A Brief Intro to Radiation Clinic

August 27, 2014.

Orientation done. Well sort of.

And I’m off to start working in my new department, in a new hospital, in a new country… half way around the world… So I’m taking my amazing work family from back home with me for moral support on this first day of my new job!

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Today starts the beginning of my orientation to the Radiation Clinic. 4-5weeks of preceptorship and learning the ropes in a new department!

Fortunately, I have my radiation therapy nursing certification, so the science of it all is no different. What is different is how the department is run. And my role here!

When I visited the unit last week, everyone was supremely welcoming and friendly. But it’s all a bit of a blur now and I really don’t remember many peoples names… Or much of where anything is!

So… I arrived at work… And met my new work momma… Shiny, my orientation preceptor. And she is absolutely the sweetest!!! I’m really going to love working with her.

And everyone is absolutely so kind and friendly… I feel like I got a giant hug today from everyone! Just scooped up and cuddled like a sad and lonely little puppy!

One of the Radiation Therapists, a beautifully vibrant and energetic and outgoing individual, shortly after meeting me, invited me along to a bunch of events this weekend as I had nothing planned due to all the other girls from my GNO group working the weekend. It was so nice to feel so welcomed and to have something to look forward to on the weekend… which is only a day away now.

Now… my first day of work was interesting. It is going to take a while to wrap my head around the differences here. I’ll go into great detail on it at some point… but for now…

The basics are that the Radiation Clinic consists of 6 treatment units for various types of radiation therapy… of which I have nothing to do with. That is where the Radiation Therapists come to play.

Then, there is the Recovery Room (nursing domain) where patients are monitored post General Anesthesia for Radiation Therapy, patients also recieve IV fluids, blood products and various other treatments if necessary.

In another corner of the department is the Nurse Clinic, where nurses see patients requiring hydration, blood products, IV starts for CT sim, medications for symptom management, and other treatments also that might be scheduled or for drop in patients.

This is all very much like home.

What is different, are the various clinics where nurses and doctors see patients throughout the week. Rooms 2&3, 4&5, 7&8… all contain different clinics depending on the day of the week. All the doctors hold clinics – stereotactic clinic, head and neck clinic, sarcoma and miscellaneous clinic, lymphoma clinic, pediatric clinic, gyne clinic, breast clinic, etc.

And the nursing role in these clinics is… well… hmm… different!

My first day was in rooms 2&3 in the Gyne/GI/GU clinic. We start out by checking charts… prepping charts (stamping and dating progress notes) … checking the rooms and schedules to make sure everything is ok. And then we start to see patients… as in we check their vital signs. Maybe assess their skin to make sure they are not developing radiation dermatitis. Obviously generally assessing the patient to ensure that they’re doing ok. But then we seat them in the room and get them ready for the doctor.

Then the doctor sees the patient and assesses how they are doing. Writes in the progress notes and maybe orders some labs or a cream or a medication.

We enter the orders. Sign off on the chart. And send the patient merrily on their way. The end.

Minimal education on side effects. Minimal assessment of side effects by nursing. No handouts on constipation management or skin care or pain managment or maintaining nutritional or hydration status…

Very different from back home where nurses do the majority of assessment and monitoring of radiation side effects and definitely the vast majority of teaching on preventing radiation side effects and how to manage side effects if they develop. At home the doctors do all this also, but a large portion of that role falls to the nurses.

Obviously a significant reason for this difference is due to language barrier. It easy enough to look at a patients radiation site and physicially assess the skin. But it is much harder to ask them about nausea, pain, constipation, fatigue, etc. and get good information if you don’t speak their language fluently. It is even harder to provide them with clear, consise information on how to manage all those symptoms if you don’t speak their language. So the majority of patient teaching falls to the Arabic speaking nurse educator.

So… learning Arabic as rapidly as possible is going to be extremely important!!! Yalla yalla Annemarie!!!

And that is the beginning of my nursing career here in Saudi Arabia. Prepare yourself for a lot more discussion on the differences on nursing care here vs. home… the benefits… the downsides… the challenges… the beauty of it all…

Until next time…

xx

Annemarie

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