diagnosis and treatment, rehabilitation, long-term follow-up, and when necessary, palliative care. There is a strong commitment to primary nursing. Patient readily indentify providing care and are as diverse ad the range of needs patients express.
These disciplines include social service, nutrition, psychiatry, palliative care service, pain service, occupational and physical therapy, and Chaplaincy. Patients who are treated with chemotherapy and biotherapy for malignant disease are also referred to th Infusion Units for treatment related or supportive therapies such as blood products, hydration, antibiotic therapy, and pain managment. Common nursing problems are related to the primary disease and/or treatment-related symptopms,
and include:
- Protective mechanisms: Alterations in mobility, skin integrity and neurologic status; and myelosuppression
- GI and GU Function: Alteration in elimination and nutrition
- Cardiopulmonary Function: Alteration in ventilation and circulation
- Oncologic Emergencies: hypercalcemia, DIC, SIADH, sepsis, tumon lysis syndrome, hypersensitivity reactions, cord compression, ICP, cardiac tamponade, and SVC syndrome
- Quality of Life: Sexuality, pain, fatique, altered body image, coping
Staff nurses support the organizational mission and the Cancer Center investment in clinical research. In tandem with the Cancer Center Protocol Office and the Research Manager, staff nurses participate in the administration of all phases of clinical trials on which their primary patients may be enrolled. The Infusion Unit nurse is responsible for patient education, medication administration, symptoom management, and documentation of toxicities for those patients participating in clinical trials as those patients receiving standard regimens. PATIENT CARE DELIVERY MODEL
Nurses are committed to primary nursing
and work in a collaborative practice model with physicians and nurse
practitioners, in the Division of Hematology-Oncology.
Nursing care is guided by institutional and
national standards. These standards of care include those developed
by the MGH Department of Nursing and the national standards of care
developed by the MGH Department of Nursing and the national standards of care developed by the Oncology Nursing Society with the American Nurses Association.
Nurses who are assigned to the Infusion Units
will be certified in chemotherapy administration and blood product
administration as described by The Norman Knight Nursing Center for Clinical & Professional Development (CCPD).
TEAM MEMBERS
Registered nurses (RNs) who are certified
in the administration of chemotherapy and blood products work in
collaborative practice with oncologists and nurse practitioners. Patient Care Associates, directed by the RN, support the RN in delivering patient care. An olcology Care Coordinator is available to assist the nursing/medical staff with planning patient' complex home care needs, including home IV therapy, prescription drug reimbursement, and facilitate referrals.
A Nursing Director, two clinical nurse specialist and an operations coordinator make up the management triad. This team is responsible for establishing standards of care, initiating quality improvement projects, and setting/supporting the overall tone for patient care. To inquire
about positions available on this unit, contact Jeff Hickey at jjhickey@partners.org.
SCHEDULING PRACTICES
The unit budget is prepared and negotiated
annually prior to beginning of the fiscal year using current and
historical data and trends in volume (workload) and resource utilization
and in concert with unit, departmental, and hospital goals and projections
(personnel budget, FTE budget). Performance against budget is reviewed
and adjusted during the fiscal year as needed based on major changes
in activity, resource requirements, goals, or projections.
STAFF ORIENTATION
Nurse orientation to the Infusion Units
requires a minimum of six weeks. New nurse employees to the MGH
will be required to attend Hospital New Employee Orientation, General
Nursing Orientation through CCPD, and a unit-based orientation.
Transfers from other nursing units within MGH where chemotherapy
administration is included in the scope of practice will require
orientation to the Infusion Units.
RNs are expected to have completed both Hospital
Orientation and Nursing Orientation and the associated competencies
before proceeding to Unit orientation. Successful completion of
Unit-based orientation requires (but is not limited to) completion
of chemotherapy, blood product, research, and ambulatory infusion
competencies.
PCA Orientation requires a minimum of four weeks.
PCAs are expected to have completed both Hospital Orientation and
Nursing Orientation and the associated competencies before proceeding
to Unit orientation.
Practice Assistant orientation requires a minimum
of four weeks. Orientees are expected to have completed Hospital
Orientation before completing the Unit orientation.
EDUCATIONAL AND DEVELOPMENT OPPORTUNITIES
Infusion Unit staff nurses support the
organizational mission and the Cancer Center investment in clinical
research. To that end, nurses are provided with education from the
Research Nursing Director and designated clinical research nurses,
which includes didactic information and clinical precepting. This
is done on an individual basis because of the growth in the number
and complexity of clinical trials, the evolving nature of experimental
cancer therapies, and the Infusion Unit's commitment to disease-focused
treatment teams. Thus, the disease-related collaborative practices
develop proficiency in the trials associated with their clinical
focus.
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