Oncology vs. Med-Surg.

herowneulogy, BSN, RN · Feb 17, 2011

BUMPING THIS FOR GOOD MEASURE

OP, your font color = eye sore, no offense :)

NICURN2013 · Feb 21, 2011

I would love to know this too! I'm a student nurse on the Oncology floor this week. It's my first term in clinical.. we don't get any information about our patients before we're there, so I'd love to look things up and get to know some procedures I might be doing.

Thanks!

CharmedJ7 · Feb 21, 2011

At my hospital Oncology is a Med-Surge specialty floor. One piece of advice/wisdom I always keep in mind with onc is that onc is everything: chemo can cause cardiac issues (as can some cancers like pheochromocytoma), cancers can be anywhere and manifest as complications as just about any system, and cancer hits every type of person and none of their pre-cancer conditions go away.

The thing is that in addition to the normal med-surge stuff they also might have chemo to deal with with usually requires special certification and training and additional things to look at (WBCs, neutrophils, platelet count) or if it's IP (intraperitoneal chemo) things like turning schedules and precautions with outputs. There's more focus on infection prevention and neutropenic precautions on such floors too b/c with a lot of pts it's not the cancer, it's an infection that kills since the chemo knocks their immune system flat. You may also see more blood clot and PE issues since cancer is a hypercoaguable state. You will probably also see more central lines and port-a-caths.

There's also an added psychosocial component I think esp with things like pancreatic CA which strike young people and seem really unfair - done so many intake with pts who, when you ask about social habits and medical hx they're like 'no smoking, no drinking, no drugs, no medical hx, always been healthy' and there's just this unspoken (or spoken) thing hanging in the air of "why me?" But then, that also contributes I think to part of the appeal with this population, I think generally onc pts are more grateful on a whole then other populations and a lot of them are really fighters and that can be amazing to see.

I work in surgical onc and although it's kind of a "specialty" I see my fair share of DKA, COPD, HTN, Gout, PE, Heart failure, Afib, etc. It's not that different from other med-surge floors, I get 4 patients generally (5 if they're being cruel and we're short-staffed), sometimes I have time to look through their chart fully, sometimes not. There's a lot of really fascinating things I see, especially with newly diagnosed pts, to see what they present with, like a pancreatic CA pt coming in as flourescent yellow or a adrenal tumour pt coming in with hirsutism and crazy high BP. It can be really sad and draining because a you see a lot of young and/or terminal people, but I think it's a great area, and I'll even say a good generalist field to start in.

nursie_pants · Feb 21, 2011

I work on a medical oncology floor at a large hospital. Our patients are either solid tumor (e.g., lung, breast, pancreatic CA) or hematological (e.g., leukemia, some lymphomas). We don't have GYN-onc on our floor.

Anyway, patients are generally there either for (a) treatment that requires in-patient status (chemo over several days, or close monitoring), (b) symptom management (pain, nausea/vomiting, fevers), or in some instances © previous cancer history and the hospital wasn't sure where else to place them. :)

Work load is similar to other med-surg type floors but our patients tend to be a little more critical. After chemo, your blood counts drop and immune system is compromised; many are very susceptible to infection/sepsis. Common transfers to/from ICU. We hang a lot of blood products. Some patients are up ad lib; others are "totals". Age range is around 19 and up. Many patients are repeat visitors. At end-stage of their disease many patients are discharged on hospice and some die on our floor.

There is a fair amount of variety as far as clinical skills used: around 75% have central lines, some trachs, G tubes, NG tubes, TPN, and chemo (obviously) and the precautions that go along with it.

Hope this helps and good luck. :)

dianearc, BSN, RN · Nov 24, 2018

I work on a medical oncology floor at a large hospital. Our patients are either solid tumor (e.g., lung, breast, pancreatic CA) or hematological (e.g., leukemia, some lymphomas). We don't have GYN-onc on our floor.
Anyway, patients are generally there either for (a) treatment that requires in-patient status (chemo over several days, or close monitoring), (b) symptom management (pain, nausea/vomiting, fevers), or in some instances © previous cancer history and the hospital wasn't sure where else to place them. :)
Work load is similar to other med-surg type floors but our patients tend to be a little more critical. After chemo, your blood counts drop and immune system is compromised; many are very susceptible to infection/sepsis. Common transfers to/from ICU. We hang a lot of blood products. Some patients are up ad lib; others are "totals". Age range is around 19 and up. Many patients are repeat visitors. At end-stage of their disease many patients are discharged on hospice and some die on our floor.
There is a fair amount of variety as far as clinical skills used: around 75% have central lines, some trachs, G tubes, NG tubes, TPN, and chemo (obviously) and the precautions that go along with it.
Hope this helps and good luck. :)

Hi í ½í¸Š I also have an interest in oncology but have qstns lol. So are there any concerns regarding side effects to nurses working in oncology? Pregnancy/infertility concerns while working in oncology? Totals...back issues? Advice? It appears to be like med-surg plus a whole lot more...so what are the patient-nurse ratios?

jawrn123 · Dec 13, 2018

hello everyone,
i'm not sure which one i am really intrested in. i would love to work in both but, could anyone give me an idea of what you do on an oncology floor from day to day?
thank you in advance for any help!! :heartbeat

Hi, Did you end up choosing oncology? If so, how do you like it?

Iwillsurvive · Jan 18, 2019

Think of oncology as med surg on steroids. you're treated as a med surg floor with patients that are critically ill and many who should probably be in SICU. oncology will make you hell of a good nurse. regular med surg nurses dread going to my floor because of the acuity.

db2xs · Jan 19, 2019

I worked in heme-onc for almost five years. I can't say whether heme-onc is med-surg on steroids because I've never worked in med-surg but we were taking care of primarily step-down-type hematology patients on a tele floor, so there were a ton of medications (almost all IV), ton of infusions (chemo, immunotherapy), symptom management. Also on our floor we took care of the more "stable" vents, managed tube feedings, cardiac drips--you name it. The only things we did not do were auto or allo transplants.

To answer dianearc's questions, if you want to get pregnant, then chemotherapy is a concern, of course, but not so much before getting pregnant--otherwise, half of the RNs wouldn't be able to work. The minute someone finds out they're pregnant, however, they should tell someone. I think back issues would go with any unit, not just heme-onc. On my unit, day shift had a 3:1 ratio unless we were severely short-staffed, sometimes (rarely) 2:1 depending on what was going on with the patient.