“ we’re just like a filling station, they (patients) come here, we fill them up and let them go”!!

This was the response from several RN’s working in a hospital based outpatient infusion center I recently visited where chemotherapy and biologic agents are administered to patients with oncologic and non-oncologic disorders, including patient’s with immune mediated inflammatory disorders (autoimmune). What triggered the response was a simple question on what  nursing assessment is performed prior to the administration of monoclonal antibody for immune mediated inflammatory disorders like Rheumatoid Arthritis, Crohn’s Disease and Ulcerative Colitis.

I was very disappointed in their response and couldn’t believe what I heard. Since the nurses also administer chemotherapy to oncology patients, I asked what nursing assessment is done for these patients prior to chemo administration. Without any hesitation, these experienced, professional registered nurses recited off the criteria they assess in the oncology patients.

My heart was broken… As an infusion nurse, I felt these nurse colleagues have betrayed the “divine secrets” of the IV sisterhood!!! **sigh**( a little drama here) . Seriously, I honestly wish I’ve misheard what they said, but no, loud and clear, they admitted only the need for assessing oncology patients. It was reassuring to know that they care for the oncology patients enough to do an assessment, but why the difference? Why would these nurses do a pre-infusion assessment only for cancer patients receiving chemotherapy/biologic agents and not for those patients receiving biologic agents for non-cancer indications?

And so it goes….whatever the reason is, the truth hurts, but I wasn’t giving up. I had to enlighten my nursing colleagues and help them understand that all patients receiving infusions, regardless what medications is ordered, should be assessed for appropriateness of the prescribed therapy, knowledge of treatment goals and disease process, drug properties, pharmacological indications, method of administration, adverse events, laboratory data, and response to treatment. (from INS 2006 standards of practice)