Work Experience- Chemotherapy

On Tuesday I had my second day of work experience at the Lister, in a chemotherapy ward with the nurses. The room was small and had 6 armchairs in for the patients to sit whilst their blood was taken or whilst they were in therapy. The atmosphere was calm and the nurses were very friendly and patients we made comfortable with volunteers making cups of tea.

The nurses put the patients' hands in warm water to make the blood vessels come to the surface so they could attach a cannula. The drugs used to be administrated by the chemo nurse using a syringe however recent technologies from the USA has made things easier and reduced any issues with blood pressure. The machine disperses the drugs after giving the patient saline solution and allows the nurse to choose the rate of dispersal. If multiple chemotherapy drugs were being given, saline was used to flush the veins before the next drug was attached. For every drug administrated, there had to be a written record which had to be checked by another nurse. Some patients build up a tolerance to their medication; the nurses are unable to prescribe any drugs, so a doctor would have to be seen if the patient requires a higher dose. Also if the patient's weight changes, the dose will have to be altered to suit their new size.

I got the chance to go into a pre-chemo session with one of the nurses; these sessions are for those patients before they have their first treatment. The sessions take place in a quiet room; the nurse goes through all the possible side effects of the treatment and the patient is give the chance to ask any questions or talk about their worries. The nurse explained to me how important it is to have good communication skills as you cannot tell how a patient will react. Some patients get very emotional in the sessions, you must be a good listener to try and help the patient overcome their fears. The nurse also gave the patient a list of precautions, for example; the patient must avoid the sun and he is not allowed to eat cheese, pro-biotic yogurts or take-away rice due to the chance of bacterial infection, as his immune system will be down. The patient then was required to give his written consent and to have an MRSA swab in his nostril and groin, which would be sent to the pathology lab.

From spending my day in the unit I learnt that being in a ward allows lots of patient contact, unlike in the theatre when the patients were unconscious, and how sitting and talking to the patients can make a difference to them especially is they were in for a full day of therapy. A nurse explained to me how important it is as a doctor to have a good relationship with the nurses; if you have lots of patients to tend to in a ward and there are nurses able to take blood tests and administrate medication then they can co-operate and you can work as a team. Alike in the operating theatre, hygiene and the organised disposal of used equipment was maintained throughout the ward.