Outpatient Chemo Infusion RN- brand new nurse!

Posted
by KayHay KayHay, ADN (New) New Nurse Student

Hi all! I am a new grad and accepted a position in a cancer center working with outpatient oncology patients as a chemo infusion nurse. I’m so excited but also nervous because this is an entirely new area of healthcare I have no experience with. Any tips, advice or information on what a usual day is like would be wonderful! Thank you!!

DowntheRiver

DowntheRiver

Specializes in Urgent Care, Oncology. Has 8 years experience. 983 Posts

Does your organization pay for the ONS Fundamentals course? My job reimbursed me for it but I would have do it anyways.

Either way, it'll be very helpful.

https://www.ons.org/courses/fundamentals-chemotherapy-immunotherapy-administration

 

Be very familiar with your organizational policies:

Who obtains consent

Who approves orders (first time vs. repeat treatments)

Who alters orders (dose reductions, etc.)

Abnormal/reportable lab values (going to be very different in an Oncology setting)

A typical day is going to vary. YMMV. My infusion center is approximately 15 chairs. We have 3-4 nurses depending on the day, sometimes have a shot nurse, too. We take patients in rotation, or if you're able to. Our ratios are that you are expected to take 10 patients in one eight(ish) hour day. However, if someone gets two FOLFOX back to back while someone else has a phlebotomy and a Keytruda, it's expected the nurse with the lighter load step up and take another patient first. We don't have MAs on the floor but they get vitals from the MAs if they have labs drawn; otherwise, it is our responsibility. The nurse assess the patient and lab values. Contacts the doctor if appropriate. Access the port, PICC, start an IV, etc. We prep all our own pre-medications. Double check other nurses on the computer and at the chair side. Administer the actual treatments. Occasionally have a reaction (Campath is the bane of my existence, ugh). Sometimes it can get ugly but you work as a team and get through it. Currently, we don't have a triage nurse so we're responsible for triage as well.

Some of my Oncology friends at different locations, however:

Work in pods of 4 patients, have 8 patients max per day

Have medical assistants for blankets, vitals, snacks, etc. Where I used to work, MAs could access ports under RN supervision.

Have LPNs for shots, port access, IV starting

Some places expect you to mix treatments. I double check but I do not mix or push because I am not comfortable doing (female in child-bearing age)

Oncology is its own specialty of nursing.  It involves a lot of empathy. Most days are really good but some days just suck. I just had two of my patients pass on hospice rather suddenly and it hit me harder than I thought.