In 2025, after three years away from the bedside, I did a crazy thing…I returned to patient care.
Now, I work three days a week as an oncology infusion nurse in a weekday-only ambulatory clinic, and my shifts are ten hours long.
It’s fast-paced AF, and there’s very little downtime. You’re juggling multiple patients, overlapping medications, charting, safety checks, and constant collaboration with other nurses throughout the day.
The best (or maybe worst?) part is that no two shifts ever look exactly the same.
If you’re a nurse considering an ambulatory infusion or oncology infusion role, I feel like an hour-by-hour breakdown is more helpful than a high-level description to show you exactly what the work truly looks like in real time.
So, here’s what a fairly typical day looks like for me as an oncology infusion nurse (so long as absolutely nothing goes wrong). 😅
0745–0800 — Arrival and Chart Review
In our ambulatory clinic, nurses start at 0745, and our first patients are scheduled for 0800, so the morning starts quickly, and we’ve gotta hit the ground running, as they say.
Assignments are made by the team lead the day before. As a newer nurse on the unit, I usually have six patients, though the range is typically six to eight, depending on experience and staffing.
The first thing I do when I clock in is review charts. I’m reviewing treatment plans, recent labs, provider notes, intravenous (IV) access, and any special considerations for the day.
Ideally, you’ve had time to review charts at the end of the previous shift, but if it’s your “Monday,” chart reviewing often continues as the morning unfolds (because literally no one can get ALL 6-8 chart reviews done in 15 minutes, but I digress).
Once I’ve reviewed at least my first three patients, I start prepping my first two chairs with all the supplies I need for their treatment plan: IV tubing, fluids, premedications, port-access kits or IV-start supplies, saline flushes, heparin flushes, and any other supplies I know I’ll need.
MY ASSIGNMENT FOR THE DAY
To make the flow of this blog post easier to follow, I’ve written out my patient assignment for the day. Here’s what that looks like:
- 0800: Patient A
- Access: Port
- Treatment Plan (TP): 3 IV premeds, cisplatin, IV magnesium, post-hydration fluids
- ~6 hours
- 0900: Patient B
- Access: PICC (includes dressing change)
- TP: Paclitaxel + 1 IV premed
- ~4 hours
- 1000: Patient C
- Access: Peripheral IV (PIV)
- TP: Nivolumab
- ~1 hour
- 1100: Patient D
- Access: Port
- TP: Oxaliplatin + leucovorin, 5-FU bolus and pump connection
- ~4 hours
- 1400: Patient E
- Access: PIV
- TP: Rituximab
- ~2 hours
- 1500: Patient F
- Access: None, subcutaneous injection
- TP: Daratumumab
- ~30 minutes
- 1600: Patient G
- Access: Port
- TP: Pembrolizumab
- ~1 hour
This mix of patients is very typical: one long 4-6 hour multi-chemotherapy treatment, a few medium-length infusions, shorter immunotherapies, and an injection toward the end of the day.
0800–0900 — Patient A (Cisplatin)
Patient A arrives right at 0800. After vitals and an assessment, I access their port and start premedications, which will take about 35 minutes.
With cisplatin, magnesium repletion is required, but magnesium doesn’t require premeds, so I don’t need to add a waiting period after the premeds. I’ll get the IV mag running over 60 minutes right after the IV premeds have completed.
While the mag is infusing, I’m already prepping my second chair for Patient B, who arrives at 0900. I’ll grab Patient B and get them settled.
0900–1000 — Patient B (Paclitaxel)
Paclitaxel also requires premeds, but the patient was able to take all of them at home prior to arriving at their appointment. They have a PICC, so this appointment includes a dressing change in addition to treatment.
After vitals and assessment, I let Pharmacy know we’re ready to receive their chemotherapy. While we wait for the med delivery, I complete the PICC dressing change and catch up on a bit of charting.
Pharmacy delivers the paclitaxel and cisplatin at the same time. I coordinate with another nurse for the chemotherapy double check using the 5-rights of medication administration — right patient, right medication, right dose, right route, right time — before starting paclitaxel on Patient B. This infusion will run for about three hours, so it becomes part of the background rhythm of the morning.
At this point, Patient A’s mag infusion is complete, and since their cisplatin has been delivered, I’ll get that one going as well.
10:00–11:00 — Patient C Arrives (Nivolumab)
Patient C arrives at 10:00 for nivolumab. Nivolumab runs for about 30 minutes, but with assessment, infusion, and monitoring, the total appointment time is closer to an hour.
Even though it’s a shorter immunotherapy appointment, it still follows the same safety protocols. I start a peripheral IV, complete assessment and vitals, and coordinate the immunotherapy double-check before starting the infusion.
At this point in the morning, all the infusion nurses are bouncing between chairs — checking ports and IV sites, flushing lines, responding to call lights, and assisting colleagues with double checks as needed.
