I'm a chemo certified nurse in an oncology/med-surg unit looking for ideas on how to handle and execute chemotherapy orders that needs to be given in a non-oncology unit (ICU, Step-down, regular med-surg). We are currently very short-staffed with 6-7 patients a piece and it is a challenge to also have 2 of our nurses to be off the floor to give chemo. We have also been having problems with getting information about orders that needs to be given outside our unit. We end up having either wasted doses, because somebody that is not a chemo nurse ordering the pharmacy to mix the medication when in fact we don't even know the order existed, hence an expired chemo. The patients has to stay a little longer,because of that setback as well.
How does your off-unit chemo orders being communicated to y'all? does the pharmacy send a copy of an order? do they call you or does the RN taking care of the patient calls you?
How do you schedule or keep track of all of your off-unit chemotherapy administration?
Do you guys have a pathway to make a smoother communication and execution?
I would deeply appreciate any information, suggestions, or opinions. Thank you very much!
Aug 13, '13
Chemo orders should be faxed/tubed to the oncology unit and two chemo nurses should verify orders and check calculations. At my hospital there is an oncology pharmacist during the day and calculations/orders are also verified with pharmacy. It's best to have all this done during day shift. Management, supervisors, and charge nurses usually handle this. We are also very short on my unit so if there are only two nurses than the non chemo unit must send us a nurse before one can leave. The other unit can give premeds just call them to cordinate time. Stay with the pt for 15-30 mins to see about reaction. Make sure you document that chemo was checked with second chemo nurse as they won't be the one to sign it off with you.
Aug 14, '13
thanks jskgx2! we pretty much have the same protocol except for orders being faxed to us. thanks again for the input.
Aug 26, '13
Where I work, other floors don't generally give chemo due to the fact that all the certified nurses work on our unit or the infusion center (which is only available 7a-5p) ^^Good idea above to coordinate pre-meds if you absolutely have to and then let a chemo nurse take over. I usually like to give my own premeds though, look over labs myself and do calculations, etc.