Unsafe Situation

[BearLV]

Hey all, I am a new member of the bb - and would like everyone's opinion on a situation I experienced a few weeks ago. I've been working on an oncology floor for approx 6 mos - my previous background is med-surg. Anyway, the oncology floor is fairly new in the hospital, so most of the time we only have a handful of actual oncology patients and the rest of the floor is med-surg. Consequently, I do not feel very experienced in oncology, and am not yet chemo-certified.

So, a few weeks ago on a Saturday, I show up at work to find out two nurses had called in sick - the charge nurse and an experienced nurse on the floor. That left me, and V., another RN who had started on floor at the same time as me - also pretty inexperienced in oncology and not chemo certified. Staffing so graciously provided us with an LPN from another floor and an agency RN - yep, neither one an oncology nurse or chemo certified. And of course, there happened to be a chemo patient on the floor. V., who has been a nurse longer than I, had to work charge with no training. That left me, the only other regular staff nurse on the floor to take the chemo patient.

Being it was a Saturday, V. and I decide to page our nurse manager to ask for help, what to do, etc. Oh- I forgot to mention that our manager also staffs the hospital's outpatient infusion center - for patients to get outpt chemo, IV abx, blood, etc. So, the nurses managers solution? - he will have the infusion center nurse, who leaves at 2pm, hang the chemo, and V and I should just "be careful and monitor the patient closely"

Needless to say, I was pissed. Easy for the nurse manager to tell me to "be careful" - it is not his license on the line if something happens! Sure I could refuse the assignment, but that would leave V, who was already overwhelmed with working charge or an agency nurse to take the patient. I thought both of these situations would be worse for the patient, so I took the assignment. As it turned out the patient was fairly young and stable and tolerated the chemo well, but I still shudder to think about what could have happened.

I had already turned in my resignation about a week before this happened, and this whole situation just reinforced my decision to leave. If they would do that to me, what else can happen in the future? Anyway, if anyone has any thoughts on how else I could have handled things I would be glad to hear them.

"Without struggle, there is no progress." Frederick Douglas

"Wanting to be someone else is a waste of the person you are." Kurt Cobain

[renerian, BSN, RN]

We always had floats monitor the client and we hung the chemo on our floor. We took some time to tell them what to look for and how to protect themselves as far as secretions. I hope your signed up for your classes soon. Takes away all the unknown which is always scarey. I loved oncology.

renerian

[mattsmom81]

Quite often IME there is only one nurse on duty in the facility who is chemo certified, so they will hang it and take it down for us, give us a quickie inservice on monitoring, and move on. Perhaps it is not ideal circumstances but in today's hospitals it isn't uncommon.

I'm sorry you are feeling overwhelmed. I agree with Renerian and perhaps if you take a few inservices this will pass quickly...I did Oncology nursing when I was young and it has a place in my heart. Perhaps if you have a heart to heart with your manager you will feel differently...perhaps not but never hurts to try.

Good luck to you! :)

[caroladybelle, BSN, RN]

Agree with Renerian for the most part - but it really depends on the drug and what kind of line.

If something like carboplatin or 5-FU, I wouldn't be too worried.

If it were something like Retuxin, L'asparegase, Herceptin, or Taxol - then I would worry a LOT more.

Also, vesicants being given peripherally would be worrisome, also.

[nurse2002]

Snookie

I hate to say this........but welcome to the real world of nursing.

Not a person we work with or for cares about our license but us.

Please, dont ever take an assignment you are not comfortable with. If anything would of happened that supervisor would not of been there for you. You would of been left alone to defend your license. And at your expense and your families expense. Even the most competent of us could make a mistake when we are forced into a position to take an assignment that we are not trained for.