There is plenty of work for the two nurses on board the Sea Stallion. But their prescriptions are more for soapy water against infections than for real medicine from the chest. Up to now the voyage has been spared serious cases of illness and accidents.
Like skipper Carsten Hvid, both Susanne Malmstrøm and Anna Kiørboe have been on special courses at the Centre of Maritime Health Service on the island of Fanø, under the Danish Maritime Authority, to learn about the special conditions that apply to nursing and care at sea. Together, the two nurses have a very broad range of skills.
What thoughts did you have in advance about the work you would face on the Sea Stallion?
Susanne Malmstrøm: “I simply made a list of everything that could happen: heat stroke, chilling, cerebral concussion, epidemics among the crew, etc. I realised that I could more or less put all diseases and accidents on my list. I also had some material from the Danish Maritime Authority as a source of inspiration. But I realised that there was no ‘illness catalogue’ for an open Viking ship. Fortunately, I have experience from both the first voyage to Norway two years ago and the trip from Roskilde to Dublin last year. That experience taught me that having a nurse on board is a very good idea, for there are so many small things that we can help the crew with in their everyday activities. Blisters, wisdom teeth, infections, seasickness, masses of trifling injuries and illnesses.”
What has there been so far in the way of illnesses and accidents among the crew on this year’s voyage?
Anna Kiørboe: “I’ve had lots to do since Dublin. Mostly with advice and guidance and I’ve prescribed lots of soapy water for infections. And I have often reminded people about the rules of hygiene because we live so close together. There isn’t much that separates the toilet and the rest and dining areas, so everyone must remember to wash their hands and the toilet with spirit. In fact they’re really good at doing that under the circumstances. Then I’ve rinsed a good number of ears and so on.
“I try to hold back on the medicine as long as possible and try the good old home remedies first. But the crew ask a lot of questions, so they receive advice and manage a lot themselves.
“Apart from a few light blows to the head, some pinched fingers, a pulled back muscle, and a case of chilling, there’s not been anything serious on this trip. No cuts, although knives are used a lot all day.”
Now there’s probably no-one who’s died of seasickness, but hasn’t the ship been hard hit by this ailment at times?
Susanne Malmstrøm: “Yes, we actually have a project in which we are registering all seasickness. We are trying to find out who is actually hit by seasickness. We will register the stretches where those affected have been seasick and how badly they’ve been affected. Last year we made some statistics that showed that it was younger women who were most affected. Older men were affected to a lesser extent. It may have something to do with the centre of balance in our ears. The older we are, the more torpid it is. That is probably the explanation. We will be publishing all the results in a report after the voyage.”
Anna Kiørboe: “Common care is important for the seasick. You have to pay attention to them all the time. They must have encouragement and should be offered something eat and especially something to drink. Seasickness pills, if they can keep them down. Get them going again, get them moving. If they give up completely, then they get really bad. The psychological element is extremely important.”
Susanne Malmstrøm: “Yes, and those who easily get seasick should of course remember to put a seasickness plaster on early enough.”
Anna Kiørboe: “Ginger and salt tablets can also help.”
Susanne Malmstrøm: “Yes – and hurrah for the placebo effect!”
What does a nurse on the Sea Stallion fear most?
Susanne Malmstrøm: “Among other things, an open skull fracture. We have heavy tackle and blocks in the air. Broken arms and open leg fractures are also very difficult to manage on board an open boat, where it may be very windy and the water washes in. These are extreme conditions. Heart attacks are also a very serious matter. They are a risk because we also have some older fellows on board.”
Anna Kiørboe: “Yes, but I feel that we are well equipped with our medicine chests. The one is an emergency chest, while the other contains medicines and bandages. In the emergency chest we have mobile resuscitation equipment – defibrillator, cervical collar, oxygen, tongue depressor, drip, everything related to acute, life-saving first aid.”
Susanne Malmstrøm: “But the middle of the sea is a really bad place to get for example a blood clot in the heart. We can help in the short term. But it’s a long way to the vital help at a hospital”.
Anna Kiørboe: “Luckily we have Radio Medical, where we can get in touch with a doctor 24 hours a day. I’ve called once, because I had so many of the crew with insect bites and a crew member who’d develop a severe infection from a bite. The doctor on Radio Medical gave me some fantastic advice. What we can prescribe from the medicine chest is also very closely monitored. The doctor on Radio Medical definitely has the final say.”
Susanne Malmstrøm: “Almost all medicine prescription occurs in close collaboration with Radio Medical.”
As nurses, do you face completely new challenges on board the Sea Stallion?
Anna Kiørboe: “Yes, definitely. You have to be very creative. I have no bed to examine patients on. I lack peace and light and the selection of instruments is limited. I cannot make a completely sterile procedure, so I try to improvise all the time. It is actually quite touching how much the crew trusts us and uses us. Some are rather hardy dogs and we rarely see them. Others are more aware of small things. We have to take them seriously too, although they don’t always have a real problem. But we are very close to them, so it’s very natural for them to come to us.”
Susanne Malmstrøm: “Yes, last year I measured really a lot of people’s blood pressure, because I had the equipment out. They became so interested in it that they started to measure each other, and that was completely OK. But it was also hard last year, when I was alone as nurse. I was never off duty and was on call 24 hours a day. I’m glad that we’re two nurses this year, because generally there’s a lot to do.”
Anna Kiørboe: “Of course we have seen to it that we each have our own watch. But I think that it is important to underline that the Sea Stallion’s crew are basically very sound and well. The way we live and work just gives some scratches and some infections. But you can’t expect anything different.”
What are your personal reasons for sailing with the Sea Stallion and for taking on such great responsibility?
Anna Kiørboe: “I was definitely uncertain about it and had to think about it because I really just wanted to be an ordinary member of the crew. But they didn’t have a nurse for the first part of the trip, because Susanne wasn’t joining the ship until Lowestoft. So I agreed. But basically I’m here to experience the adventure that is also a part of this serious research project.”
Susanne Malmstrøm: “I have followed the making of the Sea Stallion from the start. And, as I said, I was on the first long voyage to Norway. I am simply deeply fascinated by this project, which is so grand. I just wanted to be a part of it.”
Facts:
Susanne Malmstrøm:
Trained as an assistant chemist in the 1970s, followed by training as a nurse. Initially employed in various hospital departments, including medical and surgical wards. Then a consultant in wound care for a medical company. After that employment on a cardiac ward and an intensive-care ward for a number of years. Experienced emergency nurse. Worked at one of the first private hospitals as an intensive-care nurse. Then employment with a doctor specialising in acupuncture for the prevention of cardio-vascular diseases. Now employed in a general practice in Roskilde, where she treats 20 patients a day.
Anna Kiørboe:
Trained as a nurse January 2007. Then one year at the Copenhagen University Hospital’s oncology department. From 1 March this year, as a nurse at a prison in Copenhagen. Volunteer nurse in the street project “Udenfor” (Outside) for homeless people in Copenhagen.
