Tell me how bad these practices are...

[ga girl]

So I am still pretty new to Oncology. At my place of employment.......no nurses use chemo gloves to hang or take down chemo. Chemo bags are spiked within about a foot or two of the patient and then hung. The nurses wear regular gloves to do this. They do wear the chemo gloves to mix the drugs....but no gown....ever. One person, when she mixes chemo, will wear the chemo gloves..and slide them off only to reuse them again a few more times to mix that day. She will also answer a phone, type on all the computers and touch counters while she is mixing. I am new on this staff and the people doing this have been working in Oncology for years.

Is this common for protocals to be laxed after awhile? Do you think they have forgotten about contamination and how serious these drugs are that we are working with.

I am one of the newest on staff and I feel like taking a stand in our next meeting and asking that protocal be put in place and adheared to. Like no more spiking the bags anywhere near the patients! ANd wearing at least the chemo gloves to put up and take down.

Have ya'll seen this before?

[iluvivt, BSN, RN]

Yes I have seen this and it is a horrible sloppy way to practice. Do you not have a CNS that can help you enforce the chemotherapy administration standards. Are they following management of excreta post chem as well....bet not!!!!!!!

[rn undisclosed name]

I'm so glad I have not seen this. We NEVER mix chemo. It is all done in pharmacy. In fact I would not work somewhere that I had to mix my own chemo and hang it too. That just seems like an accident waiting to happen. I don't know if the difference is that I work in a hospital.

Anyways, at my hospital we have gloves (that are chemo safe) and I always double glove anyways. We have chemo gowns. When we hang chemo there are also special adapters on them to further limit any exposure in the air. I had a pt I admitted the other day. He showed me his skin in which he had a chemo spill. It looked rather nasty even after a week. Eek! I couldn't imagine not taking any precautions. I won't even open a chemo pill without gloves on. We don't have masks so I grad one of the masks cause I don't really know what I'm breathing in.

Since you are mixing your own chemo, why not have a special hood? You all are putting your lives in jeopardy every time you open that chemo and mix it. It is well known that chemo nurses have a higher incidence of developing cancer than any other nurse.

[GrumpyRN63, ADN, RN]

First off, is this a hospital or clinic/pvt office?? I can hardly believe this would be occuring in a hospital setting. I agree strongly with both prev posters. Not wearing proper precautions is just poor practice, but not mixing chemo under a hood is extremely dangerous. These nurses are putting their health and lives at risk. This can't be an accredited hospital ;JCAHO or at least the state would have heads rolling! Nurses used to mix chemo decades ago under these circumstances. The hospital I work in doesn't even let the nurses spike the bags anymore. The pharmacy spikes and sends it up primed and double bagged, to further reduce potential exposure. I would not work under these circumstances. Anyone even overseeing this mess ???

[southernbelle08]

Wow! At my hospital the pharmacy mixes the chemo and sends it up. There is a special piece of tubing on there and primed to limit exposure. The only thing out of all you mentioned that I do see at my hospital is nurses not taking proper precaution when it comes to wearing protective equipment. Gloves are some all will wear. I work nights and so the chances of giving chemo are a lot less on my shift vs day shift. Being so new, I do what I can to stay away from the chemo, just because I don't feel like I have had enough experience in dealing with it. However, the times I have hung it, I stick to the safety guidelines I was taught in my chemotherapy course. But yes, I see many nurses ignoring those things completely.

[mmatlab]

its too terrible , i have seen this where i am working now, the staff was administering the chemotherapy through grasby pump and the spiking for iv set was done beside patient . now i am new oncology clinical educator and i have checked if there any competency to administer the chemotherapy to follow so i have done new competency to safe handling of chemotherapy reference is ons

best regards

mamoon matalb

oncology nursing educator

saad specialist hospital, ksa

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suzanne4

[iluvcows]

I worked at a hospital who did not use gloves or gowns either. The chemo was placed in the regular trash and the hospital burned it on Tuesday nights.This was and is a approved hospital.THe nurses also had to crush 6-MP and place it in syrup for the kids, no hood was used. This hospital does great things for children and is well known to all. It was started by an actor to help children with cancer. Since his death his daughter does the commericals. The hospital started using the gloves and gowns just a year ago. When I departed, they were still burning the chemo. Many of the nurses working there have either had cancer or has beaten cancer. I work with a nurse now,who had a son that got treated at this hospital. Now she has cancer. I went to work there because my friends son had AML. Now she and her father have AML. I think it is because this hospital had the nurses place chemo in the regular trash in the patients room and all were exposed to it.And because they burn it and the smell is awlful on Tuesday nights. This hospital gets away with stuff that other hospitals would not.:angryfire They show no concern for their employees at all.

[GrumpyRN63, ADN, RN]

I worked at a hospital who did not use gloves or gowns either. The chemo was placed in the regular trash and the hospital burned it on Tuesday nights.This was and is a approved hospital.THe nurses also had to crush 6-MP and place it in syrup for the kids, no hood was used. This hospital does great things for children and is well known to all. It was started by an actor to help children with cancer. Since his death his daughter does the commericals. The hospital started using the gloves and gowns just a year ago. When I departed, they were still burning the chemo. Many of the nurses working there have either had cancer or has beaten cancer. I work with a nurse now,who had a son that got treated at this hospital. Now she has cancer. I went to work there because my friends son had AML. Now she and her father have AML. I think it is because this hospital had the nurses place chemo in the regular trash in the patients room and all were exposed to it.And because they burn it and the smell is awlful on Tuesday nights. This hospital gets away with stuff that other hospitals would not.:angryfire They show no concern for their employees at all.

All I can say is wow....

[jennifersrexie]

I have been an RN for two years. I am OCN certified. I have been giving chemo on our unit for about a year and a half. We do gown, glove, and follow safe handling guidlines for excreta. I am embarrassed to say that I don't know why you can't spike the bag at bedside. We do it all the time. I would love it- if our pharmacy would prime and send the spiked chemo- Can anyone show me where to look for documentation I could present to change our practice?

[peacelove&happiness]

I have very similar questions as you have. I just started at a private chemo infusion center about 3 months ago. I am new to chemotherapy although not new to nursing. I am seeing (and now doing) very similar and probably more alarming actions than you mentioned in delivering /administrating chemo. When I asked for a policy and procedure manual, I was told they do not need one because they have a nurse at another site that has 20+ years of chemo nursing and she can answer any question I may have. This response was very disheartening to me. I wonder.... I was asked to read and sign the Employee Handbook(that totally protects the company) but the company see no need for a P/P manual for patient care & safety and nurse safety???????

[Kim O'Therapy, BSN, RN]

Wow. We do not mix our own chemo; however, our policy is to gown, double glove, and wear eye protection while spiking the bag in our chemo prep area. When the infusion is complete, the chemo bag and tubing is bagged and placed in biohazard receptacles. Take care of yourself and good luck. I hope the facility changes their safety standards.