The Spanish tennis legend Rafael Nadal once said, “I learned during all my career to enjoy suffering.” For public health professionals in the cruise industry—or those considering joining their ranks—that sentiment may feel surprisingly relevant.
Few professions test resilience as intensely as cruise ship public health. At first glance, the work can appear almost glamorous. Yet behind polished recruitment phrases like “making a difference” or “seeing the world” lies a far more nuanced reality.
Whether shaping policy in corporate headquarters ashore or ensuring compliance onboard as a Public Health Officer (PHO), the weight of responsibility is immense: safeguarding the health of hundreds to thousands of passengers and crew, 24 hours a day, 365 days a year.
It can be a highly rewarding job, but it’s rarely smooth sailing. For every moment of pride, there are frustrations that don’t make the brochure. From manoeuvring through corporate red tape to shouldering the solitary role of “hygiene ambassador at sea,” the challenges are as demanding as they are unique.
The good news is they’re not all insurmountable. Recognizing them is the first step toward overcoming them. In this article, we’ll explore five of the most common obstacles and share strategies to help you navigate them effectively.
Table of Contents
Challenge #1: Long Hours and Intense Workload
Public health—or any operational role in a cruise line—is not a nine-to-five job, and in many companies, the workload can quickly become overwhelming. Shoreside teams frequently work late, respond to emails after hours, and remain on call even on weekends. This constant pressure erodes work-life balance, leaving many exhausted and struggling to maintain their passion.
For corporate managers ashore, the challenge repeatedly means juggling multiple outbreaks, inspections, and fleetwide projects simultaneously. With ships scattered across time zones, urgent requests have a way of finding you, whether at your desk or supposedly on vacation.
For PHOs onboard, the demands are equally pronounced. They must wear multiple hats—inspector, educator, investigator—while working long contracts without a day off. The role requires as much stamina as technical skill.
Younger professionals in particular may feel the strain. Unlike previous generations, many today place a higher value on personal well-being and time with family and friends, rather than pursuing career advancement at the cost of their mental and physical health.
Irregular hours and the stresses of outbreak response take their toll, and when combined with the next challenge, can make managerial roles ashore feel especially unappealing; a reality reflected in how few PHOs transition to office positions.
Challenge #2: Being a Small Fish in a Very Big Pond
Even when the workload is manageable, public health can seem like a niche concern within the broader cruise operation. It rarely receives the same level of recognition as other operational areas such as safety or environmental compliance, and public health departments usually don’t command the largest budgets either.
The result is that your wins can go unnoticed. You might spend months fine-tuning an outbreak prevention plan, only to see it overshadowed by the latest revenue initiative. Or you might propose innovative ways to boost hygiene awareness, only to have them shot down. Recognition doesn’t always follow effort, and that can be discouraging.
In larger cruise corporations, the environment can be perceived as impersonal, with office politics carrying more weight than actual performance. If you don’t fit the corporate culture, it’s easy to feel undervalued or out of place, regardless of your competence.
Recognition—or the lack thereof—usually becomes most apparent when trying to navigate the corporate machine. The combination of high workload and limited acknowledgment underscores that success in cruise line public health demands resilience and a strategic understanding of both your role and the broader organizational landscape.
Challenge #3: The Corporate Machine
Corporate structures are by design layered and bureaucratic, which can frustrate early-career public health professionals eager to make a difference. Many find themselves performing routine tasks—approving orders and entering inspection findings into spreadsheets—with little room for creativity or innovation.
Larger cruise lines in particular operate with extensive protocols, multi-person approval chains, and standardized procedures. While these systems are integral to safe and legally compliant operations, they can delay critical decisions, leaving urgent public health actions caught in a bottleneck.
For shore-based managers, this might mean waiting weeks for approval of new procedures. Onboard, PHOs can spend valuable hours navigating chains of command just to address a broken handwashing station.
The irony is that public health frequently requires swift, decisive action. Health risks don’t wait for forms to be signed or committees to convene. This mismatch between urgency and bureaucracy can make public health professionals feel as if they are rowing against the tide, which can be exhausting and disheartening.
Challenge #4: Career Growth Isn’t Always Straightforward
The frustrations of bureaucracy often amplify another challenge: the unclear career paths within public health. By comparison, career trajectories in other departments are straightforward: a junior deck officer today, a staff captain tomorrow; a superintendent can see a route to Vice-President of Technical Operations. Public health roles, however, tend not to offer such clarity.
Ashore, particularly where public health sits within the medical department, senior leadership positions are typically reserved for doctors. The best you might hope for after years of effort is to earn the word “Senior” in your title and a modest pay bump; an upgrade that does not necessarily translate into greater executive influence.
At sea, PHOs may encounter a plateau. Promotion opportunities are limited unless you transition to another department, move ashore, or secure a coveted Fleet Public Health Officer role that alternates between ships. While such a rotation can break the monotony of a single vessel contract, it generally represents the highest point a PHO can reach at sea.
Furthermore, career progression in the industry is commonly tied more to seniority than merit, which can stifle motivation. Many public health professionals eventually consider “jumping ship” to other companies—or even another industry—to advance. It’s no coincidence that those who start in large cruise lines typically move to smaller operations to find more growth opportunities and autonomy.
