Hosp vs Office Oncology - New Nurse needs help ???

[JoAnna McNurse]

i am an "older, new nurse" having graduated from an accelerated bsn program and am about to finish 6 months on a med-surg oncology floor. this hospital is not a major cancer center but does have this designated onc floor.

i am absolutely going crazy on this floor. we have 4 - 6 patients, most of whom are not in for chemos or other agressive cancer treatment, but are in for management of various other problems related to their cancers or for end of life care. we also have 25-30% of patients who are not cancer patients at all, but just plain med-surg problems that get assigned to this floor.

i feel constantly feeling overworked and overwhelmed with all the craziness of this floor and...this is not what i wanted when i "signed on" to be an oncoogy nurse. i want to give chemo therapy and have good therapeutic relationships with my patients!!! i hardly get to say hello to my patients because there are too many with so many acute problems i can barely get the meds out, assess, handle new orders, etc. (all typical new nurse problems.....but problems never-the-less!)

i live in a large metropolitan area and there are quite a few large onc practices with infusion centers. i am thinking of trying to move on to one of them where i can learn to do chem like a want to. but.....i am curious to know if this type environment is as crazy as the hospital environment. maybe i should have more than 6 months experience before i make the change. (fyi, i was an oncology pharma rep for 15 years before i retired and went to nursing school because i loved what onc nurses do.)

- are offices as crazy/hectic as the hospital floor?

- do you have time to get to know your patients?

- how may patients do you manage at a time.

- will onc offices train a "newby?"

- can you give a general comparison of what to expect if i made the switch?

would appreciate any guidence of thoughts on this subject.

[SarasotaRN2b]

I'm hoping that posting to this it will bring it to the forefront again. I too would like to hear the answers to your questions. Maybe this can be moved to the thread for nurses working in doctor's offices?

I would think that if you are working for an oncology specialist, you will deal with patients actually suffering from cancer although these patients may have other health care issues stemming from the cancer.

You probably will get to know your patients a little more because they will be coming back to the doctor from time to time for treatments or checkups.

The best way to find out would be to speak with some of the oncology MDs that come to your floor. Offer to buy them a cup of coffee and ask if you can ask some questions, maybe they can give you some pointers.

Hopefully an experienced oncology nurse can expand on this.

[RADONC-RN]

Sorry for your frustatration as a floor nurse but I fully understand it. Been there, done that! LOL Most hospitals are like that though. Any bed equals money and Administration does not care who is put in that bed as long as it gets filled. I don't foresee this changing either. I work in Radiation Oncology, which runs like a clinic but is in the hospital. It is a fabulous job with some of it's own problems. Such as...my Manager is not a nurse and does not understand the nursing aspect of it. So be careful of that.

A few of my friends work in Onc offices. They say they are busy but not the same busy as in the hospital. You do get to spend more time with patients and get to know them better. Some offices offer different positions..such as giving chemo or putting patients in rooms for consults or follow up. Some actually rotate these jobs. Be sure to find out what you would be getting into. They do offer training but your training time would be short, not like in the hospital.

May I suggest to you to try a Outpatient Chemo clinic. Some are private and some are in hospitals. They can be busy too but they are oncology patients (not stroke pts or heart pts etc). The pt/nurse ratio would depend on what you are doing at the time. The majority of them are day shifts too. Maybe some weekends. The pay would just depend on the office. I also have found that Doctors act differently in the clinic than at the hospitals.LOL. They are much nicer at the clinic.

I hope this helps you in some way. Good Luck.:)

[FLONCNURSE]

Hi, I work in an outpatient bonemarrow clinic within the hospital and work at an oncologist office part-time giving chemo. I agree with working on a regular onc. floor that you dont have time to know your pts or give the quality of care they deservice, but its a learning experience as a new nurse to improve your organizational skills. I enjoy working within the clinic because it has allowed me to have a great bond with my patients and I cherish that very much, but it can also be very hectic with 40 pts a day. The patients like the familiarity and I know their allergies and dislikes. It is very rewarding, but it takes a nurse with alot of autonomy and strong assessment skills you can only learn by being on the floor a while longer. At the doctors office they come in and out like cattle and I am one nurse with fifteen patients, mixing chemo, doing PIV, blood draws and reviwing labs, access ports. You don't get to spend quality time. You know them and they know you, but that is it. Your best bet is to sharpen up on your chemo drugs , side effects and assessment skills before traveling off to an outpatient chemo clinic or oncology office. Be strong in your skills and area of expertise. You are the patient advocate and generally its the nurse who identifies the patients problems way before the MD's. Hang in there if this is what you truly desire. In the long run it will be beneficial to you and your patients. FLONCNURSE...