During a session at the Oncology Nurse Advisor Navigation Summit, ONS member Pamela J. Haylock, PhD, RN, FAAN, at the Association for Vascular Access in Medina, TX, and Cindy Stern, RN, MSN, CCRP, of the University of Pennsylvania Cancer Network, delivered a joint presentation about some of the hurdles nurse navigators face.


Haylock began by discussing certification, which is a process where individuals who have demonstrated the level of knowledge and skill required in the profession, occupation, role, or skill are identified to the public and other stakeholders.

Professional or personal certifications are a voluntary process where individuals are evaluated against predetermined standards for knowledge, skills, or competencies. Meanwhile, certificates of participation or attendance are provided to participants who have attended classes, courses, or other education and training programs and events.

Certification is valuable in that it is associated with job satisfaction, validation of knowledge, positive challenges, more earning potential, access to job opportunities, accountability, and recognition from employers, peers, and consumers.

However, the certification process has its challenges, including costs of the credentialing, lack of institutional rewards and support, lack of access to preparation courses and materials, discomfort of test taking process for some, lack of access to certified education, and questioned relevance to daily practice.

It is the position of ONS that nurses in oncology nurse navigation roles “should possess certification through one of the National Commission for Certifying Agencies–accredited certifications offered by the Oncology Nursing Certification Corporation, minimally Oncology Certified Nurse.”

Survivorship Care Plans

Stern continued by discussing survivorship care plans (SCPs), which are an important component of the cancer care continuum. Approximately 67% of patients with cancer are living at least five years after diagnosis, and there are projected to be 18.9 million cancer survivors in the United States by 2024.

“Survivors are lost in transition,” she said, because of a lack of coordinated care, limited interactions with providers, lack of evidence-based approaches to survivorship care, and gaps in survivors’ health practices.

The Institute of Medicine suggests increasing awareness, developing evidence-based tools, implementing quality measures, furthering professional education programs, funding and conducting survivorship research, and mandating survivorship as part of the cancer control plans.

The Commission on Cancer has developed a process for creating SCPs that are developed by all members of the oncology care team (physicians, registered nurses, physician assistants, advanced practice nurses, and credential clinical navigators) and include institution and provider contact information, specific diagnosis, stage of disease at diagnosis, surgical procedure(s), chemotherapy, ongoing toxicity, and results of any genetic testing.

Stern noted that no single model of care has emerged as the best SCP, and one size does not fit all. Approaches to SCPs depend on available resources, competing priorities, patient and community needs, practice patterns, buy-in of stakeholders, and established evidence. To get started on a SCP, convene a workgroup, review the literature, assess gaps, and start to put together a program, she advised.