What Is an Oncology Nurse, and How Do You Become One?

An oncology nurse is a registered nurse who works with cancer patients. Learn what oncology nurses do, how much they make, and the career outlook for this field.

An oncology nurse is a registered nurse with advanced training specializing in working with patients who have cancer and those at risk for developing cancer. Like nearly all medical careers, demand for oncology nurses is on the rise, and that trend is expected to continue over the next three years [1]. Oncology nurses in Canada make an average salary of between Can$78,000 to Can$80,000 per year [2]. 

To become an oncology nurse, you will need to be a registered nurse and gain clinical experience and specialized training in oncology nursing. Although it’s not strictly required, oncology nurses in Canada are encouraged to pursue specialized oncology nursing learning paths and gain certification. You must also possess essential people skills, like empathy, compassion, and the ability to communicate and work with a team.

What is the oncology nurse's role?

Oncology nurses provide care to cancer patients and potential cancer patients in various clinical settings. You'll work with physicians and other medical professionals to provide patients with health care for cancer prevention, diagnosis, treatment, symptom management, and palliative care.

While clinical care is an integral part of the job, you'll also provide companionship and emotional support for your patients. Not only will you be a key member of their support team, but you'll also find yourself advocating for your patients when communicating with their health care team and their loved ones. You'll find that you play the role of educator as well. Your patients look to you to learn everything from how to live a healthy lifestyle while undergoing cancer treatment to what complicated medical terminology means.

As an oncology nurse, you'll do many things the average registered nurse would do, but you'll have a more specialized skill set because cancer is a unique disease. That might mean that the average dosage of medication may be higher than it would be for someone who doesn't have cancer, or you may need to understand symptoms better as they relate to chemotherapy treatments. For this reason, extra training and experience are necessary.

The Canadian Association of Nurses in Oncology (CANO/ADIO) describes the three levels of oncology nurses within the country:

• Generalist nurse: Receives basic oncology education and may have a specific caseload of cancer patients

• Specialize nurse: Registered nurse with specialized oncology training and experience whose primary focus is cancer care

• Advanced oncology nurse: Master's level nurse with expertise in cancer care

You can also choose a specialization within the field of oncology nursing. For example, if you want to work with children who have cancer, you might become a pediatric oncology nurse. Some other options include:

• Radiation oncology

• Immunotherapy

• Hematology

• Solid tumour

• Chemotherapy/biotherapy

• Inpatient hematology

• Inpatient oncology

• Ambulatory oncology

• Surgical oncology

• Gynecological oncology

• Bone marrow transplantation

Typical duties: What do oncology nurses do?  

As an oncology nurse, you will have unique duties based on where you work, your specialization, and the types of patients you work with. At any given time, your responsibilities might include:

• Monitoring a cancer patient's condition

• Running various tests and evaluations

• Managing symptoms in cancer patients

• Administering medication to cancer patients

• Helping to manage the side effects of treatments like chemotherapy 

• Administering chemotherapy and other treatments like infusions 

• Educating patients and their loved ones on a particular type of cancer, treatment options, and management plans  

• Educating patients and their loved ones on preventing certain types of cancers 

• Educating patients and their loved ones on living a healthy lifestyle while going through cancer treatment or after cancer treatment

• Assessing a cancer patient's mental and emotional needs

• Helping create a plan of action for a cancer patient's care 

• Working as an advocate for cancer patients and their loved ones  

• Recording a patient's health history 

• Monitoring and recording vital signs 

• Maintaining clinical documents 

• Caring for cancer patients after surgery 

• Coordinating with other health care providers

Benefits and challenges of oncology nursing

Becoming an oncology nurse offers its own unique set of benefits and challenges. Cancer can be a devastating disease that can cause stress, anxiety, further illness, and death. When a patient is facing the unknown, they need health care providers, such as oncology nurses, who are there to form relationships and offer support that will see them through their diagnosis and treatments. Providing comfort to cancer patients and their loved ones during what may be the scariest time of their lives can be rewarding, and it's one of the most significant benefits of becoming an oncology nurse. Unlike other nursing jobs where you may see a patient once or twice, you'll build relationships. 

Another benefit that many oncology nurses report is that the job helps you put life into perspective. When you see others going through a difficult time, it can help you to better appreciate what you have.  

While the emotional benefits of becoming an oncology nurse are numerous, you'll also find that it's a great way to advance your professional career.  If you are already a registered nurse or working to become one, you may eventually find that you want to advance your training and education or find a new specialty. Oncology is one option that will require you to continue learning throughout your career journey.

Oncology nurses work in various settings, and many of them, such as infusion centres and private practices, offer a steady workweek of typical office hours with nights and weekends off. If you prefer something a little more adventurous, there's also a demand for travel oncology nurses, who take assignments in various places throughout Canada [3]. Employment in the health care industry, including the need for nurses, is expected to rise for the foreseeable future, so job security is another benefit. With the number of cancer patients increasing in Canada each year, the need for health care professionals in the oncology field is likely to increase with them [4].

The main challenge that you'll face is a physically, mentally, and emotionally demanding job. While helping patients through some of the most challenging days of their lives is extremely rewarding to many people, it can become difficult too. Even when you have a bad day, you can't let it affect your relationship with your patients. Burnout is also common among oncology nurses. Far too many put their own needs aside to help others. You have to remember to take care of yourself, too.  

Another common challenge associated with oncology nursing is paying attention to detail. You'll likely work with multiple patients at a time, which means staying on top of dozens, if not hundreds, of pieces of information. As with any job in health care, if you give someone the wrong dose or the wrong medication, the consequences can be severe.  

How do you become an oncology nurse?

To become an oncology nurse, you must first become a registered nurse. You'll also need to possess specific people skills. Once you've achieved this, you can advance your career through training, education, experience, and various certifications.