Challenge #5: The Emotional and Loneliness Factor
If you are fortunate enough to work for a cruise line where the first four challenges are less evident, there is one inescapable element that remains: the emotional and solitary weight of the work. Public health carries a unique emotional load; anyone who has faced a loss of life onboard due to a preventable illness understands this deeply.
PHOs are often the first—and sometimes only—point of contact for outbreaks, compliance issues, or hygiene concerns onboard. Shoreside managers have to make tough decisions that affect both passengers and crew without immediate subject-matter expert support, especially in smaller cruise lines with one-person departments.
This responsibility can feel deeply isolating. Long hours, high-stakes decisions (with the inevitable compromises), and occasional pushback from colleagues can contribute to burnout or moral fatigue, leaving even experienced cruise industry professionals mentally and emotionally drained.
In this role, you regularly manage complex situations alone, shouldering accountability for outcomes affecting hundreds or thousands, which makes resilience, reflection, and support networks essential for sustaining both performance and well-being. No matter how experienced, public health professionals at all levels must cultivate resilience to master these emotional demands.
Strategies to Succeed in Cruise Ship Public Health
Even in the most supportive organizations, cruise line public health is demanding. The work is vital, yet it unfolds in one of the most complex and high-pressure environments imaginable. For many professionals, these realities shape whether they stay in the field or move on after a few years.
Nonetheless, the rewards are real. The ability to prevent illness outbreaks, improve health standards, and safeguard lives on a global scale is unmatched. Thriving in this career requires adaptability, diplomacy, strategic thinking, and deliberate self-management.
Here are five approaches to help you succeed:
1. Set Boundaries and Share Responsibility
Protecting health doesn’t mean doing it all alone. Block off time for focused work, learn to say “no” when priorities pile up, and pace yourself by leaning on other departments to share responsibility. Hotel, marine, and technical operations must own their share.
The inescapable truth is that your work will never be “done.” There will always be another outbreak, inspection, or new build project waiting. Long hours may come with the territory, but exhaustion shouldn’t. Keep advocating for realistic staffing and resources. If you don’t, no one else will.
2. Increase Visibility and Build Influence
Frame public health not just as compliance, but as a driver of guest satisfaction and brand reputation; metrics executives actually notice. Communicate your objectives clearly so colleagues see you as a partner, not the “public health police.” When teams understand that your work supports their goals, your influence—and job satisfaction—can grow.
Change is rarely immediate. It requires patience, repeated conversations, and careful navigation of competing priorities. Resistance doesn’t equal failure; in many instances it signals that influence will take time to build. Focus strategically, leverage small wins, and allow them to compound into meaningful impact.
3. Learn the System and Work Creatively Within It
Bureaucracy can be frustrating, but understanding formal processes is only half the battle. Cultivate informal networks across departments—personal relationships tend to move things along quicker than conventional protocols. With strategic effort and patience, even complex hierarchies can be manipulated to achieve real outcomes.
Keep perspective: while public health’s mission is to protect onboard health, it operates within operational and business realities. Initiatives that enhance efficiency alongside safety tend to gain approval more quickly. Recognizing this balance allows you to advance meaningful programs without unnecessary friction.
4. Take Charge of Your Career
As the comedian Jonathan Winters remarked, “If your ship doesn’t come in, swim out to meet it.” Don’t wait for the company to chart your path. Document your achievements and use them to advocate for promotions or lateral moves. Seek cross-functional projects that raise your visibility and expand your skill set.
Career growth may not be linear, but it is achievable with a proactive approach and creative thinking. Propose new initiatives or roles that reflect the full scope of maritime public health. Even in traditional structures, there is room to shape a position that aligns with your skills, ambitions, and the organization’s needs beyond the standard PHO or public health manager role.
5. Build a Support Network and Nurture Resilience
Public health work can be isolating. Peer groups, mentors, and professional networks provide perspective, guidance, and encouragement. Delegate and share responsibilities wherever possible, and create small rituals—checking in with colleagues, celebrating minor wins, or setting aside reflection time—to sustain resilience.
Acknowledging the emotional weight of the work is not a weakness; it’s essential for maintaining performance, mental health, and long-term satisfaction. Developing these habits helps you cope with both the highs and the inevitable lows of a cruise line public health career.
Navigating the High Seas of Public Health Careers
As Rafael Nadal observed, learning to “enjoy suffering” doesn’t mean relishing every difficulty, but it reflects the mindset required to chart a course through a demanding, high-stakes environment with perseverance and purpose.
At the same time, honesty is essential. Not every organization, department, or situation will be conducive to growth. Persistent barriers, lack of support, or misalignment with your values may signal that it’s time to explore new opportunities. Recognizing when to move on is as much a part of professional judgment as excelling in your current role.
Ultimately, a career in cruise line public health can be deeply rewarding for those who persevere. By navigating challenges thoughtfully and intentionally, you can protect the health of thousands, influence operations positively, and shape a career that reflects both your expertise and your values.
Just don’t forget Marilyn Monroe’s words: “A career is wonderful, but you can’t curl up with it on a cold night.”