New Oncology Intern RN

Chasity2495 · Sep 1, 2012

I so glad you posted this. Congratulations! I too graduated in May, took my NCLEX in June and passes 1st time. I was hired to an Oncology floor a few weeks ago. My orientation starts September 24. I am excited, but so nervous. I haven't done any hands on nursing since the end of April. I too would love to hear what the new and seasoned Oncology nurses have to say for the new graduates. I did 2 clinical rotation on oncology and a 16 week rotation on a surgical oncology floor. Funny how, I wasn't really looking for Oncology; I guess I could say Oncology found me :loveya:

lollylolly88 · Sep 2, 2012

Hey! Congrats to you also! I start orientation on September 23! We both will be starting around the same.time so cool! Just like you said, I haven't either had any hands on nursing since April. I got a PRN job for a home health agency, but they are also non-medical so as a RN, I just.vital signs, teach classes, a little paperwork. I'm hoping the experience or new Oncology nurses can give us both great tips & pointers :):):):)

wamathashiru · Sep 4, 2012

Hey guys,

We all ( [Chasity2495, lollylolly88) have alot in common. I graduated last may with BSN, did my boards in july, and passed first time (75 q? btw), and hired to an oncology floor. I will start my orientation on septemebr 24th.. I am extremely excited but nervous. Never dreamt of being an oncology RN, but hey, am looking forward to it. Goodluck to both of you.....(if i may ask, does anyone of you live in Indy?)

Thanks

Chasity2495 · Sep 6, 2012

I live in NC. Good luck to both of you as well!

emilytoc · Sep 8, 2012

Hi y'all, I just got hired as an RN Intern on an oncology floor too! I graduated in April and passed my NCLEX in July. I feel so lucky to have this job. I'm definitely nervous about the challenging environment but also really excited for the amazing opportunity. My practicum preceptor was an oncology nurse for 18 years, and I consider her the most well-rounded nurse I know. I'm hoping to really develop a strong set of nursing skills while also learning how to handle the emotions that my patients are experiencing. Any advice would be appreciated.

Congrats to us! :)

Mangofruit · Sep 17, 2012

Hi everyone! I had an internship over the summer through school on an Oncology floor. I passed boards last week applied for a position on the same floor and had a phone call for an interview the next day. My interview is this Friday. So thankful for this opportunity. I hope I get the job, yet I am also so so nervous to begin my nursing career!

bbuerke · Sep 22, 2012

Congratulations to all of you on starting your new careers! This is an exciting time for you, and I wish you all the best. As far as tips/pointers go, there are a few things to remember when starting out as a new grad.

1) It takes time to adjust, usually about 6 months to a year before you really feel comfortable and get into a groove. This is normal and your manager, charge nurses and other coworkers should be supportive of this.

2) Time management is often the hardest skill to learn. So much of what we do is task oriented, but we still want to pull it all together into a comprehensive and thorough plan of care. That can be hard to do when you're concentrating on learning skills, but be patient. The skills will come the more you practice.

3) Watch the experienced people - learn from them, take the tips and tricks that work for you and leave the rest, you'll need to trust your own judgment on this.

As far as oncology specific stuff goes, there is a lot of info. Oncology is unique in that it can impact every bodily system in weird and bizarre ways. I once saw a patient with blue skin! No, he wasn't hypoxic, it was some sort of reaction between his chemo, liver and other meds. Strange but true. What you encounter the most will depend on the patient population you are dealing with. I've worked all kinds except pediatric. One was solid tumor w/ mostly head and neck, colon, and prostate patients: lots of trachs, g-tubes, foleys, ostomies and carotid bleed outs. One was solid tumor w/ tele overflow, one BMT and another medical oncology w/ inpatient radiation (lead lined rooms for MIBG and people w/ radioactive implants for cervical cancer or sarcoma). The most common things encountered on all of them were:

1) Interns and residents who are afraid to write for narcotics. In a teaching hospital they rotate so you need to get them comfortable with the cancer patient population. These people have cancer for crying out loud, they are not drug seeking. You need to advocate for your patients and get the docs to write for an appropriate dose that will actually do them some good.

2) Fluid/electrolyte imbalances: lots of dehydration, and complications from the cancer and treatment. You'll be giving lots of supps. Also blood products of all kinds. Folks with liver involvement may have impaired clotting in addition to low platelets, so FFP as well as platelets and PRBC's.

3) Risk of infection/neutropenic fever. Lots of antibiotics, contact precautions and protective isolation. Buy some decent lotion that's compatible with your facilities' products, you'll be washing your hands a lot.

4) GI/GU issues: diarrhea from disease, treatmemt, GVHD, etc. or constipation from the opioids. Either way it's a frequent symptom that needs to be managed.

5) Dyspnea/pain - more symptom management

6) Psychosocial needs for patients and families - this one is a no brainer. You very well may have your own "Terms of Endearment" moment. Just try to be understanding and not let their anxiety get to you. Everyone copes differently. Don't forget your own needs. See my post on "Am I the only one?"

That's all I can think of for now. It's 2am and time for bed. I wish you all the best of luck and please do keep us posted on how you're doing.

tebyrd0020 · Oct 19, 2012

Thank you bbuerke! Very helpful (and timely-i have an interview Thursday)

KountryPrincess · Nov 18, 2012

If I can add one thing to that wonderful post....you *will* get close to your patients, it is hard not to, and it is one of the benefits of being in Onc. Never forget that you are not thier friend, you are their *nurse*. You must be their advocate, a good ear for their problems, and an excellent medical professional. If the relationship changes into a friendship type relationship, you are robbing them of being able to interact with you as their nurse......ie they may spare you important info because they do not want to bother you or hurt your feelings. I have seen nursing staff get inappropriately close with their pts and it really disturbs the ability to give good care. Do not get me wrong.....I adored my patients, and you will always get more involved with some than others, but never forget that they need you in your professional role. It is ok to cry with a pt from time to time, but otherwise, let off steam about your feelings with you coworkers, friends and family. That will allow you to be the strong, confident, kind and above all, professional, nurse your pts need.