Education (degrees and certifications)

Every oncology nurse must first start as a registered nurse. That means you'll need to complete a registered nurse program from an approved university, college, or other program offering a baccalaureate degree in nursing. Next, you'll need to take and pass the National Council Licensure Examination (NCLEX) and meet any requirements set by the province in which you want to practice.

Once you become a registered nurse, you'll need to gain some clinical experience. At least two years is often recommended, and the more you can work with cancer patients or within the field of oncology, the better. Not only will you gain the experience needed to advance your career, but you can also explore different specialties and find what you like best. For example, you may enjoy working with younger patients instead of adults and decide you'd like to become a pediatric oncology nurse.

Once you have some experience, you can earn a certification from the Oncology Nursing Certification Corporation. Keep in mind that each certification has prerequisites, such as a certain amount of experience or a certain amount of hours working with oncology patients. Some even require you to have a master's degree in nursing. Most of them also require you to continue your education throughout your career. The certifications offered include:

• Oncology Certified Nurse (OCN): a broad certification focused on oncology nursing for adults

• Certified Pediatric Hematology-Oncology Nurse (CPHON): a certification focused on providing oncology nursing care for children with hematological cancers like lymphoma or leukemia

• Certified Breast Care Nurse (CBCN): a certification that focuses on the prevention and treatment of breast cancer

• Blood and Marrow Transplant Certified Nurse (BMTCN): a certification focused on using blood and bone marrow transplants to treat certain kinds of cancers, including hemophilia, leukemia, and some solid-tumor cancers

• Advanced Oncology Certified Nurse Practitioner (AOCNP): a certification designed for nurse practitioners who work in general oncology

• Advanced Oncology Certified Clinical Nurse Specialist (AOCNS): a certification for advanced oncology nurses caring for patients with advanced cancers

• Certified Pediatric Oncology Nurse (CPON): a certification for oncology nurses with specialized knowledge of and experience in caring for children with cancer

• Advanced Oncology Certified Nurse (AOCN): oncology nurses with advanced experience and specialized knowledge in providing advanced-level care for adult cancer patients

Additionally, the Canadian Association of Nurses in Oncology offers a Canadian Nurses Association (CNA) Certification, which is a bilingual, nationally recognized nursing specialty credential that confirms your knowledge and commitment to the specialty practice of Oncology Nursing. The Canadian Nurses Association also offers its Certified in Oncology Nursing (C)anada or CON(C) program to registered nurses and nurse practitioners.

Certification is not required in every province, or for all nursing jobs working with cancer patients. It may, however, help make you more competitive in your field, help you earn more, and help you specialize in the area that interests you the most.   

Should you choose to advance your career as an oncology nurse even further, you might consider earning a master's degree in nursing, such as the Master of Science in Nursing (MScN) or equivalent. This can help you become an advanced oncology nurse.  As such, you will likely specialize in an area of oncology nursing, such as screening, prevention, counselling, coping, or psychosocial care.

People skills

Becoming an oncology nurse can be one of the most emotionally rewarding and challenging jobs in health care. It does require that you develop a particular set of people skills to take on this worthwhile career. Some of the most important are:

• Desire to work with people: You'll spend most of your time working one-on-one with patients, and you'll also interact with their loved ones and the rest of the health care team.

• Research-oriented: The oncology field changes constantly, and your patients and their loved ones will depend on you to answer their concerns and questions. You must enjoy learning and researching and commit yourself to do it throughout your career.

• Structure: Structure and compartmentalization can help you manage the stress of the job of an oncology nurse and find some work-life balance on your off days, so you don't experience burnout.

• Detail-oriented: An eye for detail is vital in any health care job, especially when you administer medication. Oncology nurses who help with chemotherapy treatments must be very specific regarding weights and measurements.

• Communication: Communication is an essential aspect of most jobs that involve working with patients, but as an oncology nurse, you'll need to take it to the next level. You'll need to find ways to connect with patients emotionally and look for nonverbal signs to figure out what someone isn't telling you about their mental or physical state.

• Empathy: Empathy and compassion allow you to put yourself in the shoes of your patients and their loved ones and make decisions based on what you'd want for your health.

• Collaboration: As an oncology nurse, you're part of a team that includes your patients, their loved ones, physicians, therapists, surgeons, nursing assistants, and countless other health care workers. Working together to develop the best options for those patients can be the key to a positive outcome.

Oncology nurse career outlook

According to the Government of Canada, oncology nurse job opportunities are expected to remain at a good to very good level for the next three years in all provinces [1]. While the types of registered nurses are unspecified, Statistics Canada has calculated that 233,900 people are expected to receive a cancer diagnosis, with more than 85,100 cancer-related deaths anticipated [4].  

Although the rate of new cancer diagnoses and deaths is on the decline, the overall number of cancer cases and related deaths continues to climb. This increase is attributed to the growth of the Canadian population as well as the aging population. Based on these calculations, it is reasonable to infer that the need for oncology nurses will increase [4].

Where do oncology nurses work?

Oncology nurses can work in various settings—essentially anywhere that treats cancer patients. These might include:

• Hospitals 

• Doctor's offices 

• Outpatient care centres 

• Hospice care 

• Cancer centres

• Academic institutions (training other nurses)

• Infusion centres 

• Clinics

• Extended care facilities and nursing homes 

• Home health care agencies 

• Research centres 

Next steps toward a career in oncology nursing

A big part of being an oncology nurse means continuous learning about a constantly evolving field. Browsing Coursera, you'll find numerous courses on various areas of oncology that can help you do just that.

Some of the world's leading educational institutions offer each of these, such as Cancer Biology Specialization from Johns Hopkins University. This course may even help you discover a specialty within the field of oncology that you’d like to pursue.