AAOnc22

outpatient infusion centers that I've worked at we usually let the patient decide. If they have treatment multiple days in a row we will let them leave their port accessed and go home as long as they know to be careful and to cover the dressing if showering. I'd say it's 50/50, some patients want to leave it accessed and some don't. If there's a day or more between appointments, we will deaccess.

In general, oral chemo's shouldn't be crushed anyway, there's a reason it is a pill and not a powder. You could try doing some research on if the chemo is available in other forms/routes but usually that will cost more and insurances won't cover it, especially if she passed a swallow eval for pills. Your best bet is to try and get a waiver from the facility to allow her to swallow the chemo, whether administered by their nurse or by family. The only other option would be to switch SNF facilities....Which may be worth the hassle since this chemo seems promising.

I started on BMT as a new grad and while I think there is a lot you will only learn on the job once you start, I think it could also be helpful to have a general understanding of oncology/cancer in general. ONS and many other websites/texts will have good information on the basics of cancer. Prior understanding how cancer, chemotherapy, and radiation all "work" will be beneficial as you start out.

If you want to be a nurse and it's your only option, then it's your only option! Nursing is my second degree and I went into my ADN program when I was 25. I went for an ADN and now currently finishing my RN-BSN program online. I went this route instead of an accelerate BSN route at a 4 year school because it is SOOO much cheaper, and I became an RN about a year faster. I already had a lot of debt and didn't want more. I was able to finish my ADN in two years while working full time and paying tuition out of pocket. It's not easy and sometimes I was spending 68 hrs a week at the hospital because of clinical and working as a CNA, but it was worth it to not have the debt, in my opinion. Now I am working as an RN at a large hospital while I finish my BSN online. I am taking my time with the BSN and paying it off as I take the classes since my job doesn't require the BSN right now. I just can't imagine having more debt that I already do. So I totally understand where you are coming from. If you really want to be a nurse, then go for it. If you really don't want a mountain of debt (trust me, you don't), then take your time. Jobs will be there when you are done with school. I found that New Grad Residency programs were super beneficial because you are only competing against other new grads for a job, not a whole pool of other, experienced nurses. I did not need my BSN for the new grad residency.

I am a BMT/heme/onc nurse now but worked as an oncology CNA (as well as on other floors) before becoming a nurse. working with oncology patients is really rewarding but can be difficult as well. In my experience, a lot of oncology patients are more independent than patients on a lot of other floors. Often times they are patients who are live at home but are having complications/side effects with their treatment and need extra attention. So you have patients you can chat with quite a bit and patients who can do a lot of things for themselves. You will deal with cleaning up things like diarrhea (including Cdiff...) vomiting, oral secretions, etc. with these patients. they will be very fatigued so you may need to help them with ADLs from time to time. you will also have the patients who have totally given up and want you to do everything for them. or you may have the patients who have neurotoxicity from chemo who are confused or combative (rarely). Other than that it's a lot of talking and comforting patients, LOTS of cleaning because they are immunocompromised, and helping to encourage these patients to get back on their feet. Unforunatley, oncology patients die, and on some floors you deal with that pretty often. You will have to get comfortable with post-mortem care but your training will cover that. Nights can definitley be slower than days. A lot of the times its just getting vital signs and answering call lights at night. Sometimes post-mortem care. Days can be busy. you'll get vitals, help with showers if needed, answer call lights, help with meals if needed, help with making sure things are clean, and helping patients walk the halls if they are not totally independent.

I work bone marrow transplant and give tons of chemo! our ratios are 3:1, sometimes 2:1. Giving chemo is actually usually a really quick process, so we don't necessarily change our ratios based on a patient having chemo. We are ONS certified in chemo/bio therapy and we make sure to review all orders from our outpatient clinic. When hanging chemo what really is the most inconvenient is finding a second nurse to check the order and check the math and check the drug. Every once in awhile we have to go to another unit to give chemo, but there is never IV chemo on another unit if there is not an ONS nurse working on that unit. I have gone to another unit to give oral chemo, but it is also pretty rare.

Don't worry about those two, It really is shameful to act in such a way to a nurse who is just looking for some advice. We all need help/advice/guidance at some point and I think it's great that you are thinking about your future as a nurse. It doesn't mean you are neglecting your job now. It just means that you want to know if you need to take steps now for the job you want in the future. It's respectable. As far at the OCN certification...it is true that you need oncology experience. I believe it is 1000 hours and at least 1 year on an oncology floor. And you need a certain number of CEU's...but when I took the OCN exam, my chemo certification credit hours counted for this...which you will likely have to complete as well when you start on an oncology floor. working in med/surg/tele is great experience and you shouldn't have too much difficulty making your way to an oncology floor when you are ready. I went into heme/BMT as a new grad, so there are definitely units out there that are willing to teach you the ropes of oncology nursing!