Oncology nurses are particularly vulnerable to the increasing violent incidents in the healthcare workplace, and it might be because of their specialty. “Oncology settings possess baseline patient and family stressors that may have been more pronounced during the pandemic,” researchers reported in the Clinical Journal of Oncology Nursing, such as social isolation, inadequate resources, and health misinformation, among others.

The winter holidays are marked with traditions. Although we may most often think about them in terms of family or community, celebrating traditions with our colleagues helps build feelings of community and may contribute to a positive work culture, both essential to our well-being as oncology nurse.

Whether virtually or in person, by voice or in writing, people spend up to 80% of their workday communicating. For nurses specifically, communicating about care consumes more than an hour total each shift, with 83% of that hour conversing with interprofessional colleagues. Ensuring those conversations are as effective as possible is critical with today’s staffing challenges. 

Nearly half of nurses surveyed at Magnet-recognized hospitals reported experiencing burnout, attributing it to staffing, management, work environment, and safety struggles. Researchers reported the survey results in JAMA Health Forum.  

With more than 90% of oncology radiation practices reporting staffing shortages, patients are facing new barriers to accessing timely cancer care, the American Society for Radiation Oncology said when announcing its 2023 staffing survey results. At about half of those practices, the lack of adequate staffing is delaying treatment for patients seeking interventional or palliative radiation therapy—and reducing patient navigation services—both of which ultimately influence patient outcomes.

A battalion of trained nurse reinforcements is waiting just outside the U.S. borders, eager to help alleviate the nursing shortage, but the system that lets international nurses enter and work in the United States is heavily congested. And according to the U.S. State Department’s June 2023 Visa Bulletin, the backlog is only worsening.

Making a commitment to equip today’s and future nurses with the knowledge they need to deliver safe, high-quality care, the U.S. Department of Health and Human Services, through the Health Resources and Services Administration, awarded $13 million in October 2022 to programs to improve access to. The awarded funds are part of a series of investments the Biden-Harris Administration earmarked to support pathways to nursing jobs.

The oncology nursing profession has many different paths that allow people to provide care in various ways. Some may work in clinics, others in hospitals, and some as travel nurses.

As cancer care evolves, so do new opportunities for nursing roles. Oncology nurses in any role provide essential cancer care, including addressing disparities and social determinants of health and reducing financial toxicity. However, what sets nontraditional nursing roles apart are the populations they care for, how they provide that care, and how they’re overcoming systemic disparities to ensure that all patients with cancer have equal access to high-quality oncology care.

Although healthcare providers have long faced challenges in the healthcare system, the COVID-19 pandemic exacerbated circumstances and ushered a rising healthcare worker burnout crisis in the United States, according to U.S. Surgeon General Vivek Murthy’s, MD, MBA, warning in May 2022.

Erica Fischer-Cartlidge, DNP, CNS, AOCNS®, EBP-C, will begin the role of the Oncology Nursing Society’s (ONS’s) chief clinical officer (CCO) on July 18, 2022. Fischer-Cartlidge is the former interim director of nursing evidence-based practice at Memorial Sloan Kettering Cancer Center in New York, NY.

Driven by evidence-based practice and patient-centered care, nurses have earned the faith of the American public. For two decades, nurses have been ranked the most trusted and ethical profession in the United States. Although trust is critical, what it lacks is support for the profession through federal investment in research, education, and workforce issues for long-term stability.

The oncology nursing specialty is in dire need of a solid foundation of eligible staff. As of 2020, more than 51% of the nursing workforce was aged 40 years or older, and the COVID-19 pandemic exacerbated underlying factors such as stress, physical and mental health, and inequities present in the profession for decades.

Out-of-state RNs can now practice in Maryland and certain qualified nursing students are fast tracking graduation, according to Maryland Governor Larry Hogan’s (R-MD) September 2021 announcements. The Old Line State’s steps will help increase the workforce and curtail the nursing shortage.

Tracking health workforce projections, such as supply and demand of healthcare professionals by discipline, and studying how funding, policies, and programs affect those levels, can “inform public policy to help prevent shortages and surpluses,” the Health Resources and Services Administration (HRSA) announced in September 2021. To achieve that, HRSA created a new dashboard that uses projections from the National Center for Health Workforce Analysis, based on the Health Workforce Simulation Model (HWSM).

Oncology nurses have a responsibility to continually enhance their career and practice—for their patients, for their profession, and even for themselves. Two strategies for doing that are certification and mentorship. Combining the two is an even more powerful approach.

