What is a surgical-oncology floor like?

[hakunamatata, BSN, RN]

Hi guys! I have two job offers right now and due to scheduling, it looks like I'm going to take the job on a surgical-oncology floor at a big teaching hospital. I used to work general medicine at another major hospital and found it very stressful. I've heard surgical is still of course busy, but in a different way. What is it like day to day? Are most patients oriented, able to ambulate, continent, etc? On the medicine floor, many patients were not A&O, were incontinent, and I found this stressful (I'd never be an ICU nurse, cheers to them). I am not above helping sick people, however I do like to do a lot of talking (listening) and teaching, educating is one of my favorite aspects of nurses. I'm hoping the surgical floor would be a fresh change for me, as opposed to medicine. Or are they really not that different? I've always wanted to do oncology as well, so I'm hoping that helps to make it more specialized learning.

The manager said it's a lot of ENT, gyn, and GI patients. If that helps. I'd love to hear from surgical nurses what they think.

[on eagles wings, ASN, RN]

Hi there. Congrats on your job offer!

I've been working on a large surgical unit for a year now and let me tell you it is extremely stressful. We are, according to floats, the most stressful unit in the hospital. We are a medium sized teaching hospital. But there is so much to learn everyday that it is very much worth it.

We see all kinds of surgical pts to keep census up but a large majority are surg-onc, mainly colorectal cases. So frequently we have 2 patients each who have colon CA and have or will undergo a bowel resection. So lot's of ostomies, ng tubes, wound care(for the open BR's--lots of packing deep wounds, monitoring for fistula formation, etc), pain management(as much as dilaudid q2, or PCAs). Many tests, egs, colonscopies, bowel preps, TPN. Some of them also come back with a JP drain or 2.

We also see many pancreatic CA pts so we do get the occasional whipple patients--lots of pain mgt for those. They also get lots of TPN and supportive/palliative care. Our liver CA patients have the usual octreotide drips, pain mgt, protonix drips, biopsies, and sometimes pigtails if there is an obstruction in the ducts.

Also we get thyroid CA patients, so many thyroidectomies/neck dissections for lymph mets w/ q6 serum calciums, monitoring for cardiac arrythmias, & sometimes calcium drips. they usually come back with a penrose drain or jp drain or 2.

lots of hysterectomies too. in our hospital most are done lap/robotically so i haven't had to do dressing changes for these. but lots of these come with PCAs. usually require a blood transfusion right after sx, in my experience.

for our kidney pts, nephrectomies & urostomies, biopsies, and lots and lots of teaching. strict I&Os.

all our surgical nurses are besties with the wound care/ostomy nurse. they are such great resources. ask them the best tape to use, where you can find the eakin rings. they provide the pain introduction to the patients about their new ostomy/urostomy/pigtail but you have a lot of reinforcing to do and of course discharge teaching. find where the education packets or supplemental videos are for these patients.

But in the mean time we also general surgery pts like appendicitis, cholecystitis/cholelithiasis, and even trauma patients(MVA, GSW), GI bleeds, abcesses(liver abcess or GYN related abcesses).

On our step-down side we have a load of 4 but go up to 6 if we are really short(super unsafe), but on our tele/general surgery we can go up to 7(super unsafe) lol.

Hope this helps you =) good luck

[on eagles wings, ASN, RN]

oh and i forgot to mention the urology patients. we are our hospital's designated uro floor so i don't know if it applies to you, but we get lots of prostate CA pt's who undergo turps, bladder CA w/ turps. so we often have CBI, jp's for them, and suprapubic caths. i think that's it. :)