Chemo without pumps???? A little long

[Ivanna_Nurse]

Hi all, I am a fairly new nurse with ICU experience and now work in an outpatient Chemo/Hematology/Internist office. I left ICU because of several reasons and relieved to be on days with no weekend or holidays.

I was born into a world where I look at my pt's charts and really know whats going on, from H&P's to CT results. Here there isnt time for that. Its more like get em in, get em started, get em out, cause there are more waiting...

I have a few concerns including the absense of pumps, and am afraid that I dont even know just exactly how much I dont know. (if that made sense) No crash cart/AED. No pulse ox. Nothing of that nature and that worries me ALOT.

There is one RN- myself for the office. The nurse checks labs, does the medport accessing, draws and flushes. The nurse mixes the chemo, starts and discontinues infusions.

I will be on my own starting the 1st of December and the gal I am replacing will be done as of Wednesday. I will have had 2 full weeks of training by her. (if you can call it that)

Typical day consists of 8-16 chemos in am, 2-3 infed Iv's, 5-10 procrits/B12's and then afternoon appointments that are non chemo.

I have no chemo experience, its been an on the job thing.

No pumps for chemo... I find it difficult to mix, switch over bags, start lines and disconnect these folks all by myself.

I guess that I am afraid that things are a little lax here and I worry about everyones safety, including mine. I LOVE the patients, they are the nicest. The doc is wonderful and keeps reassuring me that I am doing great.

I come from ICU and this is a whole different world. Is it just me?? I'm not sure that I am loving it, or if I will. Tell me what you guys think.

Thanks, Ivanna

[nursemary9, BSN, RN]

Thanks for all of your replies and advice. I just wanted you all to know that I am going back to ICU..on night shift...where it is safe..and where I belong. :snowman: Ivanna

Hi

I'm so glad you're leaving this situation.

NO ONE should be giving Chemo without being Certified; That said, YOU SHOULD ABSOLUTELY NOT BE MIXING

any Chemo.

You were in a VERY damgerous situation at that place.

Again, I'm very relieved to hear that you left!!

I KNOW all about Hem/Onc -- I have worked here more then 25 yrs. We do so much checking with various peoples.

[schlemj]

This is unsafe, in the clinic I work in we have a policy that no nurse works alone, there is always another oncology nurse working. We cannot put one drop of chemo in a patien without another onc nurse checking the order, dose, calculation and then co signs (two initials required) in the med book. We do mix our own chemo under the hood with gloves and chemo gowns. Also if ther is an emergency/reaction you should have more than one nurse to help! Call the MD, get the oxygen, emergency meds/equipt and someone needs to be tending to the other patients!! what if there happens to be more than one reaction at a time? It's happened were I work.

We use pumps for most everything but on a very busy day we may be short pumps, so things like 30 minute gemzar or carbo can be titrated and run according to the drip rate on the tubing-eye balling frequently of course. How the heck do you run rituxan w/o a pump??? Listen to your instincts as a nurse-you are right.

[bethchpn]

I too am grateful you are out of this situation. However dont feel that all oncology is bad. We have wonderful patients and it is a very rewarding field to work in. That is, if it is a safe situation.

[mtwife]

What a disservice to the patients. I wonder if they are aware of how unsafe the situation is. One nurse can only do so much. . . I sometimes get overwhelmed with 2 RNs plus a tech mixing chemo in our clinic when we have a busy day. So glad you left. I LOVE oncology and the patients are wonderful and complicated and they deserve excellent care-- meaning safe staff ratios and lots of safety measures like double/triple checking orders, use of IV pumps, etc. Reminded I'm blessed at my job (even when it's frustrating or overwhelming!). Hope that clinic get's its act together for the sake of the patients (and nurses!).

[Ivanna_Nurse, BSN, RN]

Thanks for the replies guys. I really did LOVE the patients, and I do miss them... I find that I am glad to be back to the ole hustle and bustle, although the nite shift absolutely stinks. I havent been a nurse all that long, but long enough to know what feels right. Thank you again, Ivanna

[paxphish]

Hi- I think you know what you need to do..always follow you're instincts...