Ward Nurse
1. Admit patients to ward and perform treatment and care as appropriate.
2. Ask patients to be by their bed for the ward-round each morning at
8:45 am.
Ward SHO
1. Perform full clinical examination, including abdomen, breasts (and,
if necessary, prostate, rectum and testes). Examine skin for atypical
moles (asking Specialist Ocular Oncology Nurse for assistance if necessary).
Document data in proforma, writing additional notes as necessary. Do
not document findings of clinical examination in continuation sheets
unless absolutely necessary.
2. Prescribe ophthalmic and general medications as appropriate.
3. Write prescription for chloramphenicol drops and mydriatics, to be
given pre-operative and post-operatively. All patients should be dilated
with cyclopentolate 1% and phenylephrine 2.5% one hour pre-operatively
and at 8.00 am each day (to enable ophthalmoscopy and to prevent synechiae).
4. Obtain results of all investigations before patient is transferred
to theatre.
5. If patient is to have local resection, endoresection, or enucleation,
obtain consent for genetic studies by adding statement to consent form.
Oncology SHO
1. Check work of ward SHO, completing tasks as necessary.
2. Obtain results of all investigations, before patient is transferred
to theatre.
3. Write the TTO's so that the medication can be obtained from pharmacy
well before discharge.
4. Write theatre list by Monday 3.00 pm for Tuesday session and by Thursday
noon for Friday morning session. Give theatre list to oncology secretary
5. Examine patients by 8.45 am on day of surgery.
6. Attend consultant pre-operative ward-round at 8.45 am on day of surgery,
making sure patients are by their bed.
7. Each Wednesday, check Friday Theatre lists with oncology secretary
and waiting list co-ordinator to identify spare capacity and fill theatre
time with general patients who are able to attend at short notice.
Usual Medications
Topical Drops
1. Topical antibiotics for one week (e.g chloramphenicol, 0.5% qid)
2. Mydriatics (eg cyclopentolate 1%, qid) for one week after markers
or plaque and four weeks after local resection.
3. Topical steroids (eg betnesol, 0.1% qid) for one week after plaque
and four weeks after marker insertion or local resection.
Systemic Medication
1. Antibiotics (eg Augmentin 375 mg, orally, tid, unless allergic to
penicillin, hepatic or renal impairment, pregnancy, or anticoagulant
therapy) for one week enucleation.
2. Prednisolone (60mg/day for two days, 40mg/day for two days, 20 mg/day
for two days and 10mg/day for two days) after local resection.
3. Analgesics (eg Ibuprofen, 200-600 mg, tid, for one week, unless peptic
ulceration, aspirin allergy) after enucleation.
4. Ranitidine (150 mg, twice daily) if steroids or oral analgesics are
prescribed and if previous or present history of dyspepsia.
Registrar
1. Supervise SHO.
2. Attend pre-operative ward-round at 8.45 am on morning of surgery.
Consultant
1. Supervise SHO and Registrar.
2. Check results of all investigations.
3. Be available for advice.
4. Attend pre-operative ward-round at 8.45 am each weekday.
Oncology Nurse
1. Visit each patient, providing information and support as required.
2. Review treatment plans.
3. Complete cytogenetic study form, to establish whether patient would
like to be informed of results, and if so, how (ie., by post, phone
call, GP, clinic appointment, etc).
Oncology Secretary
Prepare theatre list after consultation with ophthalmologist and oncology
nurse.
