Any Pediatric Oncology Nurse- Can you help me?

crazyearrings · Oct 27, 2004

I work on a peds oncology/cardiology/surgery floor. Last year we separated from the regular peds floor to separate our patients from infectious patients. My oncology patients have my heart. I work both 7a-7p and 7 p-7a so it is hard to describe a typical day. Basically, I start the day getting report, filling out my worksheet, and getting together the first 4 hours of meds so I know ahead of time if I need to call pharmacy. Then I go assess my patients (usually 4-5 - much better than when we were still on peds when I could have 7-9 pts) and take my 8:00 meds with me. I'm still adjusting to the lower patient load. I used to be lucky to see my patients once every 4 hours. Now I try not to peek in more than once every two hours so they can rest - especially on night shift. Day shift is a lot busier with doctor's writing orders, admits, transfers, discharges, surgeries, off-the-floor tests, etc. Noght shift, I might get an admit, but pretty much, after I get my patients asleep, the night goes by pretty smoothly.

What is the best thing about my job? The patients and their families.

What is the worst? Staffing. This is more of a problem on dayshift than nights, but it is amazing how much they will shortstaff us and not think it is a problem.

What do I wish I had known? About the existence of APON (Association of Pediatric Oncology Nurses.

How has it been emotionally? Heart wrenching and uplifting. I have wondered how many times my heart can be torn out when a patient dies. But for everyone that dies, there are six more I couldn't leave. The families tell me I make a difference. I had a very special patient (we shaved our heads together) die last May. I was with the family when they turned off the vent. The dad thanked me for loving his daughter. That one will stay with me forever.

I hope this helps.

crazyearrings · Oct 27, 2004

I work on a peds oncology/cardiology/surgery floor. Last year we separated from the regular peds floor to separate our patients from infectious patients. My oncology patients have my heart. I work both 7a-7p and 7 p-7a so it is hard to describe a typical day. Basically, I start the day getting report, filling out my worksheet, and getting together the first 4 hours of meds so I know ahead of time if I need to call pharmacy. Then I go assess my patients (usually 4-5 - much better than when we were still on peds when I could have 7-9 pts) and take my 8:00 meds with me. I'm still adjusting to the lower patient load. I used to be lucky to see my patients once every 4 hours. Now I try not to peek in more than once every two hours so they can rest - especially on night shift. Day shift is a lot busier with doctor's writing orders, admits, transfers, discharges, surgeries, off-the-floor tests, etc. Noght shift, I might get an admit, but pretty much, after I get my patients asleep, the night goes by pretty smoothly.

What is the best thing about my job? The patients and their families.

What is the worst? Staffing. This is more of a problem on dayshift than nights, but it is amazing how much they will shortstaff us and not think it is a problem.

What do I wish I had known? About the existence of APON (Association of Pediatric Oncology Nurses.

How has it been emotionally? Heart wrenching and uplifting. I have wondered how many times my heart can be torn out when a patient dies. But for everyone that dies, there are six more I couldn't leave. The families tell me I make a difference. I had a very special patient (we shaved our heads together) die last May. I was with the family when they turned off the vent. The dad thanked me for loving his daughter. That one will stay with me forever.

I hope this helps.

Loquax · Nov 14, 2004

I work in a pediatric oncology/neurosurgery ward in Sweden. A typical day looks something like this:

We begin with a report from the night shift. Then I make a list of medications and cytotoxic drugs for my children (we usually have 3 or 4 children per nurse). The pharmacy prepares the cytotoxic drugs, we prepare all antibiotics and everything else. Next, I change all continous i.v. infusions (e.g. 5% dextrose) and finish the in/out-lists. All is entered into our computerized patients records. I also try to look at the dressings of the CVC:s.

About then, it's time for the daily conference with the physicans, and after that I usually get a lot of work to do with blood samples, changes in medication and so on. Much of the time is also used for teaching, both children, siblings and parents and social support. We spend much time talking, both with the ones we have on ward and on the phone with the ones who are at home.

The afternoon shift starts at 1330, and before then I try to have updated all papers and written the shift report.

Worst thing: Most of the children that dies are sent at home and they usually pass away in their own bed. It's very hard to understand (emotionally, not as much intellectually) that they are really dead, since last time you saw them, they were quite well and just left the hospital as if they were sent home after finished treatment. I have at least five or six children that I cannot understand have really died.

Best thing: Families. Yesterday, I spoke on the phone with a mother who lost her son about a year ago. That hour of conversation taught me more about life than three years in nursing school.

I wish I had known more about the different treatments and drugs and so on. It's a very complex field and at school, we had two hours of pediatric oncology. Not much. But we've got a fairly good library at the ward, so I still read, read and read (I've worked here for two years now).

Emotionally, it's been more intense than I ever thought it would be. There have been times when I never before been have so happy at so terribly sad at the same time. But I bet it's the ward most prone to laughing at our hospital as well.

And I've never been so engaged in my patients before - I use to call when I've got days off just to see how 'my' children are coping. Sometimes I think it's dangerous and that I'll get burnt-out, but on the other hand, I guess it's better making a quick call and then feel ok, compared to spending the whole day beeing worried.

It's simply the best place to work.