Giving Chemotherapy not certified

Nesher, BSN, RN · May 13, 2005

What kinds of chemo are you talking about? Methotrexate for RA type chemo?

What state is it that you live in that allows this?

Have they heard of the Dana Farber case several years ago when a woman received basically an overdose of her prescribed chemo and it had passed the scrutnity of several pharmacists, and RNs? The attending as I recall wrote the wrong amount...

That said I would maybe drop off a copy of this story to your director and inform her that despite the lax attitude of the state, you are not comfortable administering these drugs without further education.

You know the other aspect of this is that chemo needs to be double checked by another RN (in my state they have to be certified) not only the order, but the dose and of course at the bedside.

Do you have an oncology CNS or a nurse educator in your hospital to back you up?

MGM33 · May 17, 2005

What kinds of chemo are you talking about? Methotrexate for RA type chemo?
What state is it that you live in that allows this?
Have they heard of the Dana Farber case several years ago when a woman received basically an overdose of her prescribed chemo and it had passed the scrutnity of several pharmacists, and RNs? The attending as I recall wrote the wrong amount...
That said I would maybe drop off a copy of this story to your director and inform her that despite the lax attitude of the state, you are not comfortable administering these drugs without further education.
You know the other aspect of this is that chemo needs to be double checked by another RN (in my state they have to be certified) not only the order, but the dose and of course at the bedside.
Do you have an oncology CNS or a nurse educator in your hospital to back you up?

I live in Kansas. I have given Methotrexate injections before on an outpatient basis. I have not actually given the chemo yet but have been told I will and I don't know the name, but I will find out. My boss is sending me to for a "shadow" day at a cancer center where our oncologist practices so I will be 'educated' on the medication.

And no we do not have an oncology CNS or nurse Educator. And if you can believe it if the drug is not premixed I will most likely mix it myself. We mix most of our IV fluids and medications ourself. But we do have a pharmacy here M-F.

Nesher, BSN, RN · May 17, 2005

Wrong. Do NOT mix chemo yourself - I won't get into mixing other drugs yourself, but for gods sake don't mix chemo. It requires a bit more than a space on the counter to do so- speciality hoods to suck the air up and away from you for example - and this skill takes more than a day of shadowing someone in a clinic. Run screaming away from this one!

TypicalFish · Jun 8, 2005

I live in Kansas. I have given Methotrexate injections before on an outpatient basis. I have not actually given the chemo yet but have been told I will and I don't know the name, but I will find out. My boss is sending me to for a "shadow" day at a cancer center where our oncologist practices so I will be 'educated' on the medication.
And no we do not have an oncology CNS or nurse Educator. And if you can believe it if the drug is not premixed I will most likely mix it myself. We mix most of our IV fluids and medications ourself. But we do have a pharmacy here M-F.

While I am just a new grad, I worked for years as a pharmacy tech-mixing chemo is not something you just "do"-not on a counter, not at the nurses station and certainly not with one day of shadowing! We had negative airflow hoods, special gowns, goggles and gloves. Some chemo requires vented needles when mixing(think of a shook up soda), filter needles, special tubing, etc etc. Does your state require that a pharmacist mix chemo? Think of what chemo does-besides the entire 'get it right' patient liability factor (which is HUGE), there is your safety and that of the other staff-what happens if you have a spill? It's tetragenic; It's basically poison! You need to aproach whomever is in charge with a planned speech and some facts to back you up-but whether or not you decide to administer, please don't mix it yourself; it would be such a dangerous choice-