Soneshine

Dee Angel, Could you please send me a link. I actually tried searching the internet first- with really no luck Thanks

Hi, I am returning to a Med/surg floor next week after being out of general floor nursing for a couple of years. I am having some anxiety about simple procedures & setting up a PCA pump is one of them? Anyone have any good instructions or tips for me! Thanks

First of all, let me say that, that is a lot of chemo pts that you see in a day for one nurse (particularly if you mix chemo). Sounds like a lot of responsibility. I also work in an outpatient chemo clinic & mix chemo. We maybe have 6 chemos per day on average and a number of hydrations, zometas, port flushes, ect. We have 2 nurses. Will you continue to be the only nurse? Who covers you when your off? Oncology is both a difficult and enjoyable area. I also love the patients (they are like no other)- and frankly make my job worthwhile. I feel a lot of intensity just having 4 chemos to be responsible for. It takes a lot of attention to detail and good time management skills to be a chemo nurse. I believe that you must be pretty awesome or have a lot of nursing experience if you're not running away after caring for 8-16 pateints! Seems a little like a safety risk- but I don't know exactly how the clinic you work at runs- perhaps you have techs, ect?

Let me add to the previous post that the 2 nurses who check chemo, need to both be chemo competent (meaning they've somehow demonstrated competency through their skills being observed by another knowledgable & experienced R.N) This is my understanding based on ONS guidlines.

Thank you! These are really good suggestions. I am feeling a bit more at ease now. The best one can do is follow all of the recommended safety precautions & not worry excessively. The fact of the matter is, is that you could die tomorrow in a car accident. You can't live in fear of the "what ifs." Oncology has it's risks- but I think I let my mind go a bit wild after reading studies about chemo drugs found in the urine of nurses who don't mix; who are just in the general environment OR miscarriages & birth defects, ect ect...... Other than mixing & hanging these drugs, this is a specialty I really enjoy!

Hi! I am new to Oncology and have been working in an outpatient clinic for a little over a month now. At our clinic, the nurses mix all of the chemo drugs in a BSC. I really like everything about this specialty so far, except for the idea of personally mixing and hanging of these drugs. It scares me more than I would like to admit. I haven't actually started mixing or hanging yet- but anticipate I will start soon. My biggest concern is exposing myself (even if it's just minimal amounts from surface contamination or the general environmental in which I work for 10 hrs/day). I'm concerned that this exposure may increase or cause me to get cancer in the future. I mean if OSHA recommends NO food/drink, or even applying chapstick in the general infusion area?? This is scary- I am within 10-15 feet of my patients at all times. The treatment rooms are only privatized by curtains. Maybe I'm blowing things out of porportion, but I need to vent & know what others feel about this- or if anyone has or has had concerns about this.... I realize that using PPE and practicing other safe measures reduces overall risk- but I can't help wonder if working in this environment will prove to be more harmful than previously thought.... Insight anyone?

1. Good assessment skills (looking at patients/family in a holistic manner). Cancer affects every aspect of the patient's/family member's life. Knowledge about the different type of cancers/drugs. Compassionate & good listening skills! 2. Oncology is a unique field because of the patient population. Generally speaking, cancer patients have a different perspective on life. They are faced with the possibility of death/dying. Many patients find a deeper meaning/understanding of life. Many strengthen bonds with family/friends that they would have otherwise taken for grantid. Also, nurses see patients frequently & stronger relationships are established!

When you're stressed & surrounded by endless goodies!!

Hi! I'm a new oncology nurse. I'm in desperate need of advice on being new in this area. Anything really would help! I'm worried about of giving chemo- and having a shorter training period than previously thought. During the interview, they made it sound like I would be trained for a few months before hanging chemo. Now, a few days into my training, they are talking as though they'd like me to start hanging chemo in the next few weeks. I haven't gone through the necessary chemo training courses yet.... Thanks

I most certainly agree with the majority here! You are not horrible or wortless anything!! Infact, probably just the opposite I bet. Please know that there are people out there that do care about your situation. Please be honest with your boss, but your priority should be your personal health and wellbeing at this time. Breathe deeply and remember that no matter how hard times are now, they will pass.... You'll be in my thoughts!

