Oncological nurses specialize in the treatment and care of cancer patients. While many oncological nurses care directly for cancer patients, some may be involved in patient or community education, cancer prevention, or cancer research. They may work in specific areas of cancer nursing, such as pediatrics, cancer rehabilitation, chemotherapy, biotherapy, hospice, pain management, and others.
Oncological Nurse Career History
The history of cancer dates back to early Greek and Roman writings, which included descriptions of the disease. Cancer affects all of the world’s populations and has been the subject of intense medical investigations. According to the American Cancer Society, approximately 1.4 million people in the United States are diagnosed with cancer each year. Cancer ranks second only to heart disease as the leading cause of death.
Nurses have always played a role in treating cancer patients, but it was not until the 1970s that oncological nurses began to receive greater recognition for their unique training and focus. The National Cancer Act of 1971 provided much-needed funding for cancer research, which improved the knowledge of oncological nurses. The First National Cancer Nursing Conference was held in 1973. A small group of oncological nurses met at this conference to discuss the possibility of creating a professional organization, and in 1975, The Oncology Nursing Society was created to represent the professional needs and interests of oncological nurses and other health care providers.
Developments in the late 20th century, such as improvements in cancer treatment and early detection, have advanced the discipline of oncology and led to further studies. In the 1950s, minor success with cytotoxic chemotherapy initiated active research to develop anticancer agents. Although most useful drugs have side effects, oncologists continue to conduct studies to find better treatments. Increased public awareness of the positive effects of a healthy diet and exercise as well as the harmful effects of smoking has helped lower the risk of developing many types of cancer. Many believe that cancer will someday become a largely preventable disease.
Oncological Nurse Job Description
Carolyn Panhorst, a registered nurse, worked as an oncological nurse in a small hospital in a small farming community in Indiana. “Our hospital was a satellite facility for a larger hospital in a metro area,” states Panhorst. “Our doctors’ offices were in the hospital, and I administered chemotherapy both to patients who were admitted to the hospital and to outpatients.”
Because cancer treatment and care differ considerably depending on the facilities and the type of cancer the patient has, oncological nurses’ job responsibilities vary greatly. It is important for them to keep up on current research, treatments, and other advances with the disease. Nurses who must administer drugs and other types of treatment must be aware of the changes in dosages, equipment, and side effects.
Panhorst relates, “Although technical expertise is definitely required when caring for cancer patients, the nurse needs to be emotionally and personally attached to the patient. If the nurse cannot give much of herself or himself, this is felt by the patient.”
Caring for patients with cancer can be an emotional nursing experience. Nurses must be aware of the psychological aspects of this type of nursing. They also need to know the effects that this disease can have on the patients, families, and friends.
“Don’t get into this area and think you are going to save anybody,” a nurse once told Panhorst. “I thought this was cold, but I understand now. You have to want to be there for your patients even though you may not be able to help them,” says Panhorst. “You try to give them what science and technology knows, and then provide them with the best nursing care possible. But, you have to know that you are not God and leave your mind open to the full reality of what the possible outcome may be.” She adds, “You must be satisfied that you did the best you could.
“Taking care of cancer patients is a different kind of nursing,” observes Panhorst. “In normal relationships people tend to be protective, but when patients are frightened by their illness, their pretense is gone. They have the ability to communicate more openly. They trust you with their innermost feelings, and that’s a huge responsibility and also a privilege.”
There are so many treatment choices available for cancer patients today that the nurse needs to be an educator as well as a caregiver. The nurse must help the patients receive the best possible care and also respect their wishes. “You need to be a patient advocate,” says Panhorst. “You have to know the difference between giving them information and advising.
“This is an area of nursing where you can easily fall in love with your patient and their family,” says Panhorst. “You can have a wonderful, meaningful relationship with the patient.”
Oncological Nurse Career Requirements
High School
If you want to become an oncological nurse, you will first need to become a registered nurse. To prepare for this career, you should take high school mathematics and science courses, including biology, chemistry, and physics. Health courses will also be helpful. English and speech courses should not be neglected because you must be able to communicate well with patients.
Postsecondary Training
You must be a registered nurse before you can become an oncological nurse. There are three basic kinds of training programs that you may choose from to become a registered nurse: associate’s degree, diploma, and bachelor’s degree. Which of the three training programs to choose depends on your career goals. A bachelor’s degree in nursing is required for most supervisory or administrative positions, for jobs in public health agencies, and for admission to graduate nursing programs. A master’s degree is usually necessary to prepare for a nursing specialty or to teach. For some specialties, such as nursing research, a Ph.D. is essential.
Entry-level requirements to become an oncological nurse depend on individual hiring qualifications of the institution or practice and the availability of nurses in that specialty and geographical region.
