[Soneshine]

Hi!

I am new to Oncology and have been working in an outpatient clinic for a little over a month now. At our clinic, the nurses mix all of the chemo drugs in a BSC. I really like everything about this specialty so far, except for the idea of personally mixing and hanging of these drugs. It scares me more than I would like to admit. I haven't actually started mixing or hanging yet- but anticipate I will start soon.

My biggest concern is exposing myself (even if it's just minimal amounts from surface contamination or the general environmental in which I work for 10 hrs/day). I'm concerned that this exposure may increase or cause me to get cancer in the future. I mean if OSHA recommends NO food/drink, or even applying chapstick in the general infusion area?? This is scary- I am within 10-15 feet of my patients at all times. The treatment rooms are only privatized by curtains. Maybe I'm blowing things out of porportion, but I need to vent & know what others feel about this- or if anyone has or has had concerns about this....

I realize that using PPE and practicing other safe measures reduces overall risk- but I can't help wonder if working in this environment will prove to be more harmful than previously thought....

Insight anyone?

[oncnurse1974]

I have to admit that I have never mixed chemo. I have been lucky enough in my career to always have pharmacy techs mixing for me!! My advice would be to go onto ons.org. There is a "safe-handling" course on the website that you can read or you can do a search about safe-handling articles; this should put your mind at ease! This has been a big buzz in the Oncology Nursing Society Community, and there have been a lot articles written. My other thought is that if you are exposed to enough drug (and I don't believe that you can absorb a lot thru your skin), you would be at risk for the same side effects as our patients....nausea, fatigue, lowered blood cell counts, etc. And think about how much they receive thru an IV opposed to you maybe absorbing some thru your skin!! I say RELAX and just be safe and follow your institutions guidelines!!

[NurseRatched67]

Luckily, I too work for a large hospital where our pharmacy techs do all the mixing. They have to, we see sometimes upwards of 190 patients a day in our outpatient treatment center. We would never have time. The pharmacy also spikes the bags for us under the BSA and we backprime only by using a pump.

I agree with going and seeing the ONS information on safe handling. Have you ever had proper ONS training in your facility on safety?

Know how to safely handle these drugs and also how to safely deal with leaks/spills as well. Knowing what you should be doing will dramatically lessen your exposure.

Also, volunteer to be on a safety committee if you facility has one. You have the power to enact change and help protect yourself at the same time. Knowledge is power!

[ds123]

Originally Posted by Soneshine

Hi!

I am new to Oncology and have been working in an outpatient clinic for a little over a month now. At our clinic, the nurses mix all of the chemo drugs in a BSC. I really like everything about this specialty so far, except for the idea of personally mixing and hanging of these drugs. It scares me more than I would like to admit. I haven't actually started mixing or hanging yet- but anticipate I will start soon.

My biggest concern is exposing myself (even if it's just minimal amounts from surface contamination or the general environmental in which I work for 10 hrs/day). I'm concerned that this exposure may increase or cause me to get cancer in the future. I mean if OSHA recommends NO food/drink, or even applying chapstick in the general infusion area?? This is scary- I am within 10-15 feet of my patients at all times. The treatment rooms are only privatized by curtains. Maybe I'm blowing things out of porportion, but I need to vent & know what others feel about this- or if anyone has or has had concerns about this....

I realize that using PPE and practicing other safe measures reduces overall risk- but I can't help wonder if working in this environment will prove to be more harmful than previously thought....

Insight anyone?

I too work in a clinic where the nurse does the mixing. All 3 of the nurses in the infusion room mix. We have a Laminar flow hood that rivals the main campus pharmacy. Use your gloves, sleeve guards and always mix with respect. Learn about the drugs and handling them with care. Wash your hands after each session in the hood. ALWAYS ALWAYS read the package insert on mixing and administration and re-read it if you have any doubts. Call the pharmacist and ask questions. I've been doing it for almost 8 years now. Also, ask about training wiht a pharmacist who mixes chemo on a routine basis.

[Soneshine]

Thank you! These are really good suggestions. I am feeling a bit more at ease now. The best one can do is follow all of the recommended safety precautions & not worry excessively. The fact of the matter is, is that you could die tomorrow in a car accident. You can't live in fear of the "what ifs." Oncology has it's risks- but I think I let my mind go a bit wild after reading studies about chemo drugs found in the urine of nurses who don't mix; who are just in the general environment OR miscarriages & birth defects, ect ect......

Other than mixing & hanging these drugs, this is a specialty I really enjoy!