Implementing a standard minimum nurse-to-patient ratio lowers mortality, readmission, and length of stay rates, according to findings published in Lancet. 

Oncology nursing is an immensely rewarding calling, but the emotional burdens and stressors can feel overwhelming. Office politics, career changes, and providing end-of-life care are difficult to navigate alone, but partnering with mentors helps nurses work through challenges and grow as leaders. As I look back on my career accomplishments, I can’t deny the influence from several mentors sprinkled throughout that trajectory. Each one gifted me with the insight to develop specific skills that enhanced my practice.

Contributing to the orientation and onboarding of new advanced practice RN (APRN) providers supports optimal patient outcomes, professional satisfaction, and nurse retention. Orientation involves working through the hospital’s training program, policies and procedures, organizational structures, and mission or vision statements, whereas onboarding builds engagement and relationships in the organization over many weeks to months. Some institutions have formalized, detailed processes for orientation and onboarding, but others may offer very little structure and support.

Guidelines give oncology nurses an evidence-based, standardized approach to cancer care. But guidelines are most effective used when they’re used as a regular part of practice—a process referred to as implementation. 
With several oncology societies releasing new guidelines in 2020 and 2021, including ONS and the American Society of Clinical Oncology (ASCO), the implementation process requires nurse managers and leaders to facilitate staff education, maintain a high quality of care, and answer the all-important question: “Why are we doing this?”

Imagine this: You are working toward a leadership position and have all the necessary qualifications and experience, but you are also shy. You’re in a brainstorming meeting with your department and have an idea that would solve the problem, but it’s totally different than what has been proposed so far. Do you speak up or stay quiet? Do you even have a chance at that leadership position if you are too shy to share your idea?

Interviewing for a job is often described as a highly stressful life event. When they’re virtual, job interviews have become even more stressful and challenging. How can you conduct a successful job interview virtually? How can both sides get to know each other without meeting in person? How do virtual job interviews differ from in-person ones?

A career of more than 40 years provides experiences and insight that can help nurses prioritize self-care, be more resilient, and stay positive during stressful times. During an on-demand session for the inaugural ONS Bridge^TM virtual conference in October 2020, Susan Childress, MN, RN, former director of nursing at Huntsman Cancer Institute (HCI) in Salt Lake City, UT, and recipient of the 2020 Mara Mogensen Flaherty Memorial Lectureship, offered advice for oncology nurses in maintaining compassionate care and resiliency in practice.

When I was a new graduate nurse, the first team I was assigned to was dysfunctional. Although we were kind to our patients, that didn’t carry over to our interactions with each other: some nurses made snide remarks and spread unfounded gossip, creating a toxic work environment. The tipping point came when the organization decided to change the oncology unit. The work environment didn’t promote innovation or encourage the staff to collaborate so the unit couldn’t handle the changes and eventually closed.

Up to $85.3 million of the U.S. Department of Health and Human Services’ (HHS’s) $107.2 million in funding awards is earmarked for nurses. The agency bestowed the awards in June 2020 to 310 recipients across 45 states and U.S. territories to increase the healthcare workforce in rural and underserved communities.

Does lack of inclusion in areas that are important to us affect how we see ourselves overall? Can someone amplify their voice without being represented in an authority position? Should leadership reflect the population that it’s leading? More and more medical organizations are publishing formal and informal position statements on diversity and inclusion, which is a great start, but the next logical step is bringing those beliefs and concepts to our institutions and communities. Here are some of the issues and the ways that any nurse can take action.

I was born in India but came to the United States of America when I was 16 years old to be with the rest of my family. Having been an American citizen for 20 years, I have called this country home for most of my life. However, I still feel like an outsider and the workplace is no exception.

Almost 96% of nurses report experiencing at least one symptom of post-traumatic stress disorder (PTSD) and nearly 21% meet the criteria for a clinical diagnosis of PTSD, according to findings from a literature review published in the Journal of Clinical Nursing.

Houston, TX, Miami, FL, and Baton Rouge, LA, are three of the many cities battling repercussions from the COVID-19 coronavirus pandemic. Most daunting is the perpetuated shortage of healthcare workers as the pandemic continues to ravage the United States.

The global COVID-19 coronavirus pandemic has forced elected officials and political leaders to reevaluate the provision of health care in the United States. To address inequal access to care and representation among health professionals, on April 24, 2020, U.S. Representative Jan Schakowsky (D-IL) and Democratic Whip and U.S. Senator Dick Durbin (D-IL) introduced the Health Heroes 2020 Act, a bicameral piece of legislation.