Certification or Licensing
Some institutions may require certification as an oncology nurse. There are three types of certification available through the Oncology Nursing Certification Corporation (ONCC). The oncology certified nurse examination is aimed at testing basic knowledge within the specialty of oncology nursing. The certified pediatric oncology nurse (CPON) examination tests knowledge in pediatric oncology. The advanced oncology certified nurse practitioner (AOCNP) and advanced oncology certified clinical nurse specialist (AOCNS) certifications are advanced certifications and test knowledge in advanced cancer nursing practices. Each specialty requires recertification.
Other Requirements
Oncological nurses should like working in a fast-paced environment that requires lifelong learning. New medical technology and treatment methods are constantly being developed and implemented. Oncological nurses should be technically inclined and be able to learn how to operate new medical equipment without feeling intimidated.
Because of the seriousness of their loved one’s illness, family members and friends may be difficult to deal with and the nurse must display patience, understanding, compassion, and composure during these emotional times. The nurse must be able to communicate and explain medical terminology and procedures to the patient and family so they can make informed decisions and understand what is being done and why.
Exploring Oncological Nurse Career
You can explore your interest in the nursing field in a number of ways. You can read books about famous nurses (such as Clara Barton, Elizabeth Fry, or Florence Nightingale) or books on careers in nursing. You might also talk with your high school guidance counselor, school nurse, or other nurses in your community about the career. You can also visit hospitals to observe the work of nurses.
Some hospitals now have extensive volunteer service programs in which students can work after school, on weekends, or during vacations. You can find other volunteer work experiences with the Red Cross or community health services. Camp counseling jobs sometimes offer related experiences. Some schools offer participation in Future Nurses programs.
To learn more about the specialty of oncology nursing, you should read books about cancer and the health care professionals who care for cancer patients, visit Web sites of associations such as The American Cancer Society (http://www.cancer.org/), and talk with oncology nurses about the career.
Employers
Oncological nurses practice in many professional settings, including AIDS, oncology, and medical surgical units, at hospitals and cancer centers or treatment facilities. Some may be employed by private practice physicians, hospice programs, or by health education centers or research facilities. Some may work as public health nurses.
Starting Out
Oncology nurses must first become registered nurses by completing one of the three kinds of educational programs and passing the licensing examination. Registered nurses may apply for employment directly to hospitals, nursing homes, and companies and government agencies that hire nurses. Jobs can also be obtained through school placement offices, by signing up with employment agencies specializing in placement of nursing personnel, or through the state employment office. Other sources of jobs include nurses’ associations, professional journals, newspaper want ads, and Internet job sites.
Advancement
Administrative and supervisory positions in the nursing field go to nurses who have earned at least the bachelor of science degree in nursing. Nurses with many years of experience who are graduates of the diploma program may achieve supervisory positions, but requirements for such promotions have become more difficult in recent years and in many cases require at least the bachelor of science in nursing degree.
Earnings
According to the U.S. Department of Labor’s Occupational Outlook Handbook, registered nurses earned a median salary of $54,670 in 2005. The lowest 10 percent earned less than $38,660, while the middle 50 percent earned between $45,710 and $66,650. The top 10 percent made $79,460 or more a year. However, many oncological nurses, because of their specialty, earn more.
Salary is determined by many factors, including nursing specialty, education, and place of employment, shift worked, geographical location, and work experience. Flexible schedules and part-time employment opportunities are available for most nurses. Employers usually provide health and life insurance, and some offer educational reimbursements and year-end bonuses to their full-time staff.
Work Environment
Some oncological nurses may work in clean, well-lighted hospitals, clinics, and other health care settings in upscale communities, while others may find themselves working in remote, underdeveloped areas that have poor living conditions. Personal safety may be an issue at times.
Generally, oncological nurses who wish to advance in their careers will find themselves working in larger hospitals or medical centers in major cities.
All nursing careers have some health and disease risks; however, adherence to health and safety guidelines greatly minimizes the chance of contracting infectious diseases such as hepatitis and AIDS. Medical knowledge and good safety measures are also needed to limit the nurse’s exposure to toxic chemicals, radiation, and other hazards.
Long hours and intense nursing demands can create “burn-out” for some nurses, meaning that they often become dissatisfied with their jobs. Fortunately, there are many areas in which nurses can use their skills, so sometimes trying a different type of nursing may be the answer.
Oncological Nurse Career Outlook
Nursing specialties will be in great demand in the future. The U.S. Bureau of Labor Statistics projects that through 2014, employment for registered nurses will grow much faster than the average for all occupations.
The outlook for oncological nurses is excellent. The U.S. Bureau of the Census estimates that the number of individuals aged 65 or older will double by 2050. As our population grows older, the need for oncological nursing will increase. In addition, managed care organizations will continue to need nurses to provide health promotion and disease prevention programs to their subscribers.
Job opportunities vary across the country and may be available in all geographic areas. Home health care will be a growing nursing area. More services will be delivered in a home setting, and patients will receive transfusions, chemotherapy treatments, and medications through home health visits.