Is hanging chemo a health hazard?

Nurses General Nursing

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I work on an oncology floor. The nurses I work with are kind of banding together to insist that the chemotherapy be rotated to different nurses. They feel it's a health hazard to be hanging chemo all the time ( some think they get all the chemo patients); management says it's a medication and we should assume we'll be hanging chemo when we come to work- after all, it's an oncology floor. So they don't feel the need to rotate it (although they do), and they don't see why they have to have another list of who did what when.

So who is right? I'm particularly interested in hearing from other oncology nurses. You wear protective gear right, and in the old days nobody did. Is that enough? Are the nurses I work with being unreasonable?

Thank you.

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It's a medication. Yes, they are being unreasonable. The risks of hanging a bag of chemo are so minute as to be laughable, certainly compared to many of the other "accepted" daily routines of nursing care.

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Specializes in LTC, Psych, Hospice.

I'm confused:confused:

Wouldn't one assume they would be hanging chemo if they work on an oncology floor?

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It is a medication and yes, you would think on an onc floor it would be expected to be part of the job. I would make sure to wear all the protective chemo gloves, gowns I could find. I have a nurse friend who did oncology for 20 years...before special gloves and other precautions were in use...she now has brain cancer....coincidence ? maybe/maybe not but there is no way to tell...

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

If they are working an oncology floor one would think the expectation would be to hang chemo...thre CDC states.

Since it was first recognized that occupational exposure to antineoplastic agents posed a potential health risk to workers exposed to these agents, various groups, institutions and agencies around the world have developed and published guidelines or recommendations for handling antineoplastic agents. The most often referred to guidelines in the United States are the OSHA Technical manual: Controlling Occupational Exposure to Hazardous Drugs revised in 1995 and the NIOSH Alert: Preventing Occupational Exposure to Antineoplastic and Other Hazardous Drugs, published in 2004. Others include handling guidelines by the American Society of Hospital-System Pharmacists, the Oncology Nursing Society and the International Society of Oncology Pharmacy Practitioners.

http://www.osha.gov/dts/osta/otm/otm_vi/otm_vi_2.html

http://www.cdc.gov/niosh/topics/antineoplastic/pubs.html

I hope you find the links helpful.....:)

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Specializes in Oncology/Haemetology/HIV.

If you/the pharmacy are using proper chemo precautions, AS LISTED BY THE ONS/OSHA!!!!! AND YOUR FACILITY IS PROVIDED PROPER NONREUSED PPE, it is safe.

The issues:

Some facilities reuse chemo gowns or provide ones that cloth and not impervious to fluids. Or nurses do not wear N95 when at risk of aerosolization.....which if proper technique and valves are used, is not a risk. Chemo should be hung and backprimed, or primed in pharmacy under the biohood. There should be NO contact between nurse and chemo, and PPE should be always worn regardless.

Too many places reuse gowns or thick gloves, or nurses are careless and do not where them. Despite the wellknown risks of thalidomide exposure, I find nurses crushing it. I can explain til I am blue in the face that it aerosolizes the drug, and risk the fetal safety of anyone who walks in.

The other issue which is bigger. Most nurses try to obey precautions when hanging the med......but are extremely careless when handling the pts sheets, urine specihat, urinal. When was the last time you saw them doublegloving, covering the commode when dumping urine/stool, and keeping the commode covered while flushing it twice.

If your coworkers are so worried, they should not be working Oncology. Even they do not handle chemo, they still will be handling the byproducts. It is also not fair to those that get stuck all the time with the task. Like source containing radiation pts, the perceived risk should be spread around.....you don't have the same nurse day after day handling rad implant pts, as they may exceed exposure limits quickly.

Also, remind these nurses that eliminate risk when they leave Onco, they cannot work in OR, L&D or PACU (anesthetic gases), pediatrics/ID or ICUs (retonovir and gancyclovir are probably more dangerous than chemo), or ER/Trauma (those scary gunshot wounds)

That really limits the safe places to work, doesn't it.

(PS The ONS AND OSHA have reviewed numerous studies involving pregnant nurse. If all PPE, safety connectors and recommended precautions observed in preparing and delivering chemo are performed there is no danger to the pregnant nurse. Key words being ALL precautions. Having said that, I have no problem hanging chemo for pregnant colleagues. By the same token, being fussy about hanging chemo. And yet continuing to care for the chemo pt, helping them, emptying the bedside commode, changing their sweating linens without gloves.... Shows a lack of logic.

But the

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I work on an oncology floor and we must first be certified to hang chemo, and most of the nurses on our floor are not certified (and they usually wait until you have been working a while before they send you to the class).

I don't think it is fair to have the same nurses always have to do the task (unless they want to).

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