Imagine you've just been newly diagnosed with a scary cancer and having to face the unknown of starting Chemotherapy. Chemotherapy is scary and complex, and there are multiple side effects that can sometimes be life-threatening if not well assessed and managed properly by the Oncology nurses and healthcare team.  This is one of the multiple stories of how complex the Chemo treatment is and how the Oncology/Infusion team works together to make absolutely sure our patients' treatment is successful and well tolerated.  

This Patient is a 52-year-old male with testicular cancer.  Treatment is 5 days of consecutive Chemo treatments that included 3 strong/potent Chemotherapy that have scary infusion reactions and side effects.  In order to manage this 3 scary Chemotherapy, complex pre-medications and post medications that needs to be taken at home prior to the Chemo Day and appropriate labs needed to be checked 2 days prior to the treatment day and again on Day 3 and on Day 5.  There's also a urine sample check for urine protein and blood as well.  This teaching is mostly done by the Charge RNs, who are experience Oncology Certified Nurses.  They will call the patient with these instructions and will send a written message with the same instructions to the patient well before treatment day. They will answer any questions the patient has prior to starting treatment.  On the treatment days, alongside 3 Chemo medications, there are 2 electrolytes supportive care, pre- and post-hydrations to help prevent kidney damage, multiple IV medications (IV push and IVPB) to help manage highly emetogenic Chemo and infusion reactions and side effects.  Each of them has to be given in the correct orders.

Teaching regarding Chemotherapy and their possible multiple side effects is done by the treatment nurse.  Starting IVs or accessing Port-a-Cath is expertly done by the treatment nurses.  All education is given verbally and in written form so Pt can refer to it later.  All questions are answered clearly to Pt at chairside.  Besides making sure Pt understand their complex treatment, emotional support is an important part of treatment as well and the Oncology/Infusion team is again and again named the most compassionate team by multiple patients. 

During Chemo infusion, patient has a reaction that is recognized immediately and managed between the treatment nurse, the charge nurse, other treatment nurses in the department, and also the Nurse Practitioner who is well versed in managing scary infusion reactions.  Everyone knows how to work together to "rescue" patient by administering hypersensitivity medications.  When the patient's symptoms are back to baseline, Chemo is most likely to continue and be completed as safely as possible.  Depends on the Chemo, managing side effects and infusion reactions is different for each medication.  Clear and precise communication and collaborative support from infusion nurses, charge nurse, and nurse practitioner made all this scary cancer treatment safe and tolerated as best as possible by our patients.  Again, compassionate, calm, and competent team members are displayed. Afterward, detail notes are done by each team members and pertinent information is passed on for the next nurse to continue treatment.  Our patients again and again expressed their gratitude, appreciation when they completed their prescribed treatment. 

The Chemo/Infusion department received countless appreciation cards and notes to say how well they are treated at this Chemo/Infusion department. Our patient actually said they missed coming to Chemo/Infusion because they missed the nurses here. I am one of the nurses in this wonderful department and every day I come to work feeling humbled, grateful for all of my coworkers.  I have worked at multiple departments before and in my bias opinion, this is one of the best departments I've ever worked on, and I can't imagine doing anything else.

Everyone in the Oncology/Infusion team deserves this DAISY Team Award!