The world needs to invest in nursing education, jobs, and leadership if it intends to prevent the projected global shortage of nurses by 2030, the World Health Organization (WHO) said on April 6, 2020, in its State of the World’s Nursing 2020 report, a first-of-its kind look at nurses’ critical role in international health care.

As use of ambulatory care settings continues to grow, so too does the demand for expertly trained nurses to staff them. Unfortunately, nurse staffing levels have struggled to meet the burgeoning need in ambulatory clinics throughout the country. Traditionally, undergraduates receive limited ambulatory-specific education in nursing school, leaving them unprepared to enter those settings after graduation. However, the nursing shortage complicates staffing issues, and we must develop programs to direct new graduate nurses into ambulatory oncology careers.  

Convenience. Flexibility. Normalcy. Ambulatory oncology clinics deliver on those three crucially important aspects of treatment to many patients with cancer, offering expert care without a hospital stay or traveling far from home.  

With evolving treatments and novel approaches to care, outpatient oncology practice has grown exponentially during the past two decades. As a vital stop on the cancer journey for many patients, ambulatory clinics have seen a boom in acuity, patient needs, and staffing demands. ONS has been actively researching the growing staffing dilemma in ambulatory oncology nursing to help institutions understand and address nurse-patient staffing and which best practices can accommodate the varied challenges.  

The Centers for Medicare and Medicaid Services (CMS) has been trying to find new avenues to implement a conservative approach to Medicaid spending at the state level. At the end of January 2020, the agency introduced a program that enables states to convert funding into block grants and determine how best to allocate health funding in their own jurisdictions.

To better understand the demands and demographics of the larger RN community, the Health Resources Services Agency (HRSA) compiled data from the National Sample Survey of RNs (NSSRN). Released in January 2020, the report is a compendium of information and questions RNs have answered about different aspects of the life and work. The data collected since 1977 provides insight into the latest trends and future workforce projections, and HRSA uses it to help allocate workforce resources.

With the 2020 election cycle kicking into high gear, upcoming presidential debates will continue to highlight health care as a major domestic issue. Downstream contests for House and Senate seats are also in play, and health care will serve a huge role in those campaigns, too. Candidates are offering a slew of different options like a new single-payer system, Medicare expansion, Medicare for All, Medicare for All with an additional buy-in program, and many other iterations.

Oncology care is one of the most challenging, yet rewarding, nursing careers that offers opportunities to care for patients in all stages of life. It’s a chance to help guide and support your patients through one of the most difficult times in their lives and be inspired by their determination, hope, and faith.

RNs encounter workplace violence and abuse at a far higher rate than in any other profession in the United States. Although the topic is uncomfortable, it’s a very real aspect of health care for many professionals. Most nurses have likely experienced an abusive, dangerous, or violent encounter in the healthcare setting at some point in their careers.  

The Health Resources and Services Administration (HRSA) announced $293 million in new funding through programs at the National Health Service Corps (NHSC) and Nurse Corps for the healthcare community to expand the clinician workforce. Strengthening care and support can help address gaps in care and limit growing socioeconomic disparities.

On July 23, 2018, the U.S. House of Representatives passed by voice vote two ONS priority bills that would provide palliative care training, awareness, and research and funding to build the nursing workforce.

One of your patients is enrolled in a clinical trial and is scheduled to receive an investigational drug today. She reports a cracked tooth and asks if it’s okay to get dental work. What should you tell her? 

A. To Set up an appointment with her dentist between treatment cycles. 

B. To check with her research team before setting up a dental appointment. 

C. Not to have any dental work done since she’s on a clinical trial.  

D. Have her tooth fixed right away and let the research team know if you have any problems. 

Nurses can do it all. After all, the often-unsung heroes of health care use their unique skills to positively impact patients and their families in more ways than most people can ever imagine. Unfortunately, role confusion and a lack of awareness of a vital specialty have led to a dire need of nurses in clinical trials.

It’s the season for graduations. My husband and I recently celebrated our youngest daughter’s graduation from Saint Louis University School of Nursing—just as we did for our two older daughters. As I reflected on this time of celebration, I was reminded of when I was asked to write for Continuing the Legacy: More Voices of Oncology Nurses, an ONS book that shares the narrative history of oncology nursing through individual nurse stories. I wrote about a patient who taught me a lot during our time together. At the end of each story, the authors were asked to reflect on their contributions and their experiences. With all of the celebrations lately, I had to look back on what I wrote.