Oncology rotation

decembergrad2011, BSN, RN · Jul 22, 2012

We did not perform IV starts in my semester on peds patients. This may or may not be true for you.

Depending on your patients for oncology, you will probably see a lot of ports and central lines on your patients rather than peripheral IVs.

allnurses Guide · Jul 22, 2012

I wouldnt think you would be starting any IVs, especially in peds, but you may have the opportunity to give some IV pushes and set up fluids. Your onc rotation (should) introduce you to the care of complex patients as well as touch on end of life care; a lot of symptom management and meds as well.

phuretrotr · Jul 23, 2012

Thanks for your replies decembergrad2011 and de2013! Honestly, I would not want to do my first IV insert on a peds patient, so I really relieved both of you said the same thing on not starting IV's.

In your experiences, what were the skills most commonly used in the care of your oncology patients?

Also for peds, did your school have any information about how to talk to the young ones and their parents? I've always been interested in pediatrics but that's the part that scares me the most! I don't have a problem talking with kids, but I don't know if it will be different with them sick. Especially since their parents are watching your every move! Yikes! :uhoh21:

decembergrad2011, BSN, RN · Jul 24, 2012

oncology patients: blood draws (constantly checking anc, h&h, and platelets), pain medications, pca (patient-controlled analgesia) pumps, chemo, blood products, and iv piggyback antibiotics. you will not be able to administer blood products or chemo, but everything else you could assist with or perform. you may also see someone with a feeding tube and/or urinary catheter. like i said before, many oncology patients have a picc line or a port, and even if they do get a piv, they're hard sticks and likely need an experienced nurse to start an iv.

peds patients: use language that they'll know - i.e. "belly" instead of "abdomen" and "pee or poop" instead of "urine/void or feces/defecate." this will also be helpful in interpreting their replies. remember that kids are very literal, so if you tell them something, be wary of if it could pull up a negative concrete visual. get down on their level by kneeling or sitting. the parents are actually the key to building rapport with children - if mom and dad trust you, the peds patient will follow their cue.

this is a good start to communication with peds patients:

www.jumpstarttriage.com/uploads/baby_talk.ppt

classicdame, MSN, EdD · Jul 30, 2012

besides IV's of various types, you will have various meds to consider. Most are dosed by weight. Compare your numbers to Pharmacy's. What would you teach the parents/patient? What psycho-social issues are at play? Which meds interact with foods and other drugs (if you google the names of drugs that cannot be given with grapefruit juice you will get a LONGGGGGGGG list.)

LadyinScrubs, ASN, RN · Aug 1, 2012

besides IV's of various types, you will have various meds to consider. Most are dosed by weight. Compare your numbers to Pharmacy's. What would you teach the parents/patient? What psycho-social issues are at play? Which meds interact with foods and other drugs (if you google the names of drugs that cannot be given with grapefruit juice you will get a LONGGGGGGGG list.)

Normally in an oncology rotation you will not be doing clinical oncology but working with oncology patients who have a reason to be hospitalized. Because these patientns are sick, you will get an opportunity to practice your nursing skills because oncology patients have alll sorts of problems. decembergrad2011 was right. You will be keeping track of the patients labs and taking appropriate action to protect the patient. Since you are not an oncology nurse, you will not be administering certain oncology meds but will have an opportunity to do lots of other meds. Once I got over the huge amount of work that an oncology nurse has, I absolutely loved the rotation. It is challenging but a great learning experience.

phuretrotr · Aug 2, 2012

Thanks everyone for the information! As semesters go by, I feel we are getting more and more intense patients, as it should be, so I'm just extra nervous about the new challenging type of patient! Do you know if students go along to surgeries and radiation treatments?

allnurses Guide · Aug 2, 2012

Thanks everyone for the information! As semesters go by, I feel we are getting more and more intense patients, as it should be, so I'm just extra nervous about the new challenging type of patient! Do you know if students go along to surgeries and radiation treatments?

Depends on your clinical site and instructor; observing XRT is likely (along with other procedures like bone marrow biopsies, PICC placements, plasmapheresis, etc). OR may be more difficult as they often limit the number of people in an OR.

phuretrotr · Aug 2, 2012

Depends on your clinical site and instructor; observing XRT is likely (along with other procedures like bone marrow biopsies, PICC placements, plasmapheresis, etc). OR may be more difficult as they often limit the number of people in an OR.

WOW! I have a lot to learn! :eek:

I just ask because I didn't do too well in OR... Didn't pass out, but was not far from it :barf02:

I'm excited to see what all these words mean!