WARD 32

ONCOLOGY UNIT

STUDENT NURSE

ORIENTATION PACK

Written by S.S.N. Angee Milne Contributed S.S.N. ASHLEY MacLeod

Updated by SCN A Inglis April 20170

Index

Welcome to ward 32 p.2

Objectives/expectations p.2

Introduction p.3

Activities to help meet your objectives p.4

Areas you may wish to visit p.5

Average length of stay p.6

Some homework! p.7& 8

Cancer glossary, personal dictionary p.9 &10

Oncology unit Consultants and cancer specialities p.11

Bipsychosocial cancer patient needs p.12

Appendix 1 – support process for student nurses p.13

Appendix 2 – student placement evaluation p.14

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WELCOME TO WARD 32!

The team in Ward 32 would like to welcome you to the Ward. We hope you enjoy your time with us and find it both an interesting and beneficial learning experience.

If you are unsure of anything, please do not hesitate to ask questions and if any problems arise, please discuss these as soon as possible with your mentor, associate or SCN Alison Inglis.

Visions of Oncology Unit

To be a centre of excellence that provides patient centred care to all patients with a diagnosis of cancer.

Aims

Promote excellent standard of care which are patient centred Promote multidisciplinary team working; Collate patient and carers feedback regarding care experiences and strive

to improve.

OBJECTIVES/EXPECTIONS

While we will all work with you to ensure you are aware of the learning opportunities available, staff are aware of how daunting it can be to arrive in such a busy environment. We are here to help facilitate your learning needs and help you to achieve your goals.

You will have been assigned a mentor and associate who will be on hand to meet with you and discuss expectations of the placement within the unit.

Mentor: Associate Mentor:

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INTRODUCTION

The Oncology Unit is divided into a number of specialised areas which cover all aspects of caring for patients living with cancer in Tayside, Fife, Perth and Angus.

These areas within the unit include:-

The Main Ward:-This has 26 beds total: 3 bays (6 beds per bay) and 8 side rooms. The ward provides care for patients receiving a range of oncology treatments, symptom control, palliative and end of life care.

5 Day Chemotherapy Unit:-Which has 6 overnight beds And 12 day case spaces. Nursing staff administer chemotherapy to cancer patients. These patients may require an overnight stay or longer depending on the regime they are receiving.

The Chemotherapy Day Area:-Is where patients come in from home to receive chemotherapy and supportive treatments within a friendly, relaxed environment and leave at the end of the day.

Out-Patient Clinic:-Where medics review outpatients and discuss future planned care and treatments within one of the 5 treatment rooms.

Simulator:-An area where radiotherapy treatment is planned.

Brachytherapy Suite/Selection:-A suite situated in the chemotherapy day area. Female patients receive radiotherapy treatment for gynaecological cancer via a sealed source of radiation (brachytherapy). Nurses on the ward care for these patients.

Iodine Isolation Room:-Again situated within the chemotherapy day area where there are two different types of treatment given. I131 Treatment for thyroid cancer and MIBG treatment for neuroendicrine cancer (hormonal). This is an unsealed source of radiation. Nurses on the ward care for these patients.

Radiotherapy Suite:-Situated on level 2. An exciting new building where radiotherapy is administered to both IPT ‘s and OPT’s.

Ugo Stefani Unit:-

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Clinical Trials Research Centre named after one of Professor Rankin’s patients who kindly donated funds to research and new treatments.

Princess Alexandra Unit:-Research offices located at entrance of 5 day chemotherapy unit.

Activities to Help Meet Your Objectives

Activity Date Completed

Introduction to your mentor/associate mentor.

Orientation to ward area

Fire points and evacuation procedures

Explain nurse call system/ emergency call and equipment used

Be aware of responsibilities in relation to the following TRUST policies:

Infection control (discuss and demonstrate) Health & Safety – Reporting Incidents / DATIX Manual Handling

Ward Routine / Daily planner

Introduction to patients

Overview of Nursing Records/ Documentation

Location of Trust/ Unit Policies

Off duty planning requests

Identify P.E.F.

