Overwhelmed

[Sadie85]

So I recently just started a job working with cancer patients in a physicians office I have no experience prior to this having been in the operating room for the past two years so I am feeling like I'm fresh out of school learning to do assessments all over again. It is a super small physician office having only two nurse practitioners and one doctor as well as an administrative assistant. I have a passion for this type of work which is why I applied for the job. But now that I'm here I'm realizing that it is way too small a practice and that my orientation was less than helpful. There is so much to do and just not enough time to do it I ask for help from the other nurse practitioners but I feel like they see me as a bother and we have no medical assistant to assist with this and I am at my wits end trying to acclimate myself to my new environment. I've never dealt with patients calling for pain medication or given instructions on cancer care before. My duties calling patients, scheduling surgery, coordinating between the other members of the oncology team, make sure the clinic is stocked with equipment and that it is not outdated, as well as scribing for the physician. Does anybody have any ideas to help me get better acquainted? Feel completely useless here having had no experience and really not starting to get things. I feel like they're losing patience with me. I have no interest in quitting but I'm really having a hard time getting the support that I need.

[OCNRN63, RN]

First of all, I would suggest that you join Oncology Nurses Association. They have wonderful resource and educational materials. If you join, you can also connect with your local ONS chapter and network with other oncology nurses. I would suggest you take some of the CEs they have for new oncology nurses. One of the resources I found helpful when I first started working in oncology is their Core Curriculum manual, which covers all kinds of oncology practice issues.

Are there policies for how to handle calls for prescription renewals? If not, I would talk to one of the docs/NPs about developing policies so you know what to do. Get to know websites that offer patient education, e.g. Chemo Care. This site has good information regarding chemotherapy drugs that you can print out for the patient.

When someone gives you instructions on how to do something, jot them down in a little spiral notebook that you can keep in your uniform pocket; that way you don't have to ask again.

Those are just a few things I can think of off the top of my head. It takes a while to get the knack of things. I went to an onc. office after ~25y of experience in other areas of nursing. I felt like a fish out of water for quite a while...very frustrating! Eventually things came together. Give yourself some time...you'll get there.

[Sadie85]

So I'm six months in now. And I feel very little has changed. My preceptor is completely unapproachable now and I'm really having a hard time. She keep saying things like I don't understand why this is taking so long we've had other nurses in this position for a less amount of time. She says I'm careless and I lack follow through. I don't feel as if I can approach management because they're changing now and frankly I should've spoke up earlier but I honestly thought that I could power through and things would get better. But it's not. I did join the oncology nursing Society and I am going to be purchasing the bundle on breast cancer. But I'm really torn because I have so many roles in this clinic and it's hard to know which ones to focus on. It's such a small clinic there's less than five people working on it, but we do volume. It's hard because we all have to know each other's jobs that way if one of us isn't there we can still function as a clinic. The doctor is extremely supportive but I'm just not getting that from my fellow nurses or nurse practitioners that is.

[annacat]

Either you are disorganized and lack follow through or your preceptor is a bully.

You need to ask your self which is it.

If your preceptor is a bully ask for another one. If you can't then maybe you need to either get help in managing a bully or find another job.

If you are disorganized how can you change that? Do you need to spend extra time coming up with an organizational plan for yourself?

If you lack follow through. How can you change that? Set reminders on your phone? check lists?

How do you eat a tree full of apples? One bite at a time. ( I changed that from how do you eat an elephant because I find that to be totally distasteful and disrespectful to elephants).

[Johnsla1]

Hi I'm two months in and having similar issues. My orientation was supposed to be eight weeks with one preceptor, it turned in to three different ent people who do things very differently, which was very confusing. It was also only 3.5 weeks before I was put in to regular staffing. I'm still lost. We mix our own chemo so I'm very slow. I also STILL do not have a good resource to tell me which drugs to wait for the renal panel to come back on before starting. I am very frustrated. It doesn't help that my IV skills are still not great, I've been in an office setting for several years. Now, my manager is going to work with me and I'm freaking out about being fired.