is it safe to mix your own chemo in an outpatient oncology setting?

[gvrn13]

Hi, I am a new graduate who has been working in an outpatient hematology/oncology setting for the past 7 months. I am just wondering on how some of my jobs practices compare to other outpatient facilities. I am not oncology certified, I do not have enough hours to qualify for the test yet, nor am I chemo certified. I know to work in a hospital you would be chemo certified through them, but I am not sure how to do this on my own. I am responsible for mixing my own meds, which I administer without a pump.... when I first started and asked about why they don't use pumps, they said that they used to use them but they had more infiltrates that way. The meds are mixed under a hood, using gloves and a gown. The only time a dose is second checked by another nurse is when it is a 5-fu pump that will be going home with a patient (of course I can always ask another nurse if I am unsure about my calculations, or just have a question, but it is not required). I am wondering if this is how it is done in other facilities? Is what I am doing completely unsafe, and out of my scope? I feel like I may be being taken advantage of, given my inexperience by 1. how under compensated I am being, and 2. tasks that I am doing that maybe I shouldn't be. I don't feel that I am doing anything that I am uncomfortable with, but am I so new that I don't even know what I shouldn't be doing (if that makes sense)? I do work with several OCN nurses, and I feel like I am guided and have good resources with working with them. This all started because I went on an interview (I am desperately trying to find a hospital job with 12 hour shifts) and the nurse manager told me that she thinks what I am doing is dangerous... so my question to all my fellow nurses is, am I being dangerous and I don't even know it???

[gvrn13]

I appreciate your feedback, and can agree that you're training was a lot better than mine. Why is the standard so much lower in a doctors office? At my job, all but 4 nurses (out of 9) are OCN, it doesn't seem to me like them requiring the chemo provider course would be too much for them to ask if they like their nurses certified. The nurse I trained under is a OCN, and I would say definitely knows her chemo, is very to the T while she works. She never mentioned it to me, and it's weird. She has been like a mentor to me, very receptive to me asking questions, encourages it, and always helps me when I ask, and pushes me to think. You are right that I should have researched this when I was hired, and that ultimately I am responsible for myself, and my license.

[OCNRN63, RN]

I appreciate your feedback, and can agree that you're training was a lot better than mine. Why is the standard so much lower in a doctors office? At my job, all but 4 nurses (out of 9) are OCN, it doesn't seem to me like them requiring the chemo provider course would be too much for them to ask if they like their nurses certified. The nurse I trained under is a OCN, and I would say definitely knows her chemo, is very to the T while she works. She never mentioned it to me, and it's weird. She has been like a mentor to me, very receptive to me asking questions, encourages it, and always helps me when I ask, and pushes me to think. You are right that I should have researched this when I was hired, and that ultimately I am responsible for myself, and my license.

Well, so now you know. And now that you know, you're going to take steps to make sure you're properly educated for this job.

I started OP oncology with zero oncology experience, but I did take the Chemotherapy/Biotherapy course before I applied to my job. That first year, I did a lot of studying after work and took a ton of CEUs to get myself up to speed. I had over 25y of exp. when I took that job, but none of it was in oncology. I felt like a new grad for a long time.

After about a year and a half, I decided to take the OCN exam. I'm ashamed to say that I did precious little studying; I guess because I didn't expect to pass. Imagine my surprise after hitting "Submit" to find out that not only did pass, but that I had done well on the exam.

I tell you this to let you know that it can be done. It sounds like you have people at your job who are supportive, and you have people here who are willing to help you, too.

[gvrn13]

Well, so now you know. And now that you know, you're going to take steps to make sure you're properly educated for this job.

I started OP oncology with zero oncology experience, but I did take the Chemotherapy/Biotherapy course before I applied to my job. That first year, I did a lot of studying after work and took a ton of CEUs to get myself up to speed. I had over 25y of exp. when I took that job, but none of it was in oncology. I felt like a new grad for a long time.

After about a year and a half, I decided to take the OCN exam. I'm ashamed to say that I did precious little studying; I guess because I didn't expect to pass. Imagine my surprise after hitting "Submit" to find out that not only did pass, but that I had done well on the exam.

I tell you this to let you know that it can be done. It sounds like you have people at your job who are supportive, and you have people here who are willing to help you, too.

Thanks so much for all your advice, I just looked on the ONS website, and I will be registering for the next online course, which will start 3/20. Even if my job doesn't require it, it will make me feel better, and I'm sure that it will make me more knowledgable about things that I am doing everyday, that maybe I really don't know too much about. Were you responsible for mixing your own chemo, or did/does your job have an onsite pharmacist that does it?