What is the Oncology floor like?

[ijuanabhappy, ASN, RN]

I've been a nurse for a year now but have very limited hospital experience. You might as well call me a new grad. I had a couple failed attempts at floor nursing (cardiac floor, NICU) but in all honesty I don't think I gave myself a chance. I felt at the time that there was no way I could ever juggle multiple patients and keep my time management in check. I do not have time management down at all, and sometimes I think I would be better suited in a nursing position that focuses on one patient at a time. Most of my experience has been in the clinic setting which was basically phones.

I have always been drawn to Oncology, as well as psych. Could anyone tell me what working on an oncology floor is like? More stressful than a med-surg floor? If one has a true desire and passion for it, can the steep learning curve and organizational skills come in time? Is it extremely fast paced? Hard physically on the body?

Any good advice? Please no sarcastic comments...those really are not helpful.

[canesdukegirl, BSN, RN]

*chuckle. You are right, the sarcastic comments don't really steer you toward any enlightenment, eh?

The onc pts that I took care of way back in the day were mixed in with other med/surg pts. I used to work on a Gyn/Onc floor. We had primarily onc pts, but were also expected to take care of post op TAH/BSO pts, general med pts if the hospital census was high and the med pts had to be placed in our empty beds, and a few post partum pts.

You will more than likely be expected to care for a plethora of pts on the Onc unit. Yes, it IS fast paced, because you are administering chemo, hanging blood, preparing pts for surgery, taking care of fresh post-ops and then taking care of the few pts that are on the med census. The experience you get from this practice is RICH. You learn so much, and you will learn time management skills as well.

[DavidFR, BSN, MSN, RN]

I work in medical oncology - I would stress to you that I am not in the United States nor have any experience of working in the US.

I "discovered" oncology after being qualified 23 years and working in many other specialities, and it's the tops! I love this speciality because it combines fast paced, acute nursing (the patients can be very unstable at a stage when they're still viable for resuscitation) with the softer side of patient relations - pain management, talking and listening wth patients and families, the sensitive side of terminal care etc. You need to really check out the facility before you take a job. Some oncology units take into account the time needed for the more tender aspects of oncology nursing, while others are just chemo production lines. Look at staff patient ratios - I would suggest the absolute maximum number of patients is up to 5 on days and up to 8 on nights - any more is compromising the time you need to give these patients. Is it possible to ask for an "observational" day or night to shadow a nurse there before you apply?

I agree with the above poster who says this is a very rich experience. Perhaps you were hard on yourself in judging your organisational skills in your first post - these things take time to perfect, and yes I do believe that the way to handle your weaknesses is to tackle them head on - with guidance and determination you can get there.

Good luck if you choose this option. Oncology is highly rewarding and vastly interesting.

[Up2nogood RN, RN]

Working with medical and surgical oncology patients can be very rewarding but also very depressing. You will need to learn healthy coping skills or you'll burn out quick. You will see the sickest of the sick in the medical pts and relatively healthy surgical pts (except for cancer).

Oncology can be busier than you're typical med-surg because you will have pts that are sicker plus need extra TLC and time to voice their wants, needs, fears. Time management is a must but it can be done if you give yourself a chance.

Getting to know my pts and their families has truly been a priceless experience for me.

[ijuanabhappy, ASN, RN]

*chuckle. You are right, the sarcastic comments don't really steer you toward any enlightenment, eh?

The onc pts that I took care of way back in the day were mixed in with other med/surg pts. I used to work on a Gyn/Onc floor. We had primarily onc pts, but were also expected to take care of post op TAH/BSO pts, general med pts if the hospital census was high and the med pts had to be placed in our empty beds, and a few post partum pts.

You will more than likely be expected to care for a plethora of pts on the Onc unit. Yes, it IS fast paced, because you are administering chemo, hanging blood, preparing pts for surgery, taking care of fresh post-ops and then taking care of the few pts that are on the med census. The experience you get from this practice is RICH. You learn so much, and you will learn time management skills as well.

This Onc floor is also Gyn too. If it is more fast paced than other med-surg floors, I wonder if I wouldn't do better starting out on a general med-surg floor since I tend to be a little slower than most at first. The ratio on days is 4-5 (good day) or 5-6 if its a bad day. I really do like the idea of working in oncology though. Thanks for your post!

[blondy2061h, MSN, RN]

I work heme-onc. I love it, but only because I work in an excellent environment. My unit would suck if it weren't for good management, great staffing, and my excellent co-workers. We see a wide variety of patients from various walks of life. Cancer doesn't discriminate. I like it because the patients truly are sick, and generally not whiney. I couldn't stand relatively healthy people acting like they were dying when I did med-surg clinicals. We do some critical care on my unit- pressors, insulin drips, bipap, etc, so that keeps things interesting.

Watching people die a lot can be difficult, but one of my coworkers said to me once, "I figure they're going to die either way, and if I'm here, I know they can die with excellent, compassionate nursing care- that's how I cope." Keeping that in mine has been tremendously helpful to me.

I really can't comment on general oncology, since my unit is strictly heme-onc.

