Outpatient Oncology Shift

annacat · Jul 14, 2011

Wher I work.

We arrive at Clinc at 0800.

Look at patient list for the day.

See if any of my patients who need to get started with hydration or premeds, blood products, or even chemo are in the treatment area. Get them started.

Look at patient list for the next 2 days, request orders from MD's/NP's for those patients, file charts to be taken to pharmacy.

Keep an eye on today's patients schedules, labs as they become available,

let pharmacy know to make patient's chemo when labs are back and within normal limits.

If labs are not good or if pt has symptoms that are not good (SOB, DOE, dizziness, fever, wounds, new bruising or bleeding, uncontrolled nausea/vommiting, rigor...) page doctor for advice or to come see patient.

It generally takes our lab 1-2 hours to result blood tests. So by 10:00 it is time to start telling pharmacy to make patients drugs.

Once chemo or blood products arrive 2 rns check it against orders and patient data.

Administration of chemo can take from 10 minutes to 8 hours per patient depending on the treatment.

There is lots of paging doctors for orders and to come see patients with changes in conditions.

Lots of time in front of the computer checking labs, charting, emailing and paging, answering phone for treatment area.

You get to know patients pretty well because they usually come in at least once a week if not more for treatment. (this is the best part of the job!)

You work with the same RN's all the time (can be great or really bad depending on personalities). I was told when I started working in the OPD that my job would be very autonomous. This is true in some ways. As I become more experienced and comfortable I can anticipate what orders I will need and communicate with the doctors efficiently. But there is a lot of working with other RN's, a lot of negotiating for treatment spots, checking chemo, helping out.

We work closely with our C.A.'s , they get the vitals, draw blood, start IV's, work hard, and don't take any lip in our clinic.

RN's in our clinic are assigned to 2-3 MD's each. Over time you develope a working relationship with the MD's. Most of our doc's are really nice and professional and easy to work with. Some are more difficult.

The ideal patient load per day is about 6 (our patients tend to be sicker than most). We do go up to 8, 10, sometimes 12 patients per RN but usually many of these patients would be just lab count checks, or shots. 12, 5 hour chemos would be enough to make you never want to come back to work.

I usually get out by 4:30 or 5:00pm. Some days I am scheduled to come in and hour or two later and stay that much later. Some days I work in our separate ports area accessing ports, drawing labs from ports and PICCs, and changing PICC dressings.

A lot of Out Patient chemo clinics require RN's to mix chemo and start IV's, mine doesn't.

Do you have Oncology experience?

If you do it will make it easier to get into the swing of things. I didn't and found myself wishing I had. But I made it through orientation and probation and after 8 months I am really starting to feel like I know what I am doing.

:lol2:

springybaybee · Jul 16, 2011

thank you for your response! It is very helpful reading about what a typical day will be like. I will start in an Oncology-Surgical unit next week, have no prior experience and am quite nervous.

annacat · Jul 23, 2011

I guess you have started already.

How is it going?

springybaybee · Aug 4, 2011

Oh I will actually start on Aug. 8. I was suppose to start earlier, but there were some issues that needed to be resolved. I will let u know though :yeah:

Nurse1242 · Sep 17, 2015

Thank you so much for this! I have an interview for an outpatient position at a cancer clinic next week and I am a new grad. I would love to have this position! How many nurses are usually hired for this setting?