Career Guide: Training and Practice for Oncology Nurses

Should oncology nursing frighten registered nurses?

The word oncology may appear frightening to new registered nurses, particularly those who have not been trained in that area. For registered nurses, who have been employed in nursing for a number of years, oncology nursing often proves to be a rewarding experience.

Why is the training and practice of oncology nursing frightening to new registered nurses? In other words, why are many registered nurses reluctant to enter into oncology nursing, as a possible career choice?

Oncology suggests the word cancer, which is rooted in the Greek word onkos, meaning tumor. When used in conjunction with the suffix logy, oncology refers to the study of tumors. Oncology is commonly referred to as the study of many different kinds of cancer.

The word cancer is immediately associated with death. The thought of an nursing a patient who is dying, may frighten new registered nurses, as well as other medical professionals who have a fear of death, though they deal with its harsh reality, every day.

In this era, there are vast amounts of cancer-related research being conducted with respect to causes, prevention, diagnosis and the treatment of cancer patients. This includes follow-up and palliative care. 

Oncology nurses have the option of being employed in any of these areas, depending upon their personal preferences.

The majority of university or college schools of nursing offer basic, as well as more advanced training and practice in oncology nursing. The direction that the careers of registered nurses take with regard to nursing patients with cancer, may depend upon the availability of appropriate training and practice in the region in which they live, work or study, as not all cities have regional cancer centers. The increasing availability of online courses for registered nurses, who wish to pursue a career in oncology nursing, offers them another viable option.

Prior to graduation and employment, most registered nurses have already practiced some oncology nursing, whether it was called oncology or not. All registered nurses give nursing care to cancer patients, at one time or another. Throughout the course of their professional nursing careers, the majority of registered nurses will become more involved in some aspect of oncology training and practice. For example, many experienced registered nurses choose to work in the area of palliative care.

If you are a new registered nurse, about to make a career choice, think about cancer this way. 

A rose reaches its full potential for blossoming and then, its petals begin to fade and drop. Why does this happen? Is it possible to stop this process? Is this a stage in its life? Each patient, who has cancer is like a rose with fading petals. Would we be fearful of a rose with petals that are fading or dropping? No, we would not. Neither should registered nurses be fearful of a patient, who has symptoms of cancer or been diagnosed with cancer. In each palliative care patient, there is beauty, just as there is in a rose. Many kinds of cancer never reach the palliative care stage, if they are treated early enough.

Nursing a patient diagnosed with cancer, may seem to be a potentially frightening experience for some registered nurses, because they feel a sense of helplessness and hopelessness with regard to cancer. That is true of other career choices in nursing, as well. Thus, the nursing profession and oncology training, teaches registered nurses to understand and deal with the process of death and dying.

Many registered nurses feel that nursing cancer patients, allows them the opportunity to function in their full capacity, as registered nurses.

Training and practice for oncology nurses, requires a wide spectrum of total patient care that involves the physical, mental, emotional and spiritual realms of a patient's personhood and life. Cancer and oncology nursing touches the lives of patients of all ages, from every race, creed and culture.

Examine a patient scenario and see when a registered nurse begins to assume the role of an oncology nurse.

Perhaps a registered nurse or a nurse practitioner is working directly with a physician, in a doctor's office. A patient may think that he or she has cancer and goes to the doctor, suspecting the worst. The registered nurse is the patient's first point of contact.

Whether the patient has cancer is yet to be determined, even though a patient may have attempted to do a self-diagnosis and made the decision that he or she has cancer. With the advent of internet access, many patients are beginning to try to do just that. Not only are patients diagnosing their own symptoms, they are becoming more and more knowledgeable about different kinds of cancer, diagnostic procedures, possible options for treatment of cancer and the prognosis of various kinds of cancer.

A patient, who is frightened and fearful of cancer, needs the full support of the registered nurse in the doctor's office immediately, as well as during the time that a diagnosis is made. The registered nurse documents the patient's symptoms and assists the doctor with the patient's physical examination. Having oncology training is beneficial to a registered nurse working in this setting.

