What do a rituximab reaction, ice fishing, chest pain, knitted chicken sweaters, hospice, and transportation all have in common? These are examples of the diverse issues, topics, and situations outpatient infusion RNs may encounter on any given day.

An oncology infusion RN, in the outpatient setting, must have a set of skills and knowledge that encompasses topics far beyond nursing. The Merriam-Webster definition of a nurse is “a person who cares for the sick or infirm; specifically:  a licensed health-care professional who practices independently or is supervised by a physician, surgeon, or dentist and who is skilled in promoting and maintaining health.” Well, let’s just say that doesn't even shave off the tip of the iceberg for the infusion RN job description. In this two part series, I hope to bring to light how incredible these nurses truly are.

An oncology infusion RN needs to be familiar with all areas of nursing because oncology patients often have diabetes, heart disease, pulmonary issues, and sadly sometimes pregnancy. Excellent IV skills are crucial because it is routinely difficult to gain IV access on an oncology patient and a patient’s trust hinges on this skill.

The infusion nurse must be knowledgeable in oncology/hematology diseases and in the hundreds of regimens employed to treat these diseases. The infusion room nurse has to be an eager learner as new drugs are FDA approved almost weekly.  This nurse must know how to safely administer these drugs, and what the potential infusion reactions and side effects might be.

As a scientist, the nurse needs to know what lab results to look for that are significant for the drugs being given. The nurse may also be required to mix chemotherapy and monoclonal antibody therapies depending on the institution. He or she needs to be a mathematician to calculate drug dosing, infusion rates, the ANC, IVIG dosing, and so on.

The infusion room nurse needs to be a teacher educating patients about their disease, the drugs they are taking, the side-effects of their drugs, and when they need to call their provider.

The nurse needs to be familiar with the chart of each unique patient to make sure that their regimen is tailored to them and the correct drug, dosing, and route of administration for that patient has been ordered. The infusion room nurse needs to be a multitasker, ready at a seconds notice to act if there is a reaction, while still caring for multiple patients at one time. An expert infusion room nurse always has a small amount of healthy fear for what could happen, as experience is an excellent teacher. They know almost anything can happen.

The outpatient oncology infusion room nurse is an incredible nurse. There is a small group of people that are able to do this job well. In part two, I will share what I feel is the hardest part of the outpatient infusion nurse’s job.