Gay Bailey, RN, MBA, OCN	Virginia Martin, RN, MSN, AOCN

A person with cancer interacts with nurses more than any other members of the health care team. What should patients know about oncology nurses? To find out, Cancer.Net welcomes Gay Bailey, RN, MBA, OCN, and Virginia R. Martin, RN, MSN, AOCN, both of whom serve on the Oncology Nursing Society Board of Directors. The Oncology Nursing Society (ONS) is a professional organization of more than 35,000 registered nurses (RNs) and other health care providers that work in settings where people with cancer receive treatment.

Q: Please describe your current jobs at your cancer centers.

GB: In my role as Director of Nursing, Ambulatory Services at Memorial Sloan-Kettering Cancer Center in New York City, I am responsible for nursing practice in multiple outpatient locations, including our regional network and screening programs. There are more than 500 nurses in ambulatory (outpatient) care working with physicians in a collaborative practice model. I work in close collaboration with my physician and administrative colleagues to ensure delivery of high-quality patient care.

VM: I am the Clinical Director of Ambulatory Care at Fox Chase Cancer Center in Philadelphia, Pennsylvania. I am responsible for the nursing staff that provides patient care during the physician visit and the coordination and management of the physician practice operations. I manage a staff of 55 that includes RNs, clinic assistants, transportation orderlies, an equipment processor, and patient service representatives.

Q: How would you define the role of an oncology nurse, and what are some examples of the various roles they have?

GB & VM: Oncology nurses care for individuals with cancer, those at risk for cancer, and those surviving cancer. Oncology nurses carry out their role by providing direct care, including chemotherapy administration. They educate patients about all aspects of their disease, including the side effects of treatment, and they coordinate care and provide psychosocial (emotional and social) support along the continuum. Oncology nurses can be found in the inpatient, outpatient, home care, or hospice settings; they also work in case management and as patient navigators and patient advocates. In addition, oncology nurses provide clinical trials support and telephone triage.

Advanced practice roles in oncology include the nurse practitioner who may see patients in a clinic or office, either with a physician or as a sole provider. Also, many inpatient units are staffed by nurse practitioners, especially in hospitals with fewer medical residents. Clinical nurse specialists function as clinicians, educators, consultants, researchers, or managers.

Q: What are the basic requirements to become an oncology nurse?

GB & VM: An oncology nurse must be a graduate of a nursing program and licensed as an RN.

Q: Some oncology nurses have additional certifications, such as oncology certified nurse (OCN) and advanced oncology certified nurse (AOCN). What do these certifications mean and what are the requirements?

GB & VM: Certification validates a nurse’s qualifications and knowledge in a defined area of nursing. It is a voluntary process and granted by a nongovernmental agency. Certification signifies that a nurse has developed specialty knowledge beyond the entry level. A candidate for certification must meet specific eligibility requirements for experience as an oncology nurse and pass a multiple choice test. The options for certification in oncology nursing are: OCN, AOCN, advanced oncology certified nurse practitioner (AOCNP), advanced oncology certified clinical nurse specialist (AOCNS), certified pediatric oncology nurse (CPON), and new in 2009, certified breast care nurse (CBCN).

Q: What are some important messages for patients about the role of oncology nurses in the health care team?

GB & VM: Oncology nurses have a wealth of experience and knowledge about cancer, cancer treatment, and side effects. Nurses spend more time with the patient than any other member of the health care team, so they are frequently the interface between the patient and caregiver and other providers.

Q: What tips do you have to help patients better communicate with nurses?

GB & VM: Don’t be afraid to ask your nurse any questions that need clarification or any concerns about your care. Write your questions down before your visit if possible. And remember: you are an important member of the team.

Q: How has the role of oncology nurses changed over the past couple of decades?

GB & VM: Oncology care has changed, as has all of medicine, with the advances in science over the last decades. When we started in oncology, there were a limited number of chemotherapy drugs, and treatment was focused on one modality (method of treatment). Today, multi-modality therapy is the standard in many diseases, and treatment is becoming more individualized with targeted therapy. Computerization has changed our practice with electronic medical records, order sets, electronic drug delivery systems, and smart pumps. Cancer treatment is more successful, so patients are living with cancer much longer, and survivorship issues are being addressed.

These changes mean that we increasingly have to be aware of the needs of older patients getting treatment and the various comorbidities (co-existing illnesses) that arise as patients live longer. For the ever growing number of survivors, we need to advise them and sometimes their primary care physicians about long-term follow-up care and recurrence (return of cancer) or second cancers.

Q: Why did you decide to work in oncology?

GB: When I first graduated from nursing school, I was an operating room (OR) nurse and loved the pace of the OR. I worked for the American Red Cross in the apheresis (a procedure where blood is collected from a patient, parts of the blood are removed, and then the blood is returned to the patient) unit for several years, which was my introduction to oncology. After a stint in a nursing home, I was recruited to work in a new bone marrow transplantation unit. I found great satisfaction in caring for patients during what was then an average six-week inpatient stay. I also enjoy the research aspect of oncology and have seen some significant and beneficial changes for our patients over the years as a result of this research.

VM: I worked in general medical surgical nursing, home care, and intensive care before settling in oncology care. In each area of general practice, the patients with cancer attracted, challenged, and touched me most deeply. I found the work extremely rewarding and the professional growth gratifying, especially becoming involved with ONS.

More Information

The Oncology Team

Managing Your Care

Additional Information

Honor Someone Special: Submit a Nomination to ONS to Recognize Your Oncology Nurse

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Last Updated: March 23, 2010