chemotherrapy administration

Our agency is recieving an increasing amount of chemo referrals. But we have a limited number of chemo certified nurses. Is anyone else having this problem and what are you doing about this?

[nursesearl, BSN, RN]

We do chemo and none of us are certified. What would you be certified in?

[renerian, BSN, RN]

I went to home health as a chemo certified nurse and did not get one case in 11 years. I don't know how it is where you are but the docs/hospitals wanted the outpatient clinics to keep that /get the money for the treatments. Was a huge turf war.

Hoolahan or Karen are you seeing this?

renerian

[Traveler]

We've been getting alot of IV Vanco. but never ever have we received any chemo. referrals. I don't believe there's anyone in our office who would feel comfortable doing this. Where are you located?

Ann

[gelia]

We're in Western Ky. It's mostly rural area. Up until recently the Dr's office's were giving all the chemo but medicare and some of the insurance companies have started to pay for home and not as much in the office. So we're getting referrals

gelia

[Traveler]

That's interesting. I'm in a rural area in SE Tennessee and we haven't seen this trend yet. I kinda hope we don't. I don't feel prepared at all.

Ann

[renerian, BSN, RN]

Not here in metro Columbus either.

renerian

[amesly15]

In rural Northern NY we have had a few cases. Recently I have seen cases where the Cancer Center will start a continuous chemo with a cadd pump then the home nurses would change the cassette q3day, change the huber needle to the infusaport, and do the dressing change. We send the nurse to the Cancer Center to see the set up prior to admit...they are not chemo certified. Cases are few and far between. I think the one I remember was a continuous 5fu on the cadd pump. Or we have discontinued the pump that was started at the Cancer Center in the past.

[Traveler]

I wrote about a month ago on this thread saying we hadn't had any chemo referrals. I spoke too soon. We did get one this weekend but did not admit the pt. I read something somewhere that said that docs USED to be able to charge an inflated rate for the chemo drugs if administering them in non-hospital clinic/office setting but that it would be reduced to what the drug actually costs. I don't remember where I saw this, don't know how true this is, but it could help explain chemo coming home!

Ann

[tburrell]

There really is No certification in Chemotherapy. There is certification in Oncology Nursing. My agency does some chemo. I take my nurses through a small course on chemo agents; are they vesicants or nonvesicants and what should be done with extravasation. Some very light brushing over how the different agents work and at what stage do they work. The nurses also have a drug book on chemotherapy. The nurses need to know all of this because the patient is going to ask. Hope this helps.

Tom