know, two dr.´s three opinions, if the ships dr. doesn´t think this is the Right Thing to do there is no Special Needs documetation that could make him/her administer the injection.

 

All of this might be a non-issue, but as I don´t know what we are Talking About, I say don´t rely on a Special Needs answer.

[ReneeFLL]

Maybe the ship dr and talk to the patients dr?

[Jared2]

I have received the following response from Special Needs:

 

 

There should not be any problems onboard treating a Guest who requires a [redacted] injection … providing that the Guest brings along all of the necessary medications for the duration of the voyage in properly labeled containers.  Once we know which ship the Guest will join, we can ask that the medical staff onboard assure that they are prepared to welcome the Guest.  We suggest that this Guest transports all of her medications in carry-on luggage to minimize the potential for diversion or loss of medications, and that all medications remain in their original, labeled prescription containers.

We can ask the Medical Center staff to permit the Guest to perform injections in the Medical Center, for the sake of sanitation, if she so desires.  However, if this guest chooses to perform injections in the cabin,  the guest should meet with the State Room Attendant or the Environmental Officer upon embarkation to further discuss the disposal of the used needles as a medically Hazardous Waste.

The Environmental Officer will assure that our company infectious waste disposal policies are followed:
Requesting the Guest to dispose of any liquids generated from their circumstance directly into the toilet. Providing the stateroom with a closed lid waste receptacle lined with a bio-hazardous bag for care of needles or pouches of bio-hazardous waste. Instructing the Cabin Steward and immediate Supervisor regarding the extra handling precautions required.

As I usually advise… at the sole discretion of the Guest, a complete medical report from the treating physician at the time of booking would be of great benefit for the entire shipboard Medical Center staff.  Then, Guests are best served by presenting to the Medical Center with a complete medical summary (history, medications, and allergies) upon boarding.

The Guest and treating physician should consider the following carefully before any cruise:

There is no Hematologist available on the ship.

Medical conditions, when unstable and poorly controlled, are potentially life-threatening, especially without back up.
These conditions should first be stabilized prior to embarking on a cruise, where a Guest may be at sea for several days without any immediate hospital and or specialist back up. The proposed itinerary is not within the U.S., and the availability of specialized shore side facilities can be problematic.

Prior to any travel, we strongly suggest that Guests contact their own Health Insurance carrier to determine what benefits they carry… particularly their benefits for Medical Providers outside of the United States, as well as available Air-Ambulance and Repatriation benefits.  In fact, for short trips, any traveler is well advised to purchase Travel Health Insurance with defined out-of country Treatment and Repatriation benefits… even if this coverage might be redundant.

Finally, the Guest should be made aware that there are charges associated with being treated in the Medical Facility during the course of the cruise, and that ordinary health insurance does not cover costs for this treatment.  If the Guest requires the assistance of our Medical Center staff, charges will be assessed, and an itemized bill will be provided which can be submitted to the Guest’s insurance company after the required injection is charged to the Guest’s onboard account.

[123funcruiser]

Sounds like Special Needs said About the same Things that have been said on this thread.

[spookwife]

43 minutes ago, nathanb2 said:

Finally, the Guest should be made aware that there are charges associated with being treated in the Medical Facility during the course of the cruise, and that ordinary health insurance does not cover costs for this treatment.  If the Guest requires the assistance of our Medical Center staff, charges will be assessed, and an itemized bill will be provided which can be submitted to the Guest’s insurance company after the required injection is charged to the Guest’s onboard account.

 and here we have it.. the official answer of the original question:  

 

yes she will be charged.  

[Charles4515]

14 minutes ago, 123funcruiser said:

Sounds like Special Needs said About the same Things that have been said on this thread.

 

They say they will be able to do the injections but there will be a fee. It is not going to be free like at home which I believe we all knew on this thread. That does not answer OPs question of whether it will be an enormous fee. Enormous is subjective. To someone used to free any fee might be large. 

Edited September 14, 2019 by Charles4515

[123funcruiser]

54 minutes ago, Charles4515 said:

 

They say they will be able to do the injections but there will be a fee. It is not going to be free like at home which I believe we all knew on this thread. That does not answer OPs question of whether it will be an enormous fee. Enormous is subjective. To someone used to free any fee might be large. 

 

I didn´t say they answered how much it will be. 

Just to be clear they did not say they will be able to do the injections. They said in General the medical Team onobard is capable of doing injections, but they did not confirm if the medical team OnBoard will do it in the case of the OP´s friend.

[cured]

On 8/30/2019 at 8:33 AM, nathanb2 said:

Self-injection is not allowed for her condition in our jurisdiction (it's not diabetes), plus she is too squeamish to do it.

 

Is it the insurance that is prohibiting self-injection or is it a law in her jurisdiction? 

 

I self-inject a non-diabetes med 3x per week.  I did have to fight my insurance for the right to self-inject because their policy was to ship the meds to the doctor's office under medical insurance rather than ship to the patient under pharmaceutical insurance. Their policy was to not allow self-injection for this type of medication for reimbursement and for liability purposes since it is not the easiest drug.   Luckily, my hematologist was pro self-injecting to helped me fight my insurance.

 

If it is insurance, can she see if she could work with her doctor and insurance to allow a 1 week waiver with the insurance, knowing there is a doctor on board in case of complications?  

 

I understand her queasiness. I HATE doing it, even after 10 years.  Mine causes nasty side effects every time, so I have a Pavlovian queasy response every time I rip open the syringe package. But, sitting on a cruise ship balcony looking over the Mediterranean did make it a tad better 🙂  And RCI was very accommodating, providing a sharps container and a medical fridge.  Another option, if allowed, is for someone in the travelling party who is not squeamish to learn for just those 2 injections.

 

If it is a dangerous med like the one mentioned above, then she is going to have to follow everyone's advice here and get in touch with the medical department.  You might need to escalate to someone with good knowledge of the medical facility who can tell you the correct information.

 

 

[SRF]

On 9/13/2019 at 8:55 AM, ReneeFLL said:

This!! Maybe the dr just wants her to have another office visit so they make more $$$. Please go with your friend and find out what's really up and question them about it.

 

This is what I was thinking.

 

Free for the patient, doesn't necessarily mean they are not getting paid.

 

If the receptionist can do it, there seems to be no reason that it cannot be self administered.

[spookwife]

4 hours ago, SRF said:

 

This is what I was thinking.

 

Free for the patient, doesn't necessarily mean they are not getting paid.

 

If the receptionist can do it, there seems to be no reason that it cannot be self administered.

Dutch medical system aside,   the receptionist can  very easily be a ,medical assistant/Tech.. meaning having had  formal training in basic things such as routine injections,   drawing blood, setting up IVs and taking Pulse/BP readings.  

[MommaBear55]

On 9/12/2019 at 4:53 AM, wendychloecruiser said:

 

Your jurisdiction must have a lot of money to pay for everyone who needs frequent injections.  Or it something she needs some further teaching to get more comfortable with the the procedure?

Most of the time injections that cannot be done by an individual is because they need to be monitored by a medical professional for side effects. I have to get my sub q injections at an infusion center because of the high risk of anaphylaxis. Diabetics give themselves sub q all the time, it's not the technique, its the medication. 

[matj2000]

I wonder if the room steward can do the injections.....

[aimsta]

I am a RN and while I'm on vacation I just want to relax and be with my family. Should a medical emergency occur of course I would happily give assistance, and have done so, as long as I'm not under the influence of alcohol. 

I think nurses by nature want to help but asking someone to take time out of their holiday to perform a clinical skill is not in their best interests no matter how good natured we may be. 

Even without risk to our registration or licence there are risks associated with any clinical encounter and unfortunately the RN may be legally/ financially liable should a complication arise.

Additionally nurses are notoriously bad at self care. A holiday should offer us a opportunity to switch off and detach from the clinical environment. This is really important and gives us the break we need to recoup and re-energise so we can give our pts our best at work.

Just my thoughts.