Wow, I would not have accepted both positions, but this is my opinion. There is a learning curve present in each job and 2 weeks is not enough time to make an accurate assessment as to whether you like the job. It took me a good 6 months before I started to enjoy my current job. Best of luck anyhow

Adequate staffing is key! Another issue is working 12 hr shifts. While I prefer 12 hrs and more days off, I think it creates safety issues. Both safety issues for the patient and the nurse. For example, as the night goes on and the stress levels remain high, I am more prone to back injuries, ect. You become less focused on the patient and more about "what needs to get done still" before your shift ends. This is not a great thing to admit- but I think we are all a bit guilty of it at times. Sometimes in order to stay sane or prevent burnout, we need to do whatever it takes to take care of ourselves. Many "sick" days are taken due to stress and burnout. But, when you call in sick because of stress, you're just contributing to the overall problem, and putting your co-workers and patients at greater risk. So, in summary, having adequate staff, shorter hours, and an emphasis on stress management are HUGELY important in preventing errors and injuries!!

Hi All, I just got a job in an outpatient oncology clinic!!! I'm very excited and nervous at the same time. I've been a nurse for a little over a year now, working in Med/surg. Before I start my new job, do you have any advice for a new nurse in Oncology? Maybe things you wished other people would have told you sooner- or that you would have known before you started in this area? I really want this to work out!! Any really good resources or books you'd recommend? Thank you so very much for any feedback!!

Hi, Would like some opinions. I'm very interested in oncology nursing and am thinking of applying for a job at an oncology outpatient center. I'd like to hear from people who have either worked in oncology or have opinions about it! Would like to know the pros and cons- or anything else regarding this area of nursing. Currently I work in med/surg. Thanks!

I'm currently working on a med/surg floor at a smaller, rural hospital. I have been there for a bit over a year now. During this time, I've had mixed feelings about being in this area. I know that it is not my niche in the nursing world- but at this point, I'm not sure what is. Prior to getting my R.N., I worked for many years as a CNA in LTC with the elderly population. I liked it, although it was often very mentally and physically exhausting. I think that as a nurse, I would prefer to be in an area that allows me to get to know my patients better and have more of a routine each day. I don't think I'd want to work in a nursing home simply because of the high patient load! Okay! Here's the situation: A while back I contacted the nurse manager at our local outpatient cancer center to inquire about job openings. I did a 6 week internship there as a student nurse and loved it! I love working with cancer patients. They didn't allow me as a student to administer chemo, but I accessed ports and hung the pre-meds. I really liked the environment and the staff there. At this time, there were no current openings. This aftenoon I got a call from the nurse manager, and she told me that a position is opening and asked me if I wanted to interview for it. She woke me out of a sleep, so I told her I would contact her tomorrow. The problem is this: My job requires a month's notice! The nightshift is usually a bit short-staffed, I am scheduled for ACLS this month, I requested holiday time off, ect ect. Although my current job, is not my "niche", it is generally pretty flexible regarding scheduling (which is so important to me). I am caught between staying in my comfort zone (which I don't love) - and moving on to something different (which I'm not sure I'll like if I actually have to give chemo or practice as an R.N. rather than a student)? I'm worried that because we are "slim-pickin's" at night at my current job, and that I've just completed several certs, that they may not consider hiring me back in the future (if I decide oncology isn't my thing). I'm also worried that if I decline to interview, that the oncology nurse manager won't consider me for future employment. Ahhhh, I am feeling stuck as to how I should go about all of this!! I'd appreciate any opinions or to hear from others who have gone through similar conundrums. Sorry this was so long!!!

I am currently working through many of the same emotions that you describe. Nursing is very taxing work in addition to your already so-called life! I am working on being more mindful of things in my everyday life. It takes a lot of patience and self-reminding. It's very easy to fall back into our normal patterns of thinking. I keep a private journal online and write in it as I feel I need it. At a miniumum, I practice deep breathing & try to go on a short walk daily. I think that what you're doing sounds like a good plan! I think it's important to slow down in order to gain perspective over things in your life. Please know that you are not alone. Reading your email reminds me (and probably other people too), that there are other people out there going through this!! Please hang in there and breathe deep! Really, life is all about how you appraise it. You have more control than you think, it just takes daily reminding sometimes.

Hi, I recently had a discussion with some of my co-workers regarding working nights and overall inpact on health. a few years back, I recall hearing that nurses who work on the night shift have a greater incidence of cancer? Something to do with disruption of melatonin production or something like this?? I am curious what others' opinions are; whether you think that working nights (particularly for many years) negatively affects personal health. I work exclusively on nights and prefer it over dayshift per my personal preference, but I'm concerned that my health may suffer in the long run. I don't think I eat as well (veggies and such) during the night. I don't eat that much at work and when I do, it's usually fruit or cereal. Love to hear your thoughts!