Further tests which could frighten the patient, may be indicated. These may include things like blood work, an x-ray or ultrasound, CT or MRI scanning. A bronchoscopy or endoscopy may be indicated or even further tests that involve nuclear medicine. Most registered nurses would be able to help their patients to understand what is involved, but further oncology training would be helpful here, too.

A registered nurse is trained to help alleviate the apprehensions of a patient, who may have cancer. The training and practice for registered nurses includes a wide spectrum of basic nursing and counseling skills. Oncology nurses strive to attain more advanced, professional nursing skills and recognized board certification.

The patient may require hospitalization initially or repeatedly, for further tests, treatments or procedures. These may include a biopsy, surgery, chemotherapy, radiation therapy or other, more specialized treatments. An oncology nurse will participate in the administration of chemotherapy, as well as other aspects of the patient's treatment and nursing care.

With cancer, there are many unanswered questions that a registered nurse must be able to answer. For example, what kind of cancer is it? Has the cancer spread? Is surgery or further surgery necessary? What kind of treatment offers the best option? Are there specialized treatments or drugs that may affect a cure? Will palliative care be needed? An oncology nurse will be able to answer many of these kinds of questions, while others have to be answered by oncologists..

Right from the beginning and throughout this entire case scenario, the patient needs the full support of a registered nurse, preferably one trained in oncology. The oncology nurse draws from all of his or her previous training and practice as a registered nurse, as well as all of his or her new skills. This becomes increasingly important, as the patient commences treatment for cancer. He or she may suffer a wide range of distressing symptoms like nausea, anorexia, fatigue or pain. Helping the patient deal with increasing levels of anxiety, apprehension and depression, is a part of the patient's nursing care, particularly when the prognosis does not appear promising.

Follow-up of cancer treatment is indicated through a doctor's office, hospital or cancer treatment center. An oncology nurse may seek employment, in any of these areas. A registered nurse may prefer to work in a different kind of oncology setting, where there is progressive teaching or where there is extensive cancer research being carried out.

An oncology nurse may acquire employment in the realm of medical ethics, directly or indirectly related to cancer. This horizon of inquiry is expanding, as increasing numbers of alternative therapies are offered to cancer patients. Many of these are not deemed appropriate, depending upon the kind of cancer that a patient has been diagnosed with. It may be suggested that there are better options for treatment that are known to be more appropriate and effective.

In terms of ethics, the patient's involvement in a clinical trial, can become an area of controversy and concern. So can the patient's choice to withdraw from treatment. He or she may also request a do not resuscitate order from his or her physician, which may be questioned by other medical professionals or family members.

It is ultimately the patient's quality of life that is important. The oncology nurse's role is directed towards sustaining life and ensuring the highest possible quality of life, for his or her patient.

With an eye to the future, a registered inquiring into a future career as an oncology nurse, might ask if there is likely to be future employment for those who become specialized in oncology. There is growing medical evidence suggesting that there are an increasing number of different causes of cancer including chemicals, radiation, sunlight, age, genetic history, tobacco, viruses and hormones.

It also appears that screening for cancer, specific for gender or certain areas of the population, helps to reduce the number of cancer related deaths, as screening allows various kind of cancer to be detected and treated earlier. The prevention of cancer through community educational programs is becoming increasingly important and oncology nurses may find possible employment in these areas.

With increased education, it seems unlikely that all kinds of cancer will be eliminated and thus, oncology training and practice will continue to be an important aspect of the nursing profession.

Oncology nurses give quality nursing care to cancer patients. They demonstrate a high level of compassion, commitment and concern for cancer patients and their families. Many of their patients and families are very appreciative of the care that they receive from oncology nurses.

It takes a special, loving, kind and gentle person to become an oncology nurse. At times, oncology nursing may not appear to be an easy career path for a registered nurse to follow, but it can prove to be a highly rewarding experience for registered nurses who are able to overcome their own fears.