AugustRain

I'm an outpatient nurse, so I follow my pts closely long term. I love doing wound care, especially for my pts with long term devices - it's very satisfying to see improvement in the wound and help the pt go back to living a more normal life.

Congrats on your new job! Each hospital will have its own chemo protocols, but the ONS Safety Standards is a good place to start: http://ons.org/CNECentral/Chemo/Standards Actually, if you haven't already joined ONS, I'd highly recommend it - it's a great resource and has a lot of helpful info/CEUs.

Yes, that's a good one. Also think about the whole picture, not just the surgical wounds - cancer, smoking (how does it affect healing, etc?), family, sexuality, teaching points...

Have you given any thought to a nursing diagnosis that would address the psychosocial aspects of her care?

This is the link to the ACIP Vaccine Administration Guidelines: http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/D/vacc_admin.pdf The first sentence on page 10 states their position on aspiration (not needed) and the rationale. I still feel funny not aspirating though.

Just wanted to clarify a point in the above post - you don't need 1000 hrs of hanging chemo to sit for the exam, just 1000 hrs of oncology practice within the 30 months prior to applying. Actually, as far as I know, you don't need any chemo experience. Surgical oncology nurses can be OCN certified too.

Don't know when your paper is due, but if you're still working on it, I'm a surgical oncology nurse and happy to point you in the right direction.

This actually depends on the facility. Some prescribers will split the daily dose and give the Lovenox q12. I've also seen this done lately if the pt is to go home on Lovenox. You could certainly take your own informal poll of pharmacists at the drug store and your clinical site to see what they have to say.

My current hospital does use Heparin on all central lines, but my previous hospital only used it when de-accessing ports. Neither P&P stated the rationale. I too would be interested in the literature on the subject, as it's something I have been looking into recently.

I went straight into oncology after graduation. Like you, I had non-nursing onc experience prior to nursing school, which did help get me the interviews. Your best bet would be to apply for inpatient oncology floors as a new grad - you'll gain valuable experience there. There are also some hospitals that have nurse residency programs in this area. As an outpatient/infusion room nurse, you'll often be expected to hit the ground running in terms of skills, as well as to have a solid background knowledge of the disease process and treatment. I'm sure there are exceptions, but this has been my experience in academic cancer centers. Oncology certifications such as chemo and OCN have specific requirements, some of which require experience. Many facilities have additional requirements for chemo cert, generally a sort of practicum where you spend a certain number of hours hanging chemo under supervision. ONS and the ONCC websites have good information on the process. Some masters degree programs do offer a specialty in adult or peds oncology, but it's not something that would apply entering the field as an RN. I would encourage you to join ONS for both the educational and networking opportunities - there is a student option for membership. Best of luck to you!

If you're still looking for someone to answer the questions for your assignment, feel free to PM me. If you can't PM yet, let me know and I'll send you my e-mail.

It all depends on the cancer. This isn't the most common form of tx and I'd probably inquire further from a more reliable source, but it wouldn't make me think she's lying. A borderline or low grade ca may not require chemo, she may be having XRT to treat symptoms first, chemo or debulking may follow, there are any number of things that can be going on. Just on a personal note, I had a non-invasive stage III ovarian ca (I was an oncology nurse first) and had a fertility-sparing optimal debulking and never did chemo...and I hope I'll never need to!

I was really squeamish about cathing people when I first started nursing school too. I observed whenever I could, practiced on the dummy many times, then started volunteering to do the procedure. My first job had plenty of opportunites for Foleys, and it didn't take long before I could get the tough ones without a problem. You'll be fine! Before you know it, you won't even remember why it made you nervous.

I'm a surgical onc nurse too, it's a great job! My first suggestion is to join ONS, if you haven't already. Take advantage of the online CEUs they offer (most aren't free, but it's worth it). Become familiar with the types of procedures you'll be seeing, typical post op course, which surgeons give certain instructions and like certain meds. Look over pain medications - PO, IV, PCA, patches - and don't be afraid to use them. If you have the opportunity to spend time with the docs while they explain procedures and evaluate pts, it will help you learn, too. Also review some chemo and radiation side effects, as many of your pts will be treated with these modalities in addition to surgery. Ask questions of your colleagues and of your pts, observe everything you can, and take part in any procedure offered. Have you worked in oncology before? It's been my experience that onc teams are very supportive and encouraging, so it's generally a good work environment. And the patients are amazing. Good luck, hope you enjoy it!

I don't think there's anything wrong with wanting a more office-based position (insurance or drug company, perhaps?), though I don't know how much luck you'll have without a little hands-on experience first. But I would look closely at outpatient jobs before you jump in expecting them to be all that clean or easy. I have a wonderful, 4 day a week job as a clinic nurse, and in the last week, I've changed dressings, given meds through a J tube, removed sutures, inserted a Foley, done IVs, blood draws, collected sputum cultures, pulled drains, among other things. It's certainly cleaner than when I worked on the floor, but I still wouldn't wear anything that can't be bleached!