YES! I felt this way, especially right after getting my first job and being on my own (without my preceptor). I had so much anxiety that I wondered the same thing as you.....are these feelings normal and am I cut out for nursing? Please try to remember there is a huge learning curve and it might take you a while to feel more comfortable. Are your co-workers/managers supportive? This is very important!! If they're not, I would consider a change in unit?? Remember to ask a lot of questions and know that you have resources available to help if you need them. It does get better I promise. Just be patient with yourself and be realistic about being new. I am a nurse with with almost a year behind my belt and sometimes still have questions- this is okay and it does get better!!! Keep your spirits on the tops shelf!!

Hi! I'll try to make this quick. I am a nurse working 12 hr nights on the medical unit at a smaller hospital. I am a fairly new nurse (almost a year). The turnover is pretty high and I will soon have to be the nurse training new nurses; become more of a resource. While this extra responsibility means increased personal growth, it makes me incredibly nervous. There are some nights that I still have so many questions myself!! For example, I still have inserted an NG tube (has never come up). I'm still not very good at starting IV's, ect ect.... My big issue is this: I tend to be more of an anxious person (always have been). I have a serious lack of self-confidence. I like what I do, but most nights feel overwhelmed and generally inadequate. I don't think that I got the best on the job training. I have had to spend a lot of my personal time (days off) researching the proper and best methods for patient care (med admin, general nursing skills, organization, time management, ect). I do ask questions still when I have them- I believe in patient safety first. Okay!!! My point: I can't figure out if I dislike my job b/c of my issues with low confidence- or if it's not the right fit for me? Prior to being an R.N., I worked as a CNA for 10 years (mostly in LTC). I didn't like how physical it was, but I miss getting to know patients on a more intimate level and feeling like an important and needed part of the team. I currently get along with my co-workers, but I don't feel a strong sense of comeraderie or connection. I feel like I'm just feeling the gap for the most part. I don't know if I would want to work in a LTC facility due to the physical aspect of it- but think that I need to be in an environment where I feel more connected to the patients and my fellow co-workers. Any advice or support would be greatly appreciated!! I apologize for writing a novel. Guess I needed to vent too!!! Thanks

Week 3 specifically, I can't honestly remember- but I do vividly recall wanting to quit on multiple occassions. This is normal. I'm sure you'll soon hear of others that feel the same if you haven't already. Hang in there though..believe it nor not, there might come a day when you miss being a student

With IV pushes, I always flush before and after with at least 5 cc of NS for peripheral IV's. If it concerns a piggyback, I will set primary fluid (if they have it) to a TKO rate and flush 10 or so cc's. With central lines, I always follow the proper recommendations using a 10 cc or greater syringe (SASH) Saline, administer, saline, heparin. Always look up meds in book to know how to give properly- and know your workplace policies. I always dilute IV meds that can be irritating or viscous such as phenergan and ativan, ect ect. Hope that helped some

Don't forget there are questions that "don't count" 75 questions is a better indicator of passing then 275!! I felt the same way you do right after I took it. I think that most people do (don't forgett that). Now try to do something nice for yourself and stop worrying about it. What's done is done and you probably passed!!!

Hi All, Just curious, what does your typical schedule look like for those who work full time? Do you work in blocks? If you work nights, does your schedule change? Thanks!

This is the site that I used prior to my job interview last year: http://www.hospitalsoup.com/interview-questions.asp I think that the key is to answer the questions as confident as possible- but act relaxed at the same time. This is easier said than done I realize, but I think if you keep your answers on the shorter side- but seem open to further questions by maintaining good eye-contact and not look away, this is helpful. I am super soft-spoken and not so confident in my every day life, so this is all a pretty big challenge for me to pull off. Just tell yourself (silently) that they need nurses and as long as you are sending off positive, friendly vibes- they will only really pay attention to about 1/3 of what you say Good luck- you'll do great.

I used Saunders and Hesi & passed with 75- I would recommend answering as many practice questions as possible- and to prioritize based on assessment first then implemention, evaluation, ect. Also keep in mind your ABC's. Remember the goal is safety. Don't overthink or overanalyze. Hope this helps and good luck. Hang in there- I know it's hard but keep in mind everyone has gone through this stress in order to get their licsense. Don't be too hard on yourself either!