All ONS Member Community

Expand all | Collapse all

New Grads Training for Chemotherapy Administration

  • 1.  New Grads Training for Chemotherapy Administration

    Posted 23 days ago
    Edited by Kristy O'Neill 23 days ago
    Hello! We have a large crop of new grads each year from our nurse residency program and our goal is after their one year mark, they train for chemotherapy administration. Typically, we have them begin by taking the cancer basics course, followed by chemotherapy fundamentals. Then they go through classroom teaching on the physical handling, hanging of IV products, double check system, ect. After this, they are then encouraged to come in on a "day off" from work to hang IV chemotherapy with an experienced chemotherapy nurse. This portion of the chemo training includes hanging 3 different "24-hours hangs," 3 IVP, 3 combo drugs, performing blood return checks and demonstrating patient education. (In a nutshell) Once the nurse is comfortable with the first couple of administrations using a day off, we try to build the opportunities into their assignment, having our experienced infusion or charge nurse assist them with the chemo portion of their day.

    My question is this: On hearing feedback from our new grads, they are finding it difficult to find these experiences during days that work in their schedules and are getting frustrated that sometimes it takes 2-4 months for them to sign off completely on each type of chemo administration. Up until the bedside portion of the training, I find our plan works well and is streamlined, but the tail end of actually physically administering chemo at the bedside can be cumbersome.

    Any tips on getting new grads through this bedside portion a little quicker while not sacrificing opportunities? How does this work in your setting?

    Thank you so much and sorry for the long message!

    Kristy O'Neill, BSN RN

    ------------------------------
    Kristy O'Neill BSN RN
    Hem/Onc BMT RN


    ------------------------------


  • 2.  RE: New Grads Training for Chemotherapy Administration

    Posted 23 days ago
    Hi Kristy
    Our approach is vastly different from what your facility is doing, and I share this below not to change your model but to let you know there's more than one way to train.

    We also have a new grad residency program, but we typically have only 6-8 per year (usually 3 at a time). We are an ambulatory comprehensive cancer center, and hand-select our residents from a pool of applicants. This may explain one of the reasons why we've been successful.

    Residents get 4 weeks of general oncology orientation before moving to our Infusion department. They are required to take the ONS chemotherapy basics classes (among others). They start hanging chemotherapy their first week on the floor. No, they're not allowed to do this independently, but they learn to  check the regimens, do the calculations, patient assessment, prepare the tubing, work with the CSTDs and program the pumps with their mentors. Competencies for chemoimmunotherapy are done after 8 weeks on the floor (week 12 of 16 total), at which point they are able to do it semi-independently with their mentor. (Blood product competencies are done 1-2 weeks earlier).

    One of the reasons this accelerated program works is because we do a tremendous volume of infusions (approximately 200/day) so there are many opportunities to learn and for repetition, refining Iv skills etc.

    Success has been defined by an exceptionally high retention rate (~85% over the past 8 years). Medication errors for the recent grads are not significantly different than for our experienced nurses.

    My point is that you may want to look at how you can accelerate your education plan by providing more experience sooner. It's tough to learn things when it's stretched out of a long period of time.

    Seth

    ------------------------------
    Seth Eisenberg RN ASN OCN BMTCN
    PROFESSIONAL PRACTICE COORDINATOR, INFUSION SERVIC
    Seattle Cancer Care Alliance
    Federal Way WA
    ------------------------------



  • 3.  RE: New Grads Training for Chemotherapy Administration

    Posted 21 days ago
    Hey Seth -

    ​During the 4 weeks of General Oncology orientation, are these residents in classroom most of this time? Do they have simulations or other training too? We are trying to develop a comprehensive orientation program and this sounds very similar to what I have laid out, currently, but I'm interested in what this general oncology orientation entails - if you are willing to share.

    Thank you!

    Stephanie

    ------------------------------
    Stephanie Bonfilio RN MSN OCN
    Oncology Clinical Education Specialist
    St. Elizabeth Health Care
    Edgewood KY
    ------------------------------



  • 4.  RE: New Grads Training for Chemotherapy Administration

    Posted 21 days ago

    Hi

    I'm not in charge of the initial 4 weeks so I may be leaving things out (I oversee the clinical portion in our Infusion department). Residents attend didactic sessions for a multidisciplinary approach; they rotate to all of the departments within the organization to provide a "big picture" approach to oncology care, including procedures (bone marrow aspirations, CVC insertions). They receive training on implanted port access and peripheral IV starts, and get to hone those skills in our specimen collection area (that department does about 300-400 blood draws daily), which is really helpful for when they finally get to Infusion. They also spend some time in the BMT area to get an introduction to the specialty, and depending on how the schedule works out, attend several programs that we offer for all staff such as our 2 day BMT class, and End of Life. We start 'broad' and then get very specific within the 'target' department later for the remaining 12 weeks. Unfortunately, we do not have access to a sim room.

     

    Seth

     

     

     

     

    Hey Seth -

    During the 4 weeks of General Oncology orientation, are these residents in classroom most of this time? Do they have simulations or other training too? We are trying to develop a comprehensive orientation program and this sounds very similar to what I have laid out, currently, but I'm interested in what this general oncology orientation entails - if you are willing to share.

    Thank you!

    Stephanie

    ------------------------------
    Stephanie Bonfilio RN MSN OCN
    Oncology Clinical Education Specialist
    St. Elizabeth Health Care
    Edgewood KY






  • 5.  RE: New Grads Training for Chemotherapy Administration

    Posted 17 days ago
    Hi,
    My name is Linda Tongson from Trinidad and Tobago,
    Just wanted to ask if you accept foreign students in this orientation.
    Thanks for your kind consideration,
    Linda

    ------------------------------
    Linda Tongson
    Oncology Nurse
    St. James, Port-of-Spain
    ------------------------------



  • 6.  RE: New Grads Training for Chemotherapy Administration

    Posted 22 days ago
    Good Morning,  If you have an AIC connection to your hospital, I would suggest they spend a few days in the AIC where there is a concentration of multiple therapies and opportunities for different skills check-offs.

    ------------------------------
    Patricia Brown, RN, OCN
    Resource Nurse
    Community Cancer Institute
    785 Medical Center Dr. West
    Clovis, California 93611
    559-709-1006
    pebrownRN@gmail.com
    pbrown3@communitymedical.org]
    ------------------------------