11:00–12:00 — Patient D Arrives (Oxaliplatin / Leucovorin + 5-FU)
Patient D arrives at 11:00 for oxaliplatin and leucovorin, followed by a 5-FU bolus and pump connection. After vitals and assessment, I access their port and give any ordered premeds.
Once Pharmacy delivers the medication, another infusion nurse and I complete the chemotherapy double check, then start oxaliplatin and leucovorin concurrently over two hours.
By the end of this hour, I’ve switched Patient A to the post-hydration bolus, I’m simply monitoring Patient B’s paclitaxel, I’ve discharged Patient C, and I’ve started Patient D’s concurrent oxaliplatin and leucovorin.
Phew, the day has fully settled into its rhythm now.
12:00–13:00 — Lunch Coverage and Discharges
From 12:00 to 13:00, I’m covering lunches for other nurses on the unit. During this hour, I’m fully assuming care of their patients — monitoring infusions, responding to call lights, hanging medications if needed, and documenting anything that happens while they’re away.
At the same time, I’m continuing to manage my own patients. Patient A completes their post-hydration fluids, so I de-access their port, review discharge instructions, and send them home.
Patient B also finishes paclitaxel during this window. I flush their PICC, complete the discharge process, and ensure documentation reflects both the infusion and the earlier dressing change.
This hour is a mix of monitoring, discharges, and charting where possible. It’s common to move quickly between chairs while keeping an eye on infusion completion times.
13:00–13:50 — Lunch Break and Handoff
From 13:00 to 13:50, I’m off the floor for lunch. Another nurse fully assumes care of my remaining patients, which, for today, is only Patient D at this point.
Before leaving, I send a Teams message outlining what needs to happen while I’m away. For Patient D, this includes administering the 5-FU bolus, connecting the ambulatory pump, and discharging the patient.
During lunch coverage, nurses often hang medications, disconnect lines, or discharge patients as long as all tasks are completed and documented. Clear communication before stepping away is essential to keep everything running smoothly.
13:50–14:00 — Returning and Resetting
When I return from lunch at 13:50, I check in with the nurse who covered my patients to review what was completed and whether anything still needs follow-up.
Patient D has been discharged with their 5-FU pump connected, so I finalize documentation and shift focus to preparing for the afternoon arrivals.
14:00–15:00 — Patient E Arrives (Rituximab, Rapid Rate)
Patient E arrives at 14:00 for rapid-rate rituximab. After vitals and assessment, I start a peripheral IV and coordinate the immunotherapy double check before starting the infusion.
Although rapid-rate rituximab is shorter than initial titrations, close monitoring is still required early in the infusion. During this hour, I’m checking on Patient E regularly while charting and assisting colleagues as needed.
15:00–16:00 — Patient F (Subcutaneous Injection)
At 15:00, Patient F arrives for a subcutaneous daratumumab injection. These appointments are shorter, but they still include assessment, administration, and documentation.
After Patient F is discharged, Patient E’s rituximab is completed, too. I discontinue their peripheral IV, discharge them, and catch up on charting.
16:00–17:00 — Patient G (Final Infusion of the Day)
Patient G arrives at 16:00 for pembrolizumab. After assessment and port access, I complete the immunotherapy double check and start the infusion. Within the hour, their infusion is completed, and I discharge my final patient of the day.
17:00–18:15 — Closing Tasks and Preparing for Tomorrow
Once Patient G is discharged, the focus shifts to end-of-day responsibilities. I complete final charting for the day, review charts for the next day if I’m scheduled to work, and help restock supplies.
Some days are more intense than others, but this is what a typical day looks like for me as an oncology infusion nurse.
Is This Role Right for You?
Oncology infusion nursing is for nurses who don’t like to sit still. 😜
If you enjoy planning your day, tracking multiple infusions at once, and knowing exactly what needs to happen next (even in the chaos), then infusion nursing will probably feel super satisfying rather than overwhelming.
Time management matters here, of course, but so does flexibility. You’re constantly adjusting as treatments finish early, run late, or overlap in unexpected ways. And you’re continually helping your colleagues with their double-checks and coverage.
You may thrive as an oncology infusion nurse if you like:
- Managing multiple patients at once and keeping track of overlapping tasks
- Administering complex medication regimens and following detailed protocols
- Working closely with other nurses and relying on teamwork for safety checks
- Building short-term but meaningful rapport with patients over repeated visits
As with any specialty, the right fit depends on what you value in your work.
Wrapping Up the Day
By the time I walk out the door at 1815, I’m tiiired. 😅
Oncology infusion nursing requires constant attention, collaboration, and flexible organization, and the pace doesn’t let up much once the day gets going. The work is verrry detailed, the schedule is predictable, and the days move SO quickly. But there’s a clear beginning, middle, and end to the shift, and that rhythm works well for me.
Every oncology infusion clinic runs a little differently, but the core of the job stays the same: safe medication administration, careful monitoring, and strong teamwork.
If you’re exploring oncology roles in an ambulatory setting and wondering what a typical day looks like, I hope this hour-by-hour snapshot helps it feel a little more real.
