Sunday, August 21, 2011

Go Time

Posted by Nina Cimino at Sunday, August 21, 2011

I'm getting ready for my last week on the oncology unit, and in my preceptor's words, it's my "go time". That means that this week, I'm on my own with rounds. Typically, my preceptor and I round together with the physician and nurse practitioner each morning, and while they have come to rely on me more, they often default to asking my preceptor's opinion. My preceptor wants me to have the experience of rounding without her, so that the physician and nurse practitioner will direct their questions to me. Of course, my preceptor will still be on the unit, so if I run into a question I need help with, I can go to her for help.

To help prepare myself for rounds and my case discussions with my preceptor each week, I have been doing a lot of reading. Typically, I look for clinical practice guidelines for specific disease states, such as lung cancer or endometrial cancer. Review articles are really helpful as well, especially for getting a general idea of the disease and the approach to treatment. Other times, my reading will be focused on a new drug that has been recently approved, or supportive care measures for some the common chemotherapy adverse effects.

One thing that has been surprising to me is the amount of internal medicine knowledge that is applied in an oncology unit. For example, many of the adverse effects patients experience, like nausea or diarrhea, need to be treated separately from the cancer itself. Also, because so many patients become immunocompromised after chemotherapy, infection prophylaxis and treatment is a HUGE concern! Often times, we can't even focus on treating a patient's cancer until their other medical issues have been stabilized. This makes for a lot of drug therapy concerns to keep up with, but it is a great way to learn!

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