Predating physician orders Melayu hookup

I would like to use this opportunity to introduce myself to all of you.

Although my intent is not to make this article like an awful episode of "Biography," as your new coordinator, I thought you might like to know a little about my background and my philosophy.

In 1986, I started working at the Fred Hutchinson Cancer Research Center in Seattle, WA, where I learned that bone marrow transplantation is its own unique subspecialty.

I became involved with the brand new Bone Marrow Transplant Focus Group (which later evolved into the ONS SIG).

During the next 15 years, I authored an article for the and began the first of several national presentations on topics such as the toxicities of high-dose chemotherapy, chemotherapy safety and administration, mucositis, and sinusoidal obstruction syndrome (veno-occlusive disease).

When the Seattle Cancer Care Alliance (SCCA) was formed in 2000 as a joint venture among Fred Hutchinson Cancer Research Center, the University of Washington Medical Center, and Children's Hospital and Regional Medical Center, I got on board as an infusion RN.

Many of the barriers are formidable, but I believe this is a battle worth fighting, and I hope our SIG will help lead the charge.

The other half of my job is involved with infusion-specific clinical practice issues. When originally approached to run for coordinator, I was flattered. Though I've held many leadership roles in my life, this is my first go-round as a SIG coordinator.

Any competent nurse would question the order rather than follow it.

So, why would the responsibility change with chemotherapy? Nurse practice acts vary from state to state, but they do have some similarities. So, the responsibility to be familiar with medications given and to question order appropriateness does not diminish as the drugs become more toxic—as with chemotherapy.

Part of the current problem regarding varying expectations about responsibility among different organizations and even within individual facilities may lie in nurses' comfort with performing necessary calculations.

Also, system problems may exist within organizations that make verification of chemotherapy dosing difficult.

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To illustrate, no nurse would balk at the need to question an order for acetaminophen 35 mg every four hours.

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