What to expect in oncology

When you come to the clinic for your visit, you will meet a team of doctors and nurses that will take care of your child in the clinic setting. You might also see other team members that you have met before such as child life, social work and perhaps the school teacher or our nutritionist. A typical clinic visit may include the following:

1. Vital signs, including obtaining your child’s height and weight: Our Medical Assistants will perform these tasks, as well as ask you or your child some questions about their health. Questions include information about pain, fever, or a trip to the Emergency Room since your last clinic visit. This will help us provide the best care we can for your child.

2. Blood tests: Most children require blood to be drawn at every clinic visit. Depending on your child’s chemotherapy treatment for the day, this may be done by a finger poke or from your child’s port or central line. On some visits, your team may have to have these results back before proceeding with your treatment. This may take 30 minutes to an hour to get these results.

3. Medication review: When your child is first diagnosed with cancer or a blood disorder, you will be given a medication bag so that you may bring your medications with you to clinic every visit. This is very important so that members of your child’s care team can review ALL medications and their dosages with you.

4. Visit by team members: In clinic you will see one or more of the following: Your primary clinic nurse, Nurse Practitioner, Medical Student, Physician’s Assistant, Oncology Fellow and an Attending. They will discuss with you the plan for the visit. A typical visit may include a physical exam, IV therapy and sometimes a procedure with anesthesia. On occasion your child may require a blood transfusion if their hemoglobin or platelets are very low.

5. Check out: At the end of your child’s clinic visit, you will be given a pink “Return Appointment” slip that will tell you exactly when you need to return to clinic. You must stop by the front desk to make this appointment and check out.

6. Miscellaneous: Our clinic has a triage nurse that can help answer questions during normal business hours. Additionally, if your child runs a fever during normal clinic hours, this is the nurse that you will speak with and will help your child to be seen in clinic or the Emergency Room.

When you stay overnight in the hospital at Children’s Medical Center, you will meet a very large team of people who are working hard to help you and your child fight cancer. Children’s is nationally recognized for its excellence as a teaching hospital and your care team may include medical students, pediatric residents and pediatric oncology fellows. Each team member has an important role to play, but as a parent it can sometimes be confusing as to who does what. It is always okay to ask anyone who enters your child’s room the following questions: “What is your name?” “What is your job?” and “What is your role in the care of my child?”

While every day in the hospital is different from every other, a typical day may include the following:

1. Vital signs: depending on the severity of your child’s illness, vital signs may be taken on multiple occasions during the day and the night. This is important to keep your child safe.

2. Blood tests: some children require blood to be drawn while they are in the hospital. This usually occurs very early in the morning. Although this can disrupt your sleep, it is important to have these test results available for your physician to review when they arrive between 6 a.m. and 8 a.m.

3. Visit by the medical team: Early in the morning, usually between 6 a.m. and 8 a.m., you will meet one of several caregivers. These include your nurse for the day and a pediatric resident or nurse practitioner or a physician’s assistant. Some days you may also meet a medical student. They will discuss with you the events which occurred overnight and any new symptoms which may have arisen. They will review your child’s vital signs, laboratory results and examine your child. They will then present these findings to the rest of your care team, including your Attending Physician, and a plan of care will be made for the day. While these visits occur early in the morning, they are extremely important to developing your plan of care for the day, and for acting upon any new or potentially serious problems which have developed.

4. Rounds with the Attending physician take place later in the morning or in the early afternoon. He or she may be accompanied by other members of the team as well. He or she will also examine your child and discuss the plan of care for the day. This process is called “Rounds.” It is helpful to write down any questions you may have before rounds to help you remember what to ask. Although the attending physician usually does not visit the patient room multiple times during the day, if your child has any concerning symptoms such as nausea or pain, or if you have any additional questions, please ask the nurse to contact your physician.

5. Depending on your child’s needs, he or she may also been seen by a physical therapist, respiratory therapist, occupational therapist, or even a massage therapist. You may also work with members of our family support services including child life, school services, social work, nutrition and pastoral and spiritual care.