How Nurse Practitioners Are Enhancing the Oncology Workforce
With improved early detection guidelines and techniques as well as advancing cancer treatments, cancer is now a chronic disease in an already aging population. In addition, the Affordable Care Act expanded healthcare coverage (https://doi.org/10.1002/cam4.769) to millions of previously uninsured Americans, increasing the need for medical services (https://doi.org/10.1200/JOP.2013.001319). With these trends in health care, nurse practitioners (NPs) are needed at the forefront to positively impact and enhance oncology care.
Filling a Variety of Roles
The 2016 American Society of Clinical Oncology Practice Census survey (http://ascopubs.org/doi/pdf/10.1200/JOP.2016.020743) revealed that advanced practice providers (NPs and physician assistants) play pivotal clinical roles, from ordering and administering chemotherapy to managing pain and other adverse effects/symptoms, and provide primary care to patients with cancer and survivors. Additionally, the survey showed that practices reported that increased patient volume, expansion of services provided, and a desire to decrease provider workload necessitated hiring of more advanced practice providers in the past year.
The NP role offers many benefits to the oncology workforce (https://doi.org/10.1111/scs.12120), including aiding physician workload, providing continuity of care, and addressing barriers to care. In rural areas, advanced practice providers may be the only healthcare providers who are routinely available. NPs often function in diverse roles across various settings in the oncology workforce, including clinical provider, leader or manager, staff and patient educator, researcher, and program developer. The clinical provider role is considered the foundation of NP practice, but NPs often practice in a variety of these roles, and NP practice will vary depending on each state’s scope of practice in addition to institutional specific responsibilities.
NPs provide a wide variety of care throughout the cancer continuum in hospital-, community-, or office-based oncology settings and at times are considered physician extenders because of their clinical role in patients with cancer. Clinically, NPs are often seen as the initial, go-to provider for questions or concerns related to patient care, including performing patient triage, evaluating new and follow-up patients, ordering and interpreting diagnostic tests, interacting and communicating with multidisciplinary teams, supervising chemotherapy and biotherapy administration, prescribing medications, handling adverse events, and providing symptom management. NPs communicate with physicians about patients’ care plans and then work with the nursing staff and healthcare team to ensure that those plans are implemented (http://oncpracticemanagement.com/issue-archive/2015/may-2015-vol-5-no-4/the-nurse-practitioner-s-role-in-the-practice/).
Although the root of the oncology NPs practice is clinically based, NPs may also serve as a mentor or preceptor (https://doi.org/10.1188/15.CJON.226-227), educate staff and patients, and contribute to the research process (e.g., problem identification, synthesis of research literature, rights of human participants).
With an ever-changing healthcare environment, patients deserve access to high-quality oncology care. NPs are high-level providers, role models, and leaders in their field. They have the knowledge and skills to meet the unique care needs of patients with cancer (https://doi.org/10.1188/16.ONF.489-496) and enhance the oncology workforce to improve overall oncology care.