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!

I used EPIC at an old job and liked it a lot. It's very user friendly and many features can be adjusted to the needs of your facility (which can sometimes speed up charting & order entry). Any time there's a hospital wide change, there's a learning curve, but you'll get the hang of it quickly.

Thank you both for your replies. I've been giving the idea some thought lately and decided to go ahead and give it a try - worst that happens is it doesn't work out!

I'm hoping to get some feedback from current nursing students. In addition to my regular nursing position, I'm considering starting a business offering tutoring/resume/job-hunting assistance to nursing students. I have done this informally and really enjoyed it. As a student or new grad, does this sound like something you would use, or would you be more likely to take advantage of the free services provided by your school? Would you find it helpful to supplement what your program offers with the tips and tricks of someone who has recently gone through the experience of nursing school, standardized testing, and job hunting in this area? Any thoughts would be appreciated!

Just thought I'd throw this out there for anyone about to start the ACE program...I graduated last fall and just found a bunch of books in my closet. I'm not familiar with the current book list, but I have a med-surg text, health promotions, leadership, informatics, HESI, Saunders NCLEX review, a couple of "Made Incredibly Easy" books, two care plan books, women's health. If anyone wants them, let me know!

I use ratio/proportion too. Here's the problem worked out with that method. Hope it helps! Order: 3mcg/kg/min patient weighs 87.4 kg Supply: 50mg in 250mL You need to do a couple of steps before setting up your ratio... First, work with the units you have: 3 mcg x 87.4 kg = 262.2 mcg/min Next, convert to mg/min: 262.2 mcg = 0.2622 mg/min Since your final answer is in ml/hr, convert from ml/min to ml/hr: 0.2622mg x 60min = 15.732 mg/hr Now you're ready to set up your ratio: 50 mg : 250 ml = 15.732 mg : x 50x = 3933 x = 78.66 ml, which rounds to 79 ml

It's totally normal to feel overwhelmed when you're first starting out. Three weeks can seem like forever when you're nervous everyday, but give it a shot. It may not be bedside nursing that you dislike, it may just be that you don't like being new and overwhelmed and disoriented - who can blame you? That goes away with time. Three weeks isn't enough time to be good at anything yet. I've only been working as a nurse for five months, and I can tell you that the difference between my first month and now is huge. You could very well discover that bedside nursing isn't for you, but at least if you stick it out for a while, you'll be able to make a more informed decision about what you like and don't like, and gain valuable experience to take with you to your next job. It takes some time to find your footing, but you can do it.

You can PM me :)

Everyone's perspective will be a little different on which quarter is most difficult, depending on their interest in the subjects, what's going on in their personal lives, and probably which professor they had. Second quarter is more intense than first quarter, and there was a lot to learn in a short period of time, but for me, it wasn't terrible. I actually found fourth quarter more difficult, because I was starting to run out of steam by then. I know it's tempting to try to figure out how you're going to manage for the entire program, but my suggestion would be to take things one step at a time. Part of being successful in second quarter is determining what works for you during first quarter, then kicking that into high gear and prioritizing your routine. Each of the 6 credit courses has a lecture and clinical component, so it can be a challenge to manage your time, but it's only 12 weeks. You can do anything for 12 weeks, so if it's rough, at least it will be over quickly. Just stay on top of your work, try not to put things off, and ask for help early if you notice that you're struggling.

Sure, PM me and we'll work it out.

I do, yours if you want it.