Absence Policy

Participate in team meetings

Communicate with all members of M.D.T. on a daily basis

Patient information leaflets (BACUP)

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AREAS YOU MAY WISH TO VISITWHILE ON PLACEMENT IN THE ONCOLOGY UNIT

Date Achieved

The Chemotherapy Five Day Unit………………….

The Chemotherapy Day Area………………….

Out Patient Clinic………………….

Radiotherapy Suite…………………

Simulator (Radiotherapy Planning)………………….

Various Specialist Nurses (Hospital Palliative CareTeam, XRT Nurse Etc.)………………….

Clinical Trials Research Nurses/Stefani Unit………………….

The Maggie’s Centre for Cancer Care…………………

Your own specific objectives:-

AVERAGE LENGTH OF STAY6

GUIDE FOR PREDICTING ESTIMATED DATES OF DISCHARGE (EDD)WARD 32

MAIN DIAGNOSIS RELATED SYMPTOM/TREATMENT

ESTIMATEDLENGTH OF

STAY

Malignant neoplasm of bronchus or lung

dyspnoeapleural effusion

infection spinal cord compression(SCC)

5 days5 days5 days

7-10 days

Malignant neoplasm of ovary

ascitespain control

infectionsub acute obstruction

4 days4 days5 days

7-10 days

Malignant neoplasm of breast

pleural effusionneutropaenic sepsis

spinal cord compression(SCC)

5 days5 days

7-10 days

Malignant neoplasm of prostate

hemi body irradiationspinal cord compression(SCC)

3 days7-10 days

Malignant neoplasm of oesophagus

dysphagia requiring stenting

post chemo side effectspost radiotherapy side effects

1 day after stent insertion5 days5 days

Malignant neoplasm of kidney

hypocalcaemia 5 days

Malignant neoplasm of colon

obstructionpost chemo side effects

7 days7 days

All tumour types nausea & vomiting 5 days

All tumour types anaemia 4 days

All tumour types planned radiotherapynumber of planned treatments

should be known

Number of days as per each

specific patient plan.

e.g. XRT 5# = 5 days

Some Homework!!!!!! Briefly what is?7

Dyspnoea

Pleural Effusion

Ascites

Sub acute Obstruction

Neutropaenic Sepsis

Hemi body Irradiation

SCC

Dysphagia

Palliative/ End of Life Care

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More Homework!!!!!! Briefly what is?

Basic Cell Structure

Carcinogens, what are they?

Basic abnormalities within the cancer cell

Metastasis

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CANCER GLOSSARY – www.meds.com/glossary.html

AAdenocarcinoma See Carcinoma. A malignant tumour arising from

glandular tissue

A.F.P. (Alpha-fetoprotein)

A tumour maker in the blood

Antigen Any substance that causes the body to produce normal antibodies

Antineoplastic agent A drug that prevents, kills and blocks the growth and spread of cancer cells

BBenign Growth A swelling or growth that is not cancerousCCancer A group of diseases in which malignant cells grow out of

control and spread to other parts of the bodyCarcinogen A substance that causes cancer e.g. nicotine – lung

cancerCarcinoma A type of cancer that skirts in the skin or lining of organs.

Basal Cell Carcinoma (BCC) – Skin cancer (most common)Squamous Cell Carcinoma (SCC) – Arising from the skin or surfaces of other structures, e.g. mouth/cervix/lungs

CEA (Carcinoembryonic antigen)

A blood tumour marker

Chemotherapy The treatment of cancer with drugs (oral or intravenously)Adjuvant Chemotherapy – Chemotherapy given to kill any remaining cancer cells usually post tumour removal by surgery or radiotherapy

EEffusion A collection of fluid in a body cavity e.g. Pleural Effusion

– lungsExtravasation The leaking of I.V. fluids or medication into the

surrounding tissuesHHickman (line) Catheter/Central Line

Aseptic surgically inserted catheter for I.V. medication/close patient monitoring e.g. CVP, antibiotics long term

