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Hospital work experience: oncology

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I shadowed a pharmacist on a chemotherapy unit who showed methat dosing is by the patient’s surface area. This is done because the dosageneeds to be very accurate for the patient’s size. In addition, the chemotherapychart is separate to the ordinary drug chart which is crucial in helping toprevent errors. Most of the patients on the ward were outpatients and just camein to receive their chemotherapy. The inpatients were either very ill or werepatients with a complex chemotherapy regime, for example, some regimes requirethe patient to receive IV fluids. The pharmacist had to deal with lots ofissues regarding nausea, vomiting and pain control, for example, if a patientwas experiencing sickness and he or she was anxious, it would be common toprescribe haloperidol. It is also important to ascertain whether the sicknessis due to the chemotherapy or due to the actual disease the patient issuffering from as this could determine the medicine used to help control it.When the pharmacist spoke to patients it became obvious that they really valuedher time as they clearly wanted someone to talk to. The ward had an unusuallyhigh number of side rooms as infection control in immunocompromised cancerpatients is very important. An issue the pharmacist was unsure of was whytacrolimus was being prescribed on a cancer ward. To understand this she readthrough the patient’s notes and discovered that the patient had received a bonemarrow transplant and the tacrolimus was to prevent rejection of thetransplant.

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