Managing the "In Between"
Our unit is currently in a state of "in between." Every week we receive more medical oncology patients, but somehow still manage to fill beds with the classic thoracic surgery or other complicated surgical patients. On any given day one can find one third of our beds with patients admitted for nausea and vomiting or electrolyte imbalance, receiving chemo, while the other two thirds have had a lung lobectomy, an esophagectomy, a colon resection, etc.
When we were primarily thoracic surgery, or at the least, just surgery, we felt like we had a specialty, now that we are receiving two polar opposites it's very difficult to gain a sense of comfort. It is not a comforting feeling walking into your shift having no idea what type of patient you're going get, when that is what you have been used to from the beginning. I only point this out because at the hospital I work, it is very evenly divided into medicine and surgery, so our unit is literally the "odd man out" with regard to the mix of patient population.
Another reason that this has become difficult is because the surgeons know the nurses on our unit and are used to the unit only having their patients so I believe it is difficult for them to understand the changing population as well. This can make communication challenging at times and the environment chaotic.
The positive is that it's certainly an opportunity to learn. It's an opportunity to continue to hone in on surgical skills, while learning about medicine patients as well. It is still an unknown as far as when the entire unit will become medical oncology so for now we are forced to ride the wave.