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What is an Oncology Nurse Practitioner? (Answered by an NP)


Written By: Kasee Wiesen DNP, APRN, FNP-C

Cancer affects millions of Americans every year. Fortunately, per the CDC, the death rate from cancer decreased 27%, but it remained the second leading cause of death after heart disease. These statistics are shocking and strongly demonstrate the need for oncology NPs. NPs, or nurse practitioners, are registered nurses (RNs) who have continued their education and passed a board certification exam determined on the specialty selected in graduate school. There are various paths an NP can take to become an oncology NP, but regardless of the track, it does take time. Below, you will learn the answers to what is an oncology nurse practitioner and how to become an oncology nurse practitioner.


What Does An Oncology Nurse Practitioner Do?


Have you wondered what does an oncology nurse practitioner do? An oncology nurse practitioner's duties vary based on the environment where the NP works. The oncology NP will assess, diagnose and treat the oncology patient. They may order various medications, including chemotherapy based on the patient’s symptoms and diagnosis. It is not uncommon, for the oncology NP to collaborate with a team of providers, including physicians to ensure the appropriate diagnosis is given and the correct treatment is initiated. The oncology NP may monitor the treatment plan, and ensure the patient is tolerating well, not experiencing significant side effects and answer their questions. They may also place consults as needed, such as to palliative care or hospice in specific scenarios. The oncology NP will work with the nurses as well and must display strong communication skills to make certain appropriate treatment is provided to the patients.


What Skills And Abilities Are Needed To Work As An Oncology NP?


A few of the oncology nurse practitioner skills that are important in the delivery of excellent care include compassion, kindness, patience, and the goal to deliver