From students
"THE STUDENT EXPERIENCE"
The following was written by two UVic students in their final practicum at the Vancouver Island Centre. The intention is to share their educational experiences with other students considering a placement at BC Cancer.
When you arrive at BC Cancer, you will begin training immediately for approximately 8 hours per day. This involves a two week orientation period put on by BC Cancer that will provide a solid knowledge base for oncology nursing and BC Cancer itself. Be prepared for information overload! It’s a lot of new knowledge to take in for two weeks, but in the end it is incredibly beneficial. During those two weeks, you and your co-student will determine which area you want to work in. It’s important to note that each area is a unique side of nursing with individualized skills and knowledge. Because of this, it works best to spend your 12 weeks in one area as it can take a while to become comfortable with this new environment.
The following outlines provide a student’s perspective of each area to help inform your placement choice during the orientation period.
The Medical Daycare Unit (RN Clinic):
This clinic is located on the second floor of BC Cancer – Vancouver Island Centre at the entrance to the chemotherapy room. The clinic operates from 0930 – 1800, Monday to Friday. Patients experiencing acute side effects related to chemotherapy or their cancer attend this clinic and are assessed by a nurse and physician if necessary. Patients attending this clinic frequently receive triaged care and may be admitted to inpatient care directly from this clinic. There is one RN who is assigned to this area daily.
Common Nursing Interventions Include:
- CVC Care (PICC, IVAD, Tunneled)
- Transfusion Surveillance
- Paracentesis Management
- Thoracentesis Management
- Lab Draw
- Baxter Infuser Pump Disconnection
- Patient Teaching
Helpful Pre-Practicum Review:
- CVC (PICC, IVAD, Tunneled) care and troubleshooting
- IV insertion/maintenance
- Common IV medications: Ondansetron, Dexamethasone, Metoclopramide,
- Prochlorperazine, Dimenhydrinate
- Focused assessment skills
- Care of chemo-related side effects such as diarrhea, constipation, fatigue, nausea, pain, peripheral neuropathy, dehydration
- Handling of chemotherapy and hazardous waste
- Normal Lab Values (CBC, lytes, etc…)
What to Expect:
Each day you will be working with a different nurse. There will be a variety of scheduled appointments for various care needs, as well as assessments that can be requested throughout the day. Patients will often be booked into the clinic throughout the day as per recommendation of a physician. These appointments take longer and involve assessment and nursing interventions. A day may look slow to start, but can quickly become very busy. The nurse works collaboratively with the GPO (General Practitioner in Oncology) and occasionally the MRP (Most Responsible Physician) to provide the highest level of care. The RN clinic is closely supported by a Unit Clerk as well as the nurse who handles the triage call line.
Radiation Therapy:
The Radiation Therapy Nurses (RTNs) deal mainly with side effects experienced by patients going through radiation therapy by assessing current patient concerns and anticipating possible concerns related to the treatment or the disease. The nurses can then work with the patient and the doctor to identify the best way to ease the discomfort they are in or evaluate an already applied intervention. The two RTNs on the unit work as part of a multidisciplinary team with Radiation Oncologists (Rad Oncs), General Practitioners in Oncology (also called Clinical Associates or CLASS), Radiation Therapists, Patient Care Aids, the occasional Medical Oncologist (Med Oncs), and the Clerks.
The clinic is in an outpatient setting where patients are assessed in an exam room by a nurse or doctor. The nurses see side effects such as radiation skin reactions, diarrhea and/or constipation, nausea and vomiting, dehydration, pain, and fatigue all of which have their own teaching which must be done. Focused assessments are completed every time the patient attends their appointment in order to offer symptom support and nursing care where appropriate. The nurses are able to work very autonomously to practice a wide variety of nursing interventions aimed at supporting patients with symptom management and meeting their information needs.
Common Nursing Interventions Include:
- Assessments (home environment, side effects, triage, follow-up)
- Teaching (symptom management, medications, side effects of both chemotherapy
- and Radiation, etc…)
- Symptom Management (symptom management guidelines on the BC Cancer website)
- IV insertion
- Dressings (both for skin reactions and malignant wounds)
- Reporting to other team members
- Patient calls/Telephone Triage
- Establishing Therapeutic Relationships
Helpful Pre-Practicum Review:
- Be comfortable with assessing a patient and reporting that assessment to others
- Medication review
- Analgesics
- Anti-emetics
- Anti-diarrheals and Laxatives (Imodium, Senokot)
- Dexamethasone
- Flamazine
- Wound Care Principles
- moist environment
- infection prevention
- comfort
Extra Opportunities:
There are many optional experiences that can be taken advantage of during your time at BC Cancer. Some of these include:
- High Dose Radiation
- Pre-chemotherapy Education Sessions
- Pain & Symptom Management Clinic (Wednesdays & Thursdays)
- Observation shifts
- Chemotherapy & Patient Support Clinic
- Medical or Radiation Oncologist
- Education In-services
- Placements swap with co-student for a day(s)
Good luck in your placements and have fun!!
Jenna & Tyler
UVic Students 2012
