A registered nurse at the Cancer Treatment Centres of America (CTCA) hospital, Cheryl Lynn, said, “Nurses are at the centre of patient care, and for this reason, they can significantly influence the quality of care provided and, ultimately, patient outcomes.” To fully understand this statement, Lourein Smit, a local oncology nurse, tells us about what she faces every day.
“I don’t know how you do it?” This is the first response an oncology nurse will get when telling any person what they do. Little do people know that being an oncology nurse is the most rewarding and satisfying job, and no two days, on the job, are ever the same.
One smile can change a patient’s whole day. Not only does the job entail hard work, dedication and applying all knowledge but it also requires teamwork, team spirit, alleviating fear, celebration, believing and, most important, connecting with every patient.
Working in one of Gauteng’s busiest oncology units (Benoni Oncology Unit) can be a daily challenge. Working with a high volume of patients never gets easier, but you, as a person, gain strength.
Oncology nurses must keep track of numerous details for each and every patient throughout the day. One mistake could adversely affect a patient’s health, so attention to detail is critical. As an oncology nurse, one needs to be compassionate, loving, hardworking and, more importantly, able to multitask. Oncology nurses strive to provide the best possible care to every patient, ensuring that no one is compromised at any stage.
A typical day starts at 07:30am; I prepare myself as well as the chemo lounge for the day. Soft music plays in the background and there are televisions for sport fanatics. We call it a lounge and not a treatment room because here we laugh together, cry together and it’s a place of healing and relaxation.
Twenty six patients are booked for the day; I go through the list. My first patient arrives just before 08:00; “Good morning Mr Jones, how are we doing today?” I believe one feels special when they are greeted by name. Observations gets monitored, blood results reviewed and the patient’s condition is assessed before any treatment is commenced. Soon after that the next patient arrives and the next, and before we know it the chemo lounge is full to capacity. I ensure all my patients are comfortable for their treatment day, and the same process is followed for each patient.
Then the IV (intravenous) access area is evaluated, prepared and IV tubing is primed (filling the tubing with fluid, removing air to safely connect to a patient) before the chemotherapy drug is added. It is important to use a main IV line (direct line) to provide direct access to the patient in the event of an adverse reaction to the chemotherapy.
Before administrating the drug, patency of the IV site is checked without patients even noticing it. Extravasation (leakage of intravenous fluid into extravascular tissue) can cause severe damage to tissue, especially in the case of vesicant drugs (drugs that cause blistering and other tissue injury).
Strict instructions are given to patients to immediately report any pain, irritation, redness or swelling at the IV site. While treating patients, we as nurses, check the IV lines, continuously assess every patient, and check the IV site. We monitor each and every patient in a way without them even knowing.
Nurses are always right there with their patients, in real time, and it is us who are most likely to catch medication errors, detect early reactions, and intuitively react when a patient requires immediate attention. We’re also there to provide compassion and keep them calm during a difficult situation. We build relationships with our patients and learn a lot about their life and family.
The patient is the focus of our attention throughout the day – the right drug, at the right dose, to the right patient. We have three check points before any drug reaches the correct patient: the oncology pharmacist checks the dose and drug that has been prescribed by the oncologist. Once mixed, nurse 1 checks the drug and dosage again with nurse 2, before it goes to the patient. Once the medication arrives at the patient, we check the drug and dosage again as well if it is the correct patient by verifying with the patient.
Being an oncology nurse also has its risks working with hazardous drugs. Chemotherapy can be life-saving to a cancer patient, but unintentional exposure to these cytotoxic drugs can be harmful to the lives of nurses. Safe handling techniques and appropriate consistent use of PPE (personal protective equipment) are in place. This ensures safety to both the nurse and patient safeguarding that nobody is compromised at the end of the day. Making use of high quality consumables, ensuring minimal exposure to both the patient and nurse is of high priority. Using good quality consumables is as important than the drug that is been administered.
Just like Maya Angelou said, “As a nurse, we have the opportunity to heal the heart, mind, soul and body of our patients, their families and ourselves.”
I certainly agree with her.
MEET OUR EXPERT -LOUREIN SMIT
Lourein Smit is a registered oncology nurse and works at Benoni Oncology Unit in Gauteng. She has over 13 years of experience in the field of oncology, and has recently completed her pharmaceutical dispensing course.