Download WARD 32 - School of Nursing and Midwifery

WARD 32
ONCOLOGY UNIT
STUDENT NURSE
ORIENTATION PACK
WRITTEN BY S.S.N’ANGEE MILNE
Contributed S.S.N.ASHLEY CAIRD&
PRINTED DECEMBER 2008 DATE FOR REVIEW JULY 2009/ Jan 2015
Updated 18/02/2016
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Index
Welcome to ward 32!
p2
Objectives/expectations
p2
Introduction
p3
Activities to help meet your objectives
p4
Areas you may wish to visit
p5
Average length of stay
p6
Some homework!
P7, 8
Cancer glossary, personal dictionary
p9, 10
Oncology unit Consultants and cancer specialities
p11
Bipsychosocial cancer patient needs
p12
Appendix 1 – support process for student nurses
p13
Appendix 2 – student placement evaluation
p14
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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 Lynne Clarke or SCN
Alison Inglis.
Visions of Oncology Unit
To be a centre of excellence that provides a high standard of evidence based quality care to all
patients with cancer.
Aims
 Promote multidisciplinary team working;
 Promote patient and public involvement in any new developments;
 Collate patient and carers feedback regarding 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 radiotherapy (XRT) treatments, symptom
control, palliative and end of life care.
5 Day Chemotherapy Unit:Which has 10 beds (5 beds per bay). And 4 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 newly refurbished 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:Clinical Trials Research Centre named after one of Professor Rankin’s patients who kindly
donated funds to research and new treatments.
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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 / I.R.1.
 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.(currently awaiting allocation)
Sickness 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 VISIT
WHILE 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 Care
Team, XRT Nurse Etc.)
………………….
 Clinical Trials Research Nurses/Stefani Unit
………………….
 The Maggie’s Centre for Cancer Care
…………………
 Your own specific objectives:-
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AVERAGE LENGTH OF STAY
GUIDE FOR PREDICTING ESTIMATED DATES OF DISCHARGE (EDD)
WARD 32
MAIN DIAGNOSIS
RELATED SYMPTOM/TREATMENT
ESTIMATED
LENGTH OF STAY
Malignant neoplasm of bronchus
or lung
dyspnoea
pleural effusion
infection
5 days
5 days
5 days
Malignant neoplasm of ovary
ascites
pain control
infection
sub acute obstruction
4 days
4 days
5 days
7-10 days
Malignant neoplasm of breast
pleural effusion
neutropaenic sepsis
5 days
5 days
Malignant neoplasm of prostate
hemi body irradiation
spinal cord compression(SCC)
3 days
7-10 days
Malignant neoplasm of oesophagus
dysphagia requiring stenting
post chemo side effects
post radiotherapy side effects
1 day after stent
insertion
5 days
5 days
Malignant neoplasm of kidney
hypocalcaemia
5 days
Malignant neoplasm of colon
obstruction
post chemo side effects
7 days
7 days
All tumour types
nausea & vomiting
5 days
All tumour types
anaemia
4 days
All tumour types
planned radiotherapy
number of planned treatments should
be known
Number of days as
per each specific
patient plan.
e.g. XRT 5# = 5
days
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Some Homework!!!!!!
Briefly what is?
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
A
Adenocarcinoma
A.F.P. (Alphafetoprotein)
Antigen
Antineoplastic agent
B
Benign Growth
C
Cancer
Carcinogen
Carcinoma
CEA (Carcinoembryonic
antigen)
Chemotherapy
E
Effusion
Extravasation
H
Hickman (line)
Catheter/Central Line
Hodgkin’s Disease
I
Immunosuppression
L
Lesion
Leukaemia
Leucopoenia
Lymphocytes
Lymph Nodes
M
Malignant Tumours
See Carcinoma. A malignant tumour arising from glandular tissue
A tumour maker in the blood
Any substance that causes the body to produce normal antibodies
A drug that prevents, kills and blocks the growth and spread of cancer
cells
A swelling or growth that is not cancerous
A group of diseases in which malignant cells grow out of control and
spread to other parts of the body
A substance that causes cancer e.g. nicotine – lung cancer
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
A blood tumour marker
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
A collection of fluid in a body cavity e.g. Pleural Effusion – lungs
The leaking of I.V. fluids or medication into the surrounding tissues
Aseptic surgically inserted catheter for I.V. medication/close patient
monitoring e.g. CVP, antibiotics long term
Cancer that affects the lymph nodes = lymphoma
Weakening of the immune system, reduced ability to fight infection
A lump or abscess maybe caused by injury or disease such as cancer
Cancer of the blood. WBC present in blood excessively thus body unable
to function correctly
Reduction of white blood cells (WBC)
WBC that kill viruses and acts as a defence
Small oval bodies that contain lymph. First line of defence against
infections
A tumour made up of cancerous cells of the type that can spread to other
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Melanoma
Metastasize
Myeloma
Myelosuppression
N
Neoplasm
Neutropaenia
Non Hodgkin’s
Lymphoma (NHL)
P
Palliative Treatment
Pathological Fracture
R
Regression
S
Sarcoma
parts of the body
A cancer of the pigment forming cells of the skin or retina of the eye
A spread from the first cancer site e.g. breast to bone
A malignant tumour of the bone marrow associated with the production
of abnormal proteins
A decrease in the production of RBC, platelets and some WBC by the
bone marrow
A new growth of tissue or cells, a tumour that is generally malignant
A decreased number of WBC (neutrophils)
A cancer of the lymphatic system. Relate to Hodgkin’s disease but is
made up of different cell types
Treatment aimed at the relief of pain and symptoms of disease but not
intended to cure
(#) Caused by a cancer or some other disease process
The shrinkage of a cancer growth
A malignant tumour of muscles or connective tissue
Personal Oncology Dictionary
Word
Definition
Personal note of common cancer treatment drugs
Drug Name
Drug Desired Effect
Drug Side Effect
Use overleaf if required
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ONCOLOGY UNIT CONSULTANTS AND CANCER
SPECIALITIES
Head and Neck
Gynaelogical/Testes
Dr Casasola (RJC) &Melanoma
Dr Niblock (PGN)
Dr Lord (HKL) (Glioma)
Dr Casasola (RJC)
Dr Ferguson (MF)
Dr Armstrong (SA)
Breast
Upper G.I.
Dr Adamson (DJA)
Dr Niblock (PGN)
Colorectal
Dr Adamson (DJA)
Dr Mohanamurali (MM)
Lung
Dr Scott (AS)
Dr Lord (HKL) & XRT Planning
Dr Mahanamurali (MM)
Dr Sanders (IS)
Dr Armstrong (SA)
Sarcoma
Dr Ferguson (MF)
G.U.
Dr Polunsamy (SP)
Dr Niblock (PGN)
Dr Brown (EB)
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BIOPSYCHOSOCIAL
CANCER PATIENT NEEDS
Maggie’s Centre
Ψ Review
Translators
S.A.L.T
Dermatology
McMillan Nurses
D.N.’s
Day Centre
Roxburgh House
Support – Nurse Marie Curie
Specialists
Chemotherapy Nurses
X Roads
Spiritual Care
Hospital Palliative Care
Oncology Support Team
Dietician / Diabetes
P.E.G. (Parenteral
Nutrition)
Physio / OT S.W.D.
Carers
Podiatry
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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
Were you rostered to work with your mentor in
week 1?
CIRCLE
ANSWER
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
At what level do you feel the practical
experience and teaching available on the ward
is?
POOR
SATISFACTORY
HIGH
Were you made to feel part of the multidisciplinary team?
YES/NO
COMMENTS
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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