Nursing shortages and high rates of turnover are documented problems that negatively affect patient care and institutional costs. During a session for the inaugural ONS Bridge™ virtual conference, Christopher Brooks, MS, RN, CENP, AOCNS®, director of nursing professional development and education at Memorial Sloan Kettering Cancer Center (MSK), outlined philosophies and programs his institution uses to recruit and retain its nursing workforce.
“At MSK, we have always believed in a philosophy of grow your own, and so our orientation programs and oncology curriculum reflect that,” Brooks said.
Partnerships at Regional Colleges
MSK has 56 affiliation agreements in place with nursing programs at colleges and universities at the baccalaureate, graduate, and doctoral levels. For example, at the Lienhard School of Nursing at Pace University, MSK offers a three-credit oncology elective year-round. Designed and taught by MSK staff, the course includes capstone placement and simulations. The course has had five cohorts to date, leading to 21 hires, Brooks said.
MSK also offers an immersion elective with State University of New York at Stonybrook. The elective includes a three-day observation experience, journaling, capstone projects, group presentations, perioperative modules, and more. It has led to nine hires so far, with good retention.
Through the Barbara H. Hagan School of Nursing and Health Sciences at Molloy College, MSK hosts a program for the clinical nurse specialist (CNS) role, where recruitment is particularly challenging. The program is taught on-site at MSKCC, leading to the CNS post-master certificate. Two nurses participated in the first cohort, and the second cohort is underway.
Orienting Toward Success
Historically, acute care areas hire new graduates almost exclusively, which is starting to expand to outpatient sites, he said.
Onboarding new oncology nurses is challenging because of the complex and ever-changing nature of the specialty, Brooks said. In addition, MSK wants to encourage professional development and promote retention from the very beginning. Therefore, the institution uses an onboarding process that addresses not only the intricacies of the specialty but also organizational culture, productivity, and patient outcomes. “An organization’s recruitment and orientation strategies directly impact nurse retention and growth,” he said.
All RNs joining MSK attend an eight-day orientation with didactic presentations, skills workshops, and simulation sessions. They must complete a foundations of oncology nursing course, which covers:
- Cancer epidemiology and pathophysiology
- Major types of cancer
- Major treatment modalities
- Symptom management
- Palliative and end-of-life care
- Sexuality and cancer
Specialty courses are added as appropriate for the nurse’s intended role, such as oncologic emergencies, hematologic malignancies, certain types of treatment, the role of charge nurse, clinical trials, telephone triage, and more. The institution also provides and promotes review courses to help nurses prepare for certification examinations.
Nurse Residency and Externships
Another MSK strategy is the nurse residency program developed by Vizient and the American Association of Colleges of Nursing. All new graduates are enrolled upon hiring, and the program transitions nurses into more confident clinical practice over 12 months, using an evidence-based curriculum, didactic presentations, interactive exercises, simulations, and a final project. The American Nurses Credentialing Center has accredited the program with distinction. MSK has participated in the program since 2008, and the retention rate has been 90%–96%, Brooks said.
MSK also offers a highly competitive summer externship, which invites nurses from around the United States and is a helpful recruitment tool, Brooks said. The institution continues to seek more school partners and is exploring an interdisciplinary simulation program and specialized nurse residency pathways (e.g., critical care, outpatient nursing).