Day Five: Safety and Chemotherapy


Published: 28 February 2016

If I had to leave Vietnam tomorrow, I’d depart with a great sense of achievement, confident that we had made a difference to the lives of our Vietnamese colleagues.

As a nurse, it’s imperative to recognise the importance of personal safety: we cannot possibly care for our patients if we don’t care for ourselves first. So today we worked alongside the local Oncology nurses and demonstrated how they could improve their safety when handling chemotherapy.

safety and chemotherapy

The room used to prepare chemotherapy/store room/medication/treatment room.

As the preparation and administration of chemotherapy is highly controlled in Australia, we were eager to learn about the practices and precautions taken in the local hospital.

We began by observing a nurse prepare and administer chemotherapy. On this particular ward nurses are required to mix and prepare the chemotherapy. In Australia chemotherapy is prepared by highly trained pharmacists, working under strict safety regulations.

While the administration of intravenous chemotherapy, including the priming of lines, was identified as being high risk, waste disposal did not appear to pay respect to the inherent dangers of these highly toxic chemicals.

safety and chemotherapy

A Vietnamese nurse beginning to prepare chemotherapy.

safety and chemotherapy

Preparing intravenous chemotherapy.

Though resources are limited, we believed that we could add some valuable steps into their existing process that would enhance their practice.

After discussing with my fellow team members – among which was a highly experienced Oncology Clinical Nurse Consultant – we decided to demonstrate and implement a few simple changes that would potentially decrease any risk of exposure and improve safety.

Before getting started I thanked this nurse for allowing us to work with her, reiterating that we’re grateful for the opportunity to share our knowledge. I also tried to encourage the other nurses present that they would need to act as leaders, and demonstrate these practices to their colleagues. However, with one nurse to roughly 20 patients we knew how busy they were.

safety and chemotherapy

Those present included the Chief Nurse and nurses from the Oncology ward.

With the rest of the team there, adding valuable support and input, I gowned up. The local nurses whipped out their smartphones, videoing as I worked with a nurse as she prepared and then administered intravenous chemotherapy. With the Chief Nurse, Oncology doctors and a translator, we worked the process step-by-step. The goal was to provide practical support and demonstrate simple changes, using their existing resources, that could improve their chemotherapy practice.

While giving lectures is great for the transfer of knowledge, there truly is no better way to learn, or teach, than to demonstrate.

safety and chemotherapy

Providing practical suggestions to improve chemotherapy safety.

We are so lucky that in Australia we do chemotherapy safety pretty damn well. But for us, it’s not just the resources and education. We have good systems and regulations set up around the use of chemotherapy.

Unfortunately, thus far, these nurses’ practices are dictated by a system that does not afford the education and resources that we are so fortunate to have. But everyone has a right to be safe. No matter the systems currently in place, best-practice can be identified and strived for. Resources, can be adapted. Barriers to safety must be broken down.

I am hopeful that we have demonstrated a few simple steps that our colleagues can take to improve their safety practices, which will no doubt improve patient outcomes as well. Moreover, perhaps we encouraged these nurses to prioritise their own safety.

But we were not the only team that was able to spend some quality time with our Vietnamese colleagues! A team of preoperative nurses – two from Melbourne and one from Mount Gambier – alongside two Infection Prevention and Control Nurses, spent the morning in the operating room. They did a mock count and demonstrated ways to guarantee safe sterile procedures. Another example of the joy of shared learning alongside our Vietnamese colleagues.

A good day all round and a great way to finish our first week!