Quota

6 weeks isn’t even close to enough orientation for a new grad on any floor let alone an oncology medsurg unit. I think I had 12 weeks, now new grads have a fellowship and 15 weeks. It also sounds like your preceptor isn’t doing a lot to support you, you shouldn’t feel like you’re on your own at 6 weeks. Oncology is a hard unit, and I’d never have a brand new post whipple on my floor. Deep breaths and take things one day at a time. You shouldn’t be expected to be on your own after 6 weeks…

I work inpatient but we never heparin flush PICC lines, only ports when we are going to de access them. Even pts who go home with a PICC just do daily saline flushes themselves, and home health to do dressing changes.

No advice but the outpt infusion clinic that most of our pts go to when they don’t HAVE to be inpt is basically the same base rate (as far as I know). It’s within the same hospital system and literally across the street from my hospital. I’m pretty certain my old coworkers who transferred to the infusion clinic kept their same base rate. They do end up making less usually because no differentials with clinic hours. Part of why we have better staff retention on night shift than day shift on my unit. “Better” hours for about the same pay for day shift nurses but pay cut for night shift.

I work inpatient ONC and only difference I’d have is adding 25mg Benadryl to the pre-meds. Nothing in those vitals would have caused me concern. Same d/c instructions as all outpt neutropenic pts, go to ED for sustained fever over 100.4.

You need to be working on an oncology unit and chemo giving chemo. Even to get biotherapy certified you need to be working on an oncology unit for about six months first. OCN cert after about 2 years, I’m working on mine right now after about 2.5 years on an oncology unit.

I’m currently precepting a new grad who missed out on a lot of clinical experience, no capstone either. She went through the same ABSN program I did a few years ago. It was a bit of a rough start as I realized just how lacking in hands on skills she was but with a little patience she has caught on quickly to most things. Her orientation has been extended slightly because of this but I think she will do well on the unit in the end. Things certainly would have been easier if she had that clinical time and hands on experience but she is hard working and knows when to ask questions.

The only work related use my cell phone gets is using tiger text (encrypted service) to message doctors. The nurses on my unit were recently granted access to use tiger text, in general most nurses at our hospital do not have access to tiger text at this time. I think we are in a pilot group getting access. We still have hospital issued spectra link phones to use on our shift for normal communication. In general some doctors are either not reachable through the hospital paging system or are just slow/bad at responding timely or at all. So far all the doctors I’ve contacted through the tiger text system have responded quickly and things have gone much smoother than paging. We do have to use our personal cell phones to use tiger text but it is an optional thing, not required. I will say 90% of my tiger text usage has been with our oncologists who do know me vs medical attending I might not know well or at all.

No hazard pay but we did get our merit increases, I got my chemo cert increase, and we just got a retention bonus the other week so $$$ in some form.

I’ve got friendly and fair minded coworkers for the most part. The majority of us are willing to make the occasional swap to help each other out. Things come up sometimes you couldn’t plan ahead for. I’ll use RTO for specific days if I know about it far enough in advance but sometimes you just need a swap. Swaps require completing a form with both parties signing and management approval.

I work oncology so I give blood and platelets all the time. We prime the tubing with saline first and our orders are always by the unit so no worries about volume. We do always want to get all the blood product to the patient, our infusion volumes are calculated in EPIC based on the start/stop times we put in EPIC along with the rates. Standard practice on my unit is to start the infusion at a somewhat higher rate and watch until the blood product reaches the patient then slow to 120ml/hr for the first 15 minutes of the infusion. Come back and take your vitals, check on the pt, then up the rate. New policy is to not infuse faster than 1 unit in under 2 hours, so in general a max rate of 180ml/hr. When the blood bag is empty switch over to the flush to get all the blood to the pt. Taking vitals at 15 minutes, 1 hour, and on completion as a general rule.

I can be either one depending on my assignment that day, usually I’m in between, I’m occupied most of my shift but not overwhelmed. On days that my assignment ends up being easy and I have lots of free time I spend that time asking coworkers if I can help them with anything. Plus whatever healthstream crap I’m supposed to do. Things have to go really crazy for me to end up staying really late catching up on charting. It happens but not on the regular and my coworkers are great and help out if they can.

Seems early to be floated to me. Our policy on my unit is you won’t be floated until six months after orientation ends. I was just floated for the first time about two weeks ago so just over a year as a nurse. It was awful haha, made me appreciate my oncology floor even more. Of course my unit hasn’t had the staffing for people to get floated for a few years so it’s not something that happens often. Even better I’m at the bottom of the list for floating now. Medsurg hell plus the disorientation of being on a different unit.

I work in patient oncology and some of our patients are on the unit for 30 days stretches only to come back for another 30 days 1-2 months later. Certainly develop friendly relationships with some of those patients, they know I’m a crazy dog lady, I probably know a decent amount about their family/pets as well. I don’t think I really cross any boundaries but they certainly know more about me than the random med/surg type pts who are on our floor for a few days and leave.

I work on an oncology floor and previously all our neutropenic pts had their own box of masks either in their rooms or just outside their rooms. With the mask shortage all masks have been moved to the controlled access supply room. Yesterday I couldn’t find any masks for a neutropenic pt looking to walk some laps anywhere. I asked our unit secretary to order some more masks and when she called they said our clinical director had to request them. On further follow up with my director all masks are in a secured room in the hospital and only something like 5 people know where that is. She has to make the requests for more masks and they will only send 6 boxes at a time. She is supposed to keep those extra boxes in her locked office. Her plan was to make ziplock bags with 5-10 masks each to place in our neutropenic pt rooms to replace as needed and have one open box in the supply room for staff. This is new so we’ll have to see how this works out. Being an oncology floor we very rarely have anyone on droplet precautions, generally of anyone comes positive for anything requiring droplet precautions they get transferred off our unit.

My hospital paid for my chemo certification and I have a raise coming at the six month mark post certification. They will also pay for me to get my OCN when I reach the two year mark which will earn me a bonus. Certification is also required if I want to advance up the ladder for a pay raise. I believe they will also provide educational assistance for prepping for your certification.