Hodgkin’s Disease Cancer that affects the lymph nodes = lymphoma

IImmunosuppression Weakening of the immune system, reduced ability to fight

infection

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LLesion A lump or abscess maybe caused by injury or disease

such as cancerLeukaemia Cancer of the blood. WBC present in blood excessively

thus body unable to function correctlyLeucopoenia Reduction of white blood cells (WBC)Lymphocytes WBC that kill viruses and acts as a defenceLymph Nodes Small oval bodies that contain lymph. First line of

defence against infectionsMMalignant Tumours A tumour made up of cancerous cells of the type that can

spread to other parts of the bodyMelanoma A cancer of the pigment forming cells of the skin or retina

of the eyeMetastasize A spread from the first cancer site e.g. breast to boneMyeloma A malignant tumour of the bone marrow associated with

the production of abnormal proteinsMyelosuppression A decrease in the production of RBC, platelets and some

WBC by the bone marrowNNeoplasm A new growth of tissue or cells, a tumour that is generally

malignantNeutropaenia A decreased number of WBC (neutrophils)Non Hodgkin’s Lymphoma (NHL)

A cancer of the lymphatic system. Relate to Hodgkin’s disease but is made up of different cell types

PPalliative Treatment Treatment aimed at the relief of pain and symptoms of

disease but not intended to curePathological Fracture

(#) Caused by a cancer or some other disease process

RRegression The shrinkage of a cancer growthSSarcoma A malignant tumour of muscles or connective tissue

Personal Oncology DictionaryWord Definition

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Personal note of common cancer treatment drugsDrug Name Drug Desired Effect Drug Side Effect

Use overleaf if required

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ONCOLOGY UNIT CONSULTANTS AND CANCER SPECIALITIES

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Head and NeckDr Casasola (RJC) &MelanomaDr Niblock (PGN)

ColorectalDr Sanders (IS)Dr Armstrong (SA)

Gynaelogical/TestesDr Casasola (RJC)Dr Ferguson (MF)

G.U. Dr Polunsamy (SP)Dr Niblock (PGN)Dr Brown (EB)

LungDr Scott (AS)Dr Lord (HKL) & XRT PlanningDr Mahanamurali (MM)

BreastDr Adamson (DJA)Dr Mohanamurali (MM)

SarcomaDr Ferguson (MF)

Upper G.I.Dr Adamson (DJA)Dr Niblock (PGN)

BIOPSYCHOSOCIAL CANCER PATIENT NEEDS

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Translators

Maggie’s Centre

Dietician / Diabetes

Ψ Review

Support – NurseSpecialists

P.E.G. (ParenteralNutrition)

PodiatryPhysio / OT S.W.D. Carers

McMillan NursesD.N.’sDay Centre Roxburgh HouseMarie CurieChemotherapy NursesX RoadsSpiritual CareHospital Palliative CareOncology Support Team

S.A.L.T

Dermatology

APPENDIX 1 – SUPPORT PROCESS FOR STUDENT NURSES

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APPENDIX 2 – STUDENT PLACEMENT EVALUATION

Please take a moment of your time to complete this form, as this highlights to us improvements needed to make appropriate changes if necessary. Please be honest and explain your answers. Complete and return prior to end of placement.

QUESTION CIRCLE ANSWER

COMMENTS

Were you rostered to work with your mentor in week 1?

YES/NO

Was your mentor allocated to you on your first day?

YES/NO

Were you orientated to the ward on your first day?

YES/NO

Was the ward routine explained?

YES/NO

Were you shown and informed about everything in the orientation checklist?

YES/NO

Did you set objectives and develop a learning contract in the first week?

YES/NO

Did you feel your mentor fulfilled their role?

YES/NO

Did you achieve all your personal objectives, if not, why?

YES/NO

Did you enjoy your placement? Please try to explain.

YES/NO

Do you feel anything can be done to improve the learning experience?

YES/NO

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At what level do you feel the practical experience and teaching available on the ward is?

POORSATISFACTORYHIGH

Were you made to feel part of the multi-disciplinary team?

YES/NO

Any other useful comments

Thank you and we all would like to wish you the very best of luck in your nursing career!!!

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