Rheumatology Infusion Nurse

Training

Education for licensed practical nurse (LPN) requires a 12-month diploma program in practical nursing; a registered nurse (RN) requires 2-4 years for an associate degree (AD) or Bachelor of Science in Nursing (BSN).

• Continuing education is required for licensure and recommended for specific infusion knowledge
• Rheumatology nurses giving chemotherapy medications will need specialized chemo training
• Infusion nurses work collaboratively with a rheumatologist or APP as part of a health care team and will learn many of their skills in that setting
• Infusion nurses need education about each rheumatology medication they will infuse

License/Certification

LPNs and RNs maintain state licensure and may have additional certification through national organizations.

General Description

An infusion nurse is a professional nurse who assesses, plans, implements and evaluates nursing care for patients/families in his/her area. The nurse: evaluates/manages patients within the infusion clinic through the use of nursing process; collaborates with the MD/NP and other members of the health care team by communicating patient’s history, current assessment findings, current status and patient response to care; gives basic nursing care within age-specific guidelines; supplements advanced nursing care through the performance of treatments and procedures as indicated; provides education to patients/family and peers. Most infusion nurses are licensed professional nurses (LPN, RN) depending on the setting.

Rheumatology Skill Set

• Correctly identifies the patient for infusion
• Inserts/maintains IV catheters
• Collects routine lab specimens
• Maintains equipment to be used with patients
• Assesses patient throughout the infusion for adverse reactions to the medication
• Documents medications, vital signs, and side effects in the medical record
• Educates self, staff, and patient family regarding all infusion medications and premeds
• Responds appropriately to side effects, adverse reactions, or anaphylaxis during infusion
• Obtains and maintains chemo certification if required by practice setting
• Recognizes general signs and symptoms of rheumatology diseases and personalizes care accordingly and as appropriate for age/developmental level

How/When to Refer

A provider must write an infusion order for patient to be seen by a rheumatology infusion nurse. Infusion nurses may work in a hospital, private of academic infusion center, or home health and the setting will dictate the referral process.

Case Study

Rose, a 50-year-old single female, was diagnosed with rheumatoid arthritis one month ago. She just started methotrexate and prednisone to control inflammation. She reports a one-year history of general pain and swelling in her hands and feet, morning stiffness lasting 2 hours, extreme fatigue and malaise, and often drops things held in her hands, particularly if they are heavy. She is having difficulty getting through her morning routine and getting to work. She does office work, and finds it difficult to type, walk or stand for long periods, due to pain and fatigue. She has two children in their middle teens. She will soon start infliximab infusions every 4 weeks.

What Can This Professional Do for Rose?

Nurses who administer infliximab should have a thorough understanding of the product to prevent or manage adverse events. In this way, they can help ensure the safe delivery of the agent and optimize patient outcomes. The nurse will educate Rose about the infusion center, admission process, frequency and duration of appointments, lab work, and monitor for side effects and reactions. The nurse will make Rose comfortable with appropriate diet, comfort measures, and pre-medications if ordered. The nurse can also encourage Rose regarding how the medication will improve her disease and reduce pain as well as assess any barriers to transportation, appointments with rheumatologist/NP/PA and obtain assistance of the social worker as needed.

Updated August 2024