1. Providing Health Care at Sea
Good Afternoon,
I am one of seven USPHS nurses still performing the original mission of the USPHS which was to provide medical care to US Merchant Mariners after the Civil War. A merchant mariner is, a civilian sailor that sails aboard predominantly commercial vessels, however, the federal government employs approximately 450 merchant mariners. Those mariners work aboard a fleet of 4 hydrographic survey ships and 12 scientific research ships managed by NOAA's Office of Marine and Aviation Operations.
LCDR Randy A. Collins, RN, BSN, BSB, ASCVT, USPHS Medical Officer NOAA Ship Okeanos Explorer

2. Learning Objectives Introduction to NOAA Introduction to NOAA Ships
Introduction to Okeanos Explorer
Introduction to Medical Officer aboard Okeanos Explorer
Located within the Department of Commerce with headquarters in Silver Spring, Maryland, NOAA (National Oceanic and Atmospheric Administration) is a federal agency focused on the condition of the oceans and atmosphere. NOAA collects, analyzes, and supplies data and products such as weather warnings and forecasts; manages national coastal and marine environments, regulates fisheries and marine sanctuaries, and leads applied scientific research in the areas of ecosystems, climate, weather and water, and commerce and transportation.
NOAA’s vessels are located in various locations around the United States. The ships are managed by the Marine Operations Centers (MOC) in Norfolk, Virginia, Newport, Oregon, and Honolulu, Hawaii. The scientific research ships provide research platforms for government and university funded oceanographic, atmospheric, and fisheries research. Current projects aboard these ships include research related to El Nino prediction, causes of atmospheric warming, the impact of the Deep Water Horizon oil spill on fish populations in the Gulf of Mexico, the receding ice shelf in the Arctic and Antarctic Oceans, and preservation of coral species in our national maritime sanctuaries. Okeanos Explorer is one of these scientific research ships.
NOAA Ship Okeanos Explorer (EX) is a multi-tasked vessel and is considered the flagship of our research fleet. It was originally the USNS Capable, a Navy intelligence gathering vessel and re-commissioned by NOAA in 2008 and refitted to NOAA’s mission specifications. EX typically operates 200 days per year and is capable of mapping the oceans with specialized equipment called multi-beam sonar, split beam sonar, and single beam sonar. This equipment is operated by specifically training physical scientists and ship-board personnel. Sub-bottom profiles of the sea floor also are produced which are exceptionally accurate. The Bell of the Ball, however, is EX’s capability to carry and deploy a remotely operated vehicle (ROV) for very deep dives, up to 6,000 meters deep, to obtain scientific information which would be unattainable otherwise. Okeanos Explorer is a 224 ft. research vessel whose hull number is R-337. EX carries a wide variety of very specialized electronics and 26 permanently assigned Officers and Wage Mariners. Also when deployed 20 Scientists, mostly PhD’s from varying fields of study which include Geology, Ocean/Marine Biology, Zoology etc., join the ship to help operate the specialized equipment aboard. All information you could possibly want on our expeditions/deployments and NOAA can be found on our web site; to see video of creatures and sub-terrain never before explored:
The NOAA Ship Medical Officer provides primary, urgent, and emergent care to embarked crew and scientists. Medical Officers are not only well experienced clinically, they must possess the ability to think and act critically in emergent situations. Often times the EX is thousands of miles from the nearest port, so it is critical the Medical Officer is well trained and competent in a wide variety of medical situations and conditions. Medical Officers are Department Heads who interact with other Officers, Professionals, and various personnel throughout the military.

3. USPHS RN, NP, or PA Initiative Research Collaboration
My job on the ship is to provide occupational health services as well as acute and emergency medical care to the crew and scientists sailing aboard the ship. This means that as the ship’s Medical Officer, I am on duty 24/7, approximately 200 days at sea per year.

4. Initiative
The USPHS RN, NP, or PA are encumbered with Administration of a hospital contained within our fleet’s ships. And to interact within the agency to accomplish successful operation of the department. The Medical Officer performs, but is not limited to the following duties: Administration of the fleet’s biological health monitoring, wellness (such as, alcoholism, hearing conservation, nutrition, heat stress), illness/injury and control programs aboard open ocean or long voyage vessel’s. We live and work for extended period of times aboard the ship in remote areas which create occupational health challenges due to the proximity of work hazards and living spaces. We carefully screen persons coming aboard to stay overnight or longer so that diseases are not passed easily in the close quarters. We also provides acute and emergency care for illness and injury at sea or while in foreign ports (within ship’s capability). Presents CPR, First Aid, and health promotion training for the ships crew and embarked personnel. Advises the ship’s command on health-care issues, including securing medical support beyond shipboard capabilities. Maintains medical records for crew and embarked personnel. Responsible for all medical administrative matters including ordering, storing, maintaining all medical supplies, medications, personnel issues, records, reports, and logistics. Maintain healthcare spaces and gear in a state of readiness and promptly informs the Commanding Officer of any condition that would degrade readiness to provide operational medical support. Supervise personnel and provide ongoing refresher training of Medical Persons in Charge (MPIC).

5. Research
On going research as the Environmental Health/Sanitation Officer and Assistant Safety Officer programs are accomplished by; Sound testing research data, Heat Stress research data, Air pollution research data, and Hearing Conservation research data which are collected by the Medical Officer. These data are transmitted to onshore professionals for study and suggested changes in policy and procedures. Medical Officer’s: Inspect and maintain eye wash stations which are placed strategically around the ship and are vital to ocular emergencies/safety. MO’s also manage and maintain levels of available oxygen aboard the ship.

6. Collaboration
Medical Officer’s: collaborate with on shore federal and other health care agencies to coordinate emergent MEDIVACS. Conduct NOAA health promotion programs and implement programs for the prevention and control of disease and injury in collaboration with CDC, OSHA, and other agency guidelines. MO’s seek direction from the Regional Director, Health Services at NOAA marine centers, as well as, Physicians at Maritime Medical Access (MMA). NOAA Medical Officer’s must operate within the specific health program requirements, objectives, and priorities developed by the Regional Director. Within the broad framework of those guidelines, the Medical Officer exercise responsibility for actions, decisions, and technical advice provided. It is essential that Medical Officer’s recognize the need for advice and assistance on matters exceeding medical experience or capability, and to seek the assistance of the Regional Director.
Medical Officer’s must also assimilate into the NOAA Commissioned Corps Wardroom. Collaboration with NOAA Officer’s is essential to communication and keep abreast of ship board operations. Training and performing collaterally as Officer of The Deck is a good way to understand and grow close to our fellow NOAA Corps Officers that manage, navigate, and drive the ship. Officer of The Deck (OOD) is a 24/7 required watch of the ship for safety and emergencies in port. The OOD, after training and certification given by the Commanding Officer, acts with the authority of and for the Commanding Officer. What a responsibility!!

7. Nursing Leadership
How do I, an RN, make a difference as the Medical Officer
Strong and well rounded experience, education, and leadership attributes are essential within my profession, as well as, within the Medical Officer position. It is essential to communicate, plan, organize, and direct. It is essential to provide the best medical care possible. It is essential to be committed to research, development, and training. One must possess the ability to collaborate with professionals, peers, and outside agencies for the greater good. Leadership as an RN, a Medical Officer, and a Medical Professional has a positive impact on those I serve aboard ship and those I team with. Initiative, research, and collaboration are an integral part of daily life at sea where we are 9 days from the closest point of land. As the medical officer I am the first line of care for the ship’s crew and the visiting scientists.