Advice on Oncology Unit

EmmaG, RN · Dec 19, 2007

Congratulations on your new job!

As far as post-mortem care, you'll just follow your hospital's policies on that, so no real need to look up anything.

Because of their treatments, many of your patients will be anemic, at risk for infection and at risk for bleeding. So you will be shown the precautions in caring for these people. STRICT handwashing, before and after patient contact, is of utmost importance. The unit will have additional specific precautions you'll learn in caring for those at risk for infection.

Because of their low blood counts, fatigue, risk for bleeding, and spread of the cancer (to the bones or brain, for example), these patients are at high risk for injury; so as a CNA you'll be responsible for assisting them out of bed, to the bathroom, ambulating, etc. You'll need to be careful in assisting them in moving about or positioning in bed and very patient with them as well; many move very slow because of pain or other issues.

You'll need to know how to take accurate vital signs, and report them to the nurses in a timely manner. Be aware of patients who've had mastectomies, dialysis grafts, or have IV lines or ports; there should be signs posted in the rooms if you cannot use either (or both) arms for blood pressures, but sometimes that is overlooked so it is a good idea to ask the nurse and the patient where you can take BPs. Also know how to take a manual BP.

Be aware of fevers in your patients. If you take a temp, ALWAYS take a full set of vital signs, including BP. If a patient has chills, don't simply get them a blanket but take a full set of vitals and report it to the nurse asap. That is a sign that their temp is going up and they could be going septic. You'll be doing alot of vitals in any case because of treatments, transfusions, etc.

I'm running late this morning; that is what I can think of off the top of my head (and having just woke up lol) It's a fast-paced unit, and many of these patients are critically ill. You'll learn alot. Good luck :)

MrsCannibal · Dec 19, 2007

I think that Emmanuel did a very good job in answering this post but I did have one thought: during clinicals on the oncology floor a nurse told us to really think about what we say before we say it. Even the smallest things that were seemingly innocent could have a deeper meaning to one of these patients. For instance, the patient with brain cancer who only had a month or so to live probably wouldn't appreciate me chattering about the following summer. I don't know, maybe that nurse was extra sensitive and this isn't an issue you will face, but I have never forgotten what she told us.

wayunderpaid · Dec 19, 2007

Hello All Nurses community,
I'm a pre-nursing student who just got hired as a PCA in an Oncology Unit. I don't have any prior experience working in this unit. I just got my CNA certificate in November. I'm so excited to get this opportunity. The hospital I will be working for is a teaching hospital so I think that's why they took me without any experience. I'm so grateful to get to have this opportunity. I was wondering if there is any RN out there who would share with me some of their experiences working in the Oncology Unit and also is there somethings that I can prepare myself for or maybe read up on. I really would like to prepare myself for this job. I'm so excited about this opportunity. I was wondering if I should look up post-mortum care (I think I spelled that right) I know in the interview she said I would be doing a lot of that. Please anyone get back to me I start my new positon on Jan 8th. I'm so excited.

Ditto to the above posts. Also, when you take vitals, make sure that the EQUIPMENT is sanitized after each patient. A lot of infections in the oncology ward can be passed on because patients are immunocompromised (neutropenic). Strict aseptic techniques are an absolute must! Great luck on your new job!

FemmeRN · Dec 19, 2007

Congrats on your job!

I did my first clinical rotation in Nursing school on an Oncology floor, and was very nervous about knowing what to say or what not to say to the patients and their families.

I read a book called "Help Me Live: 20 Things People with Cancer Want You to Know." It's by Lori Hope, and you can get it cheap from Amazon, or I'm sure most local bookstores. It was very helpful to me, and made me feel a lot more comfortable in clinicals.

Best of luck!

Michelle

misslo · Dec 19, 2007

That sounds like an awesome book. I am starting a CNA course next month and was wondering what some of the do's and dont's are. I think I will buy that book in hopes that it will help me to keep my foot out of my mouth!

MissLo

carlaveronica · Dec 19, 2007

Thank you so much for the advice. I know patients are fragile in this unit and the immune system is extremely sensitive. I will remember everything you said and I will do the best work I can. I lost my mother this July to ovarian cancer. I took care of her in her final days and i know how sensitive she was. To have to watch my beloved mother go through that pain was something i will never forget. I will treat all of these patiences with the upmost dignity and respect and will do the best job I can. I have one quick question. Should I read up a little bit on the subject to try to understand the different stages of cancer? The terms that will be used in this unit.. Let me know I really appreciate your post and I really appreciate you taking the time out before work. I will talk to you soon. Carla

EmmaG, RN · Dec 19, 2007

Thank you so much for the advice. I know patients are fragile in this unit and the immune system is extremely sensitive. I will remember everything you said and I will do the best work I can. I lost my mother this July to ovarian cancer. I took care of her in her final days and i know how sensitive she was. To have to watch my beloved mother go through that pain was something i will never forget. I will treat all of these patiences with the upmost dignity and respect and will do the best job I can. I have one quick question. Should I read up a little bit on the subject to try to understand the different stages of cancer? The terms that will be used in this unit.. Let me know I really appreciate your post and I really appreciate you taking the time out before work. I will talk to you soon. Carla

I am so sorry for the loss of your Mom. Absolutely, you can read up on cancer and oncologic emergencies and general care. That will not only help you as a CNA but in your nursing program as well.

This patient population can be very, very sick, and even if they look pretty good they can crash very very fast. Many docs will keep them on the floor as long as possible to avoid exposing them to an ICU, so careful monitoring is essential. I didn't mention I&Os above; that is also a very important aspect of your duties as a CNA. Because of treatments or tumor obstruction, these patients need careful I&O and monitoring of their bowels too. They often need help with meals or even monitoring while eating. Oh, and be aware of odors--- good and bad. Many cannot tolerate strong smells (or even 'normal' odors). Don't use perfumes or fragrant lotions or strong smelling detergents/softeners. Take the lids off their meal trays before entering the room or just inside, instead of right in front of the patient; getting hit with those food odors can exacerbate nausea. And make sure those trays are removed from the room after they're finished eating. Keep the trash emptied, don't leave dirty depends in the room, empty and clean out 'hats' and bedside commodes. That kind of stuff.

The most important thing to remember (aside from handwashing!) is to communicate with your nurses. If they don't come to you at the beginning of their shift, go find them and get an update on your patients--- anything special you'll need to know while you're caring for them. A good CNA is worth their weight in gold, IMO. They've saved my tail many a night.

Good luck :)

EmmaG, RN · Dec 20, 2007

I think that Emmanuel did a very good job in answering this post but I did have one thought: during clinicals on the oncology floor a nurse told us to really think about what we say before we say it. Even the smallest things that were seemingly innocent could have a deeper meaning to one of these patients. For instance, the patient with brain cancer who only had a month or so to live probably wouldn't appreciate me chattering about the following summer. I don't know, maybe that nurse was extra sensitive and this isn't an issue you will face, but I have never forgotten what she told us.

I'm not so sure I agree with this; most patients I've cared for didn't want this kind of kid-glove treatment. Also, because they are admitted repeatedly, we get to know them and their families--- and they get to know us--- on a level you don't see in many other specialties. Of course you have to be sensitive, but for the most part I haven't seen where this disturbs them.