Chemotherapy training

[Mayiri]

Hi. I'm curious as to how other facilities train their new chemo certified nurses. I have noticed that at mine, after the two day ONS course, they sign you off three times on a checklist and boom, that's it, you can double check chemo with any other chemo nurse and hang it. I've noticed that the new nurses don't feel safe since they don't know the pharmacology of what they're giving, in the sense that you know how Protonix, Levaquin, Neupogen, etc work. So, how do other hospitals and units train new nurses? Do you get a few days in an OP setting, if available, where you see drug after drug and the cancer it treats? I'd think that'd help nurses become familiar. Any other ideas? I'd greatly appreciate any input.

[msjellybean]

I started on an in-pt onco unit in February and I've not yet gotten my certification. The way our unit educator does chemo certification for new grads is thus: she has us on the floor for several months, getting exposed to all of the different types of chemo and the cancers they're used for and their side effects. Then she does the 2 day ONS course, we take the test and then we're good.

Her rationale is that by being around the chemo and getting familiar with it, it gives us a basis to more easily remember the things we learn in class.

For example, a couple months ago, the unit educator had a pt who was in for induction for AML. She was getting her second dose of adriamycin and she grabbed me, put a chemo gown on me and informed me that I was going to push the adria (under her supervision & guidance, or course).

[Mayiri]

Yes, on our unit we also have a year's experience before we go to the 2-day course. So, I guess their idea is like your educator's, in that we'll take care of patients who have had this chemo before, and now we take care of them going through the side effects, so our familiarity builds up, but non-certified nurses don't usually have pts currently receiving chemo during their stay; they're assigned to chemo-certified nurses. So, novice nurses aren't always exposed to actual chemo administration often, like it seems your educator does to you.

Thanks for your reply.

[msjellybean]

We try to have all the chemo patients (even if they're only getting chemo during the day) go to chemo certified RNs, but sometimes it's just not possible. We're a small unit (12 pts max) and some nights, we only have two RNs. If it's just me and another RN, it doesn't always work out that she can take all of them.

Really though, the only time I ever get chemo patients (since I'm not on orientation, which is when I got some chemo exposure when I still had a preceptor) is when they're on an off day in their cycle or they're discharging the morning after the night I care for them.

[Abbygirl09]

Mine was similar to yours, after about 9 months on the floor I completed the two day ONS class, took a competency exam (50 questions), and had 3 check offs or return demonstrations. I heard the training was sporifice before I started it so I had started watching other chemo certified nurses hang their chemo if they didn't mind me tagging along. If you aren't comfortable you can still watch other nurses, and someone will always be double checking you. I agree chemo is the scariest drug I have ever given and I think its normal for it to make us nervous, considering the toxicity and side effects involved.