Being a nurse in medical oncology during the covid19 epidemic

ABSTRACT

Background: Until February 21, 2020, Covid 19 was a disease known exclusively in China. Since that date, our working life has changed considerably. The number of cancer patients has not changed and their needs have always been fulfilled without interruption. Our department has not stopped its activity and the staff have been exposed to the risk of contagion because patients were not able to access the preventive tampon. Method: Our department has followed the regional and internal directives issued by the Health Department in conjunction with those issued by the Istituto Superiore di Sanita. The staff have protected themselves with PPE such as masks of different types, gloves, sanitization and body temperature monitoring. The same protection methods have been used for patients. In order to avoid our patients' unchecked access to the department, a doorbell has been installed to signal their arrival. We have granted the correct social distancing in the waiting rooms and the shifting in the therapy rooms. Because of the absence of a secretary in our department the staff has had to deal also with the several telephone calls, that in tis period have increased further. Our patients in oral treatment have received medications to continue their treatment for a longer period (two months), all the chemotherapy cycles with a second day (e.g. Folfox-4) have been converted into a single day (Folfox-6 and so on). Periodic checks have been postponed after medical evaluation. Results: During the months of March to May, 1589 chemotherapy cycles were performed. In the same period 49 patients were discharged from the hospital ward. Just first or emergency visits were granted. Conclusions: Our workload has not been reduced. Patients were welcomed with new rules. No one has complained about our organizational changes. In a high turnout department like ours, this has been a stressful period for our staff, because in addition to the infectious risk from Covid the nursing and administrative workload have both increased. The volunteer staff to whom the reception is usually delegated remained at home and so did the psychological and nutritional support. From a psychological point of view, this period was not without emotional consequences. None of the staff fell ill, while some of 44 cancer patients tested positive were discovered during our work. 21 of them died.