Advice for New Oncology Nurses: Insights from Experienced Oncology Nurses

By: Briauna Driggers, Ron DiGiaimo, MBA, FACHE, Pamela Phipps, RN, BSN, CHONC, and Heather M. Nolting, RN, BSN, CHONC

​Oncology nursing is a unique specialty within the nursing profession. It involves not only the care of patients with cancer but also the management of complex treatment protocols and emotional support for patients and their families. With an estimated five million nurse shortage by 2025, onboarding new nurses effectively is more crucial than ever. Two seasoned oncology nurses on the RCCS team, Pamela Phipps and Heather Nolting, sat down with RCCS CEO Ron DiGiaimo and Content Marketing Manager Briauna Driggers to discuss the nuances of oncology nursing and provide advice for new and upcoming nurses to be successful in this challenging and rewarding career.

​Advice for New Oncology Nurse

You’re a Nurse… Now What?

There are several educational paths to becoming an oncology nurse, whether you're an LPN, RN, BSN, or MSN. Regardless of your starting point, continuing education and professional development are essential. Nursing school provides the foundation needed to be successful, but each sub-specialty requires further education. Within the healthcare industry, oncology is a highly intricate sub-specialty. It is strongly recommended for all medical professionals in oncology, including nurses, to obtain additional certifications for increased knowledge base and confidence in their ability to treat critical patients.

Keeping Up with Technological and Medical Advancements

​Now is an exciting time to work in oncology with rapid advancements in technology and medicine developing every few years. For example, the shift from traditional chemotherapy to tailored treatments has transformed patient care compared to 10 years ago. Being an oncology nurse means staying abreast of these developments and understanding the mechanisms of new treatments to better counsel patients on potential side effects.

Understanding Medications

​Understanding the medications you administer is crucial for ensuring patient safety and effective treatment. This includes understanding how the drug works, consulting package inserts for detailed information, and keeping up to date with brand name and generic alternatives, as well as staying informed about the growing use of biosimilars. Accurate administration and dosage management are essential to prevent adverse effects and ensure efficacy. Ongoing education on new drugs and personalized treatments is vital for staying current in the field. By mastering these aspects, oncology nurses can provide comprehensive care and effectively counsel patients on their treatments.

Safety Is a Top Priority

​Prioritizing safety involves a multifaceted approach that includes comprehensive drug knowledge, accurate administration, and vigilant monitoring for adverse effects. Nurses must diligently read package inserts to understand correct dosages and mix ratios and be prepared to manage vesicants to prevent severe tissue damage. Given the compromised immune systems of oncology patients, strict adherence to infection control and aseptic techniques is essential. Additionally, educating patients and their families on medication management and potential side effects empowers them to receive the necessary care. Robust communication and collaboration within the healthcare team enhance safety by ensuring a cohesive and well-informed treatment approach.

---

Career Progression and Professional Development

Certification and Education

Investing in certifications such as Oncology Certified Nurse (OCN) or Chemo and Biotherapy Certified Nurse sets you apart in the field. Joining professional associations like the Oncology Nursing Society (ONS) provides valuable resources and networking opportunities. Some employers may cover certification costs, but even without employer financial support, pursuing these credentials is worthwhile for your career growth. Staying updated and utilizing resources provided by professional associations (and others like chemocare.com for patient education) is crucial.

Coding and Billing Knowledge

​Understanding the coding and billing side of oncology nursing can also make you a better advocate for your patients and give you a stronger understanding of how their treatment will be covered by insurance. Cancer is an expensive disease to treat, and something as simple as accurately linking medication administration to ICD-10 codes is critical for ensuring payers cover treatments. Even if you are not an expert in oncology coding and billing, knowing where to find information on the guidelines and understanding when to delegate tasks are essential skills for oncology nurses. Utilizing coding and billing experts while educating yourself on these aspects helps you provide comprehensive patient care, makes you a financial asset to your department, and creates a critical resource for the insurance authorization process. 

---

Essential Advice for New Oncology Nurses

1. You’re Not Just a Nurse… You’re a Patient Advocate

In oncology nursing, your role often extends beyond administering chemotherapy; you also provide crucial psychological support for your patients. Assessing both physical and emotional well-being is vital. Are they more emotional than usual? Is their usual caregiver absent? These subtle signs can indicate underlying issues that you, as their advocate, can help address. As a patient advocate, you can connect patients with financial counselors, arrange transportation for overwhelmed caregivers, or create comforting spaces like a used book library. These small gestures make a significant difference in your patients' lives.

​As an advocate, your patients will often confide in you more than they will with their doctors or even their families. It is a profound responsibility to be their support system, listening to their concerns and helping them navigate their treatment journey. By paying close attention and taking their needs to heart, you honor the trust they place in you and enhance their overall care experience.

2. Don’t Just Practice Self-Care… Make It a Priority!

​Burnout is a significant issue in nursing, especially in oncology, due to the emotional toll of patient care and staff shortages. Finding a creative outlet separate from nursing is crucial to prevent burnout. Strategies like taking off your badge at the end of the day to mentally disconnect from work, debriefing with a coworker, and finding hobbies that help you relax can be beneficial. Remember, self-care is not a luxury but a necessity. Also, remember that spending time with your family or doing other “everyday” tasks is not always self-care. Everyone operates differently and will find solace in different activities, but taking the time to do something for yourself is consistently important.

3. It’s All About Professionalism

​Oncology nurses are respected and essential parts of the healthcare team. How you present yourself professionally impacts how you are perceived by patients and colleagues. Avoid infantilizing patients and always treat them with the dignity they deserve. Professionalism extends to your attire, so consider your appearance and choose appropriate workwear.

4. We’d Be Lying If We Said It Wasn’t Hard… But It’s Worth It!

Oncology nursing is emotionally challenging. It's not all about death; it's about hope and advancements in treatment. Be prepared for the emotional aspects and recognize the privilege of supporting patients through their journey, even during end-of-life care. Don't shy away from difficult conversations about end-of-life issues and always know your resources and when to delegate tasks to support staff.

---

Summary

​Oncology nursing is a challenging but immensely rewarding field. Continually seek education, practice safety, and maintain professionalism. Remember, you are not just a nurse; you are a vital part of your patients' journey, offering hope and support through some of their most difficult times. Despite the challenges, this career path is truly fulfilling, and the impact you make on your patients' lives is invaluable.