Mixing meds

[dreamrider212]

I have been offered a position in an outpatient oncology infusion center but it is a stand alone building that doesn't have an onsite pharmacy and so requires the nurses to mix the chemo meds. I know they have a mixing hood but I am a little worried about the safety aspect and whether this is a normal situation for oncology. I would appreciate any and all comments regarding this so I can make an informed decision as to whether to accept the position or not. Thank you

[gvrn13]

Hi, my first job out of school was an outpatient oncology center where I, along with the other nurses were responsible for mixing our own drugs. I actually wrote a similar question on here about the safety aspect and got a lot of good information. The nurses at this job, did not really even think twice about mixing. It was just what they did. There was a hood to mix, and gloves were always used, a gown not so much. I was always nervous doing this, but I did do it for about 6 months. Some nurses on here will tell you to not do this, that it's not right, but I have found that this is how it is done in the outpatient facilities in my area. If you are going to take this job, I would take the "chemo provider course" that is offered through ONS, your employer may pay for it. Taking this course is not certification, just more of a background of information on these extremely dangerous drugs and how they should be handled and side effects and such. I personally felt that I was thrown into that job, and was not really given too much info about giving chemo. Do some research, and see how you feel. Good luck!!

[annaotis]

I worked in an outpatient oncology facility apart from the hospital for 4 years. We had an in house pharmacist each day. The only time I ever had to mix chemo was during snowstorm. I lived close and was sent to call the patients to tell them not to come.One doctor and several patients drove in the storm. No pharmacist. I was scared out of mind. I did call one of our pharmacists each time I had to mix as I had no one to check it with. I would not want to do that again. Also, as crazy busy as we always were(only two nurses), there is no way we would have had the time to mix and hang. My worst day was 28 infusions. But most days it was around 10. Personally I wouldn't take the job if I had to mix. There are pharmacists for a reason.

[SoldierNurse22, BSN, RN]

Nowadays, no--it is not a standard scenario for oncology.

When I worked in oncology, we received our chemo--mixed with IV tubing primed--from the pharmacy. It was actually a policy that it come primed to us from pharmacy so as to minimize our potential exposure to the chemicals.

[SierraBravo]

I've read about this practice in the past. The Chemo and Biotherapy provider course from ONS is not going to do anything for you in terms of being responsible for compounding chemo. There is so much more to the process than just reconstituting vials. For example, you need to understand the way a vertical flow hood works and how to manipulate items in the hood. There is no way whatsoever I would take a job like this unless there is proper and thorough training by a licensed Pharmacist.

[L♡vER]

I just interviewed for a similar outpatient position, and was shown the *lab* area where the chemo is mixed. This is solely done by the RNs. Thoughts? Can I be taught to do this safely? I am highly ignorant of chemo since it's barely touched on in school and I've never worked with it in the inpatient world. I guess I am going to exhaust Google and see what I can find :)

[ShantheRN, BSN, RN]

I work in inpatient peds oncology. We can't even cut oral chemo on the unit. Everything has to be done by pharmacy for safety reasons. I've never looked into it, but there was a big to-do at my hospital about RNs compounding regular meds. It is considered outside our scope of practice and we're not supposed to do it...at least that's what pharmacy told us.