[Aeterna, BSN, RN]

I work on a medical/oncology/palliative floor so we see a wide array of people and diagnoses. I can't say which specialty in particular is the "busiest". They have so many different needs, different personalities, etc. We don't see surgical onc patients, though - they tend to recover on our surgical floor before having them transferred back to us for further treatment (i.e. chemo or radiation).

With oncology, you must be very vigilant, I find. Blood work has to be looked at as early as possible to gauge what you need to look out for. Chemo basically wrecks all a patient's blood counts, so hanging blood products is not uncommon and you want to do it as early as possible in the day. Even chemo itself needs to be watched carefully in case a patient reacts. There's lots and lots of patient education, special precautions, and emotional support. It's especially difficult seeing a young person with cancer, and even harder watching them die.

Still, I love working with my onco patients. I find they are so grateful and so happy for the smallest pleasures in life or even a little bit of success in recovery. Also, onco patients tend to stick around longer due to lengthy treatments, CBC recovery, etc., and they often come back if they spike a temperature at home or for further treatment, so you get the opportunity to really build relationships with the patients and their families. The patients will remember your name even weeks after you've cared for them and you will remember the little details about them, like how they like their coffee.

I think it's a difficult specialty overall because of the complexity and acuity you see in oncology. They are some of the sickest of the sick. Still, as someone else mentioned, it is a very RICH experience and, should you choose to pursue it, you will walk away with vasts amount of knowledge. I have been working on my floor for almost a year and I still feel in way over my head, but it is a gradual learning process and I learn something new every day.

[kool-aide, RN]

Not trying to be sarcastic/negative, but I think oncology is sad and depressing. But I have limited experience w onc.

[canesdukegirl, BSN, RN]

This Onc floor is also Gyn too. If it is more fast paced than other med-surg floors, I wonder if I wouldn't do better starting out on a general med-surg floor since I tend to be a little slower than most at first. The ratio on days is 4-5 (good day) or 5-6 if its a bad day. I really do like the idea of working in oncology though. Thanks for your post!

Honestly, I think that the GYN/Onc floor would be better for you. It is more focused than a general med/surg floor, thus allowing you to concentrate on a particular population of patients rather than the entire spectrum of med/surg. You will of course have the mix as I described in my previous post.

If you feel that you are doubtful about going to the onc floor, sit down with the nurse educator on that floor and tell them what your doubts/concerns are. Perhaps they can give you a better understanding of expectations, and you can go from there.

[TinyRNgrl]

I always thought hospice/pallitive care would be a interest of mine someday. I think it would be very rewarding, yet depressing too in the long run, to care for these pt's and families during their final days. As others have posted, most floors have the mixed pt population. Maybe an interest to you would be along the lines of hospice home health. You would have that one on one with the pt in their own home. Just my two cents. Whatever path you choose I wish you luck and like others have said, time managment comes with experience, don't beat yourself up. I am sure you are a wonderful nurse. :)

[Munch]

I actually worked in a cancer hospital, maybe some of you heard of it (Memorial Sloan-Kettering Cancer Center...they also take care of patients that need bone marrow transplants that don't have cancer, they have some rare disease that could only be cured by a BMT). I worked in the main hospital in Manhattan(they have satellite locations where patients can get chemo and blood products, but they don't do surgery and they don't accept peds patients...the surgery and peds patients have to go to the main hospital in manhattan). I lasted there for about a year. I wanted to work oncology because I lost my father to Pancreatic cancer, My uncle to glioblastoma multiforme, my cousin to neuroblastoma (when I was young) and my Grandfather to Esophageal cancer. I wanted to work with oncology patients because I wanted to help them like my family members were helped.

I worked on the bone cancer unit and I lasted about a year. While I did like bonding with the patients and their families(on my break if a patient wanted something to eat on the outside world I would bring it to them, I would talk with family members, eat ice pops with the patients and so on). But Bone cancer is painful and depending on the type of bone cancer they had, the cancer liked to spread to the lungs and other organs. Once the cancer spread it was pretty much over for them. I would hear patients screaming in pain, no kind of opiate or medication would help them(not even an epidural), some patients would have an amputated leg or after having surgery they would come back to the unit and almost learn how to walk again(the looks of pain on their faces almost made me break down and cry), some patients were my age or younger and some patients would stay on the unit for months without a single visitor(I would steal some of my break time and chat with them).

I just couldn't take the sadness of it all. Every floor had a different type of cancer. I couldn't take it because it would always remind me of my family members the succumbed to the disease(two of my family members we're treated there).

BUT everyone is different and not everyone had the same experience that I did. It really is a rewarding field and if you can handle it(I thought I could, but it just hit too close to the bone for me) then I suggest going for it.

One more thing....Peds oncology is the saddest of them all.

[birdie22]

I've worked in surgical oncology. To be honest, I didnt even feel like the patients had Cancer. They felt like regular med/surg patient except with an underlying diagnosis of CA. We didnt even administer chemo on our floor. The patients would either receive a couple rounds of chemo/radiation prior or after surgery, and they had to healthy enough to even have the surgery in the first place.