The onboard medical professional is becoming more widespread. At one time only associated with the largest motor yachts, and in the context of the well-being of the guests, they are now present on a wider range of yachts. Medical support providers, such as MedAire, are a phone call away, but having a professional, such as a nurse, onboard to interpret, assess and treat situations adds another dimension to onboard health care.

Bianca Dunham is the nurse on board the 107m Oceanco Black Pearl. Having started her career at sea on a range of conservation and research vessels, she now navigates a duel role on of the largest, and busiest yachts in the fleet. Superyachtnews speaks with Dunham about finding the balance in the role and working with a shoreside medical support provider through challenging situations.

Bianca Dunham in the crows nest on the 107m Oceanco Black Pearl

“My job, as with most nurses onboard, is a dual role,” starts Dunham. “It can be very busy with nursing work, as many crews take advantage of having a medical professional onboard. When I joined Black Pearl, I had to figure out the priorities! How busy we are, I am sure, is partly due to the size of the crew but it is also due to the crew taking advantage of having a medical professional onboard and being cautious with medical issues.”

To this last point, it is interesting to note that, perhaps counter-intuitively at first, often the yachts with medical support professionals onboard are also those with the highest frequency of calls to Medaire. While many factors contribute to this, fostering a culture of communication and openness about health concerns will lead to more issues, both physical and mental, being relayed to MedAire.

Many yachts now have equipment that is complex enough to warrant a full-time professional in order to maintain it. The days of a boson or chief stew giving the grab bags a cursory look during monthly safety checks have long since passed. Technology and the capacity for medical care have progressed rapidly and accelerated further with the heightened health awareness brought on by the COVID-19 Pandemic. A specified medical professional who can take responsibility for the medical kit, much of which is highly specialised, is becoming imperative for some of the fleets.

“Another large component of the job is training.” continues Dunham. “Training the crew with equipment, running through medical journals, and tracking inventories. We are a relatively large boat, so we have a lot of medical kits onboard. We are very lucky in that regard, but it takes a lot to maintain and track, most of which falls to me.”

I asked Dunham if she also found that the line is getting blurred between the level of care the crew think that you can perform in your capacity as a nurse?

“Yes, and you need to be quite confident in your role and ensure that there is a well-established boundary. For example, I often need to say, ‘I am not a doctor, I cannot do that but I can recommend this course of action or to call shoreside for treatment advice,” says Dunham. “Having MedAire there makes such a difference for us on Black Pearl. I have worked on other research and conservation vessels without this support, and it’s a challenge. Having MedAire available at all times is a huge advantage.”

Splitting her time between her responsibilities as a stewardess and as a nurse, Dunham explains, helps create a culture of openness and seeking treatment onboard. “For me, being part of the crew is a great help. It helps me build a level of trust that means that they are happy to come to you for support, with both physical and mental health issues. They can open up to you.”

The interaction that a nurse or health care professional has with a guest is on a level far more intimate than that of even the chief stew. In the typically stratified and compartmentalised hierarchical structure onboard, the nurse breaks through these traditional barriers. As Dunham explains, this takes care and caution. “These are very rich and famous people, and that can be a little intimidating. A good nurse needs to get over this, and also recognise that you are still just working on someone else's property. Yes, you are serving them as part of your dual role, but you are also a health care professional at the same time. This certainly has its challenges.”  

“To succeed as a nurse, you need to have a particular set of attributes, and your personality needs to be quite specific, not every nurse is going to be able to slot in onboard a busy yacht, concludes Dunham. “Anyone wishing to take on this kind of job needs to be prepared for that. You need to be flexible, adaptable and extroverted. This is not the job for what may be termed ‘the hard-arsed nurse!' It is very rewarding, and challenging, and having MedAire in contact to provide support really helps.”

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