I jumped on the Golden Princess Nov 27th. She's currently doing the endless loop of Hawai'i: leaving LA, stopping by Hilo, Honolulu, Lihue, Lahaina, Ensanada, then back to LA. Your demographics are primarily USA with a mix of UK and Canada filling up 95% of the people. Every cruise is different. My first had a gastroenteritis outbreak, then next few where a constant battle with Influenza A. It is a six bed ER complete with Xray, minor surgical, and lab capabilities. Currently, people tend to give us a major medical issue the first or second day at sea. I think we've had about two MIs, a host of random infections, a few idiopathic seizures (and they always happen while they're either standing by or in the pool), and a seizure that turned out to be having an MI.
You swap your rig, MRX, airway and RX bags out for a 12kg FR bag and a wheelchair. You’ll get to know all the knooks and crannies in the ship, and everybody just calls you ‘doc’. You’re more visible than most of the medical team because of your FR responsibilities. There are bi-monthly ACLS related drills that involve the whole medical team, security, accommodations, and the bridge. Once a cruise there’s the general MICD/fire drill and they take all of it seriously. Since there are only 6-7 seven of us with medical training, the crew become your hands and you do a lot of delegating.
One thing I've noticed, we, as Americans, don't work outside our borders much. The only other Americans you’ll meet on ships are the guest entertainers. And, it makes sense: there's so much of our country to pick from that we don't need to travel. I must admit I was pissed when I ended up on the Hawaii loop, but my next contract is taking me to Europe in the summer.
Now, every ship is different. We’ve had a FB group up to discuss things and some medics have it worse than others. It depends on your medical team and senior physician, depends on the Captain’s standing orders. For example, I can go anywhere I want on the ship because I’m an officer (to eat, socialize, etc.). However, another ship’s standing orders allows only two strip and above to do that. But we’re not consistent either. Our current senior nurse was pleasantly surprised on his first day to find me mixing Ceftriaxone to set up a drip for the doc. Apparently, his last ship had paramedics that were unwilling to expand on their FR responsibilities. But then there are ships where the medics have been moved from room to room as the system hasn’t adjusted to having two of us (since we replace one nurse).
I can’t say about hiring and expansion. It’s a big project to set this all up, and I figure shoreside is busy just keeping pace. I’m sure part of it is the turnover. Its hard to get people to stay when we can just go home and go back to our old jobs without missing a beat.