Hematology/Oncology Nurses, often abbreviated to Heme/Onc Nurses are those individuals who work with patient populations undergoing both solid and bloodborne cancer diagnoses, treatment and remission.
Searching for open internal positions online at local hospitals is the best approach to finding a position. New graduate nurses will need to complete an internship program which involves both a didactic component as well as working alongside a nurse-preceptor as part of the interdisciplinary team to learn the role.
Experienced nurses coming from a different specialty will have similar training. Training may be tailored to meet their didactic and practical needs.
What Are the Education Requirements for an Oncology Nurse
A Bachelor of Science in Nursing degree is considered to be competitive for applying to an Oncology Nursing position, however at this time, nurses with an Associate's Degree in Nursing may apply as well. Specializing in oncology and cancer care requires the nurse to take on additional coursework and clinical training; there are also additional continuing education courses and contact hours that are specifically focused on various aspects of the oncology specialization.
Any Certifications or Credentials Needed?
After working as a Heme/Onc nurse for some time, the nurse becomes eligible to take exams and become certified in the specialty. The Oncology Certified Nurse (OCN) exam requires 1000 hours of oncology RN experience as well as 1 year as a RN and 10 contact hours in the field of oncology. The certification is valid for 4 years then requires renewal.
For nurses who administer chemotherapy, earning the ONS/ONCC Chemotherapy Biotherapy Certificate is a great way to demonstrate expertise and dedication to nursing. Eligibility includes administering chemotherapy for at least 1 year and at least once a month and this certification provides 15 contact hours. Read more for further clarify on oncology nurse certifications.
Since the advent of advanced cancer treatment, mid-sized to large hospital campuses often have an oncology team to manage patient diagnoses and treatment plans. For specific or rare kinds of cancer, patients may travel to prestigious hospitals and teaching facilities for innovative treatments; these facilities are magnets for nurses who feel called to the forefront of treatment for those with cancer.
Each facility should have a process for overseeing students and probationary employees which typically includes a checklist of skills. Once the preceptor, or person assigned to orient and train the student, has deemed the student capable of managing skills on their own, the preceptor can act as a resource to the student and no longer needs to oversee each task.
If the preceptor determines that the student is not able to manage the tasks on their own after appropriate instruction over time, the preceptor should consult with the charge nurse or manager so feedback can be provided to the school of the student’s failure to perform at the expected standard level.
Students should refer to their school’s policy or the policies of the institution for further clarification.
The main difference between the two is that the ADN is a college degree while the RN diploma is, well, a diploma. Both programs take about two years to complete, and both are considered “entry-level.” They also both prepare students to sit for the NCLEX-RN exam for licensure. However, RN diploma programs are typically hospital-based and might be offered in technical or vocational schools. Students gain valuable hands-on skills throughout the program and take courses specific to healthcare and nursing.
ADN students also gain clinical experience but are also required to complete general education courses to fulfill associate degree requirements, some of which may or may not include healthcare-related courses.
While both prepare students for licensure as a registered nurse, there are a few considerations one should keep in mind. Students should always check their state board of nursing’s website to determine educational requirements, and they should also find out what minimum education requirements are needed in places of employment. For example, some organizations or facilities prefer a minimum of an ADN, and some even a BSN.
Dispensing of medication can be described as preparing, packaging, labeling, and then providing the medication to a patient or their representative to be taken at a later time. Dispensing is different than administering medication where the medication is provided to the patient for immediate dosing via the prescribed route.
Nurses are responsible and accountable to provide safe, competent, and ethical care to the community and the patients they serve. Each state Board of Nursing determines the Standards of Practice through the Nurse Practice Act. Most states collaborate with the Business and Professions Code to further define, or amend, regulations for dispensing and administration of medications.
For example, in California, the California Board of Registered Nursing and the California Business and Professions Code was amended in 2013 to allow for registered nurses in that state to dispense certain medications under specific circumstances to aid in the distribution of contraceptive medication. A registered nurse may dispense medications such as self-administered hormonal contraceptives once the nurse has been trained and deemed competent in providing the ordered medications.
There are currently 16 states in the U.S. that allow RNs to dispense a limited number of medications under specific criteria. Nurses must refer to their individual state Board of Nursing for direction on dispensing medication in their state.
A 2-year associate’s degree in nursing is the minimum degree requirement to become licensed as an RN. Bachelor’s degree nurses are RNs who have completed a 4-year degree program. BSN nurses work in many of the same roles as ADN nurses. However, they have more career opportunities in areas including leadership.
So, the question remains: What leadership positions are available to ADN nurses?
In reality, it depends on the organization. Many large teaching hospitals prefer BSN-prepared nurses even for just bedside nursing. Some organizations don't have a BSN requirement. Depending on the facility, ADN nurses can work in the role of a charge nurse, which is the first step in clinical leadership. Some employers even allow ADN nurses to take positions in management or as house supervisors. In many cases, it depends on years of experience and work performance.
However, it’s important to note that the pendulum is swinging towards BSN nurses, especially in leadership roles. This does not mean ADN nurses are out of luck when it comes to leadership roles. As stated earlier, some employers hire ADN nurses into leadership and supervisory roles, and some hire into the roles and assist the nurse in earning a BSN.
The hematology/oncology, or Heme/Onc nurse provides both curative and palliative treatments for all types of cancer and blood disorders. The nurse is responsible for quickly assessing and providing the appropriate interventions. The Heme/Onc nurse is able to tolerate a wide variety of emotions throughout the day and enjoys the challenge of caring for very sick as well as stable patient populations. Administering chemotherapy is common as well as assessing for complications from this therapy. Working with the interdisciplinary team to develop a plan of care is the cornerstone of the role.
- Provide care for cancer patients that have acute or chronic illness due to cancer or exacerbating conditions.
- Monitor patient condition, prescribe medication and manage symptoms through sharing strategies with family and patient.
- Offer education and support to patient families
- Offer empathy and dignity in regard to end of life care
- Administer chemotherapy
- Manage immediate and long-term chemotherapy side effects
- Assess cancer patients' ongoing physical, psychosocial and spiritual needs and status
- Formulate and implement a care plan that is directed by concrete goals
- Uses communication methods and skills to convey information to patient, family and staff
- Is responsible for own professional development
- Demonstrates expertise in legal issues and safety principles
- Is a strong advocate of patient needs to the interdisciplinary care team and family members
Given the advancing age of our population and the argument that we live in an increasingly carcinogenic world, the field of oncology is forecast to expand faster than national averages over the next 10 years or so. There are several opportunities for nurses to pursue oncology specialist work to meet this need.
The average salary for a Heme/Onc RN is $67,197 with a national range of $45,698 - $89,644. These salary figures depend on location and skills, nursing certification and degree level.
- Clinical Journal of Oncology Nursing
- Oncology Nursing Society
- ONS Voice
- European Journal of Oncology Nursing
- Association of Pediatric Heatology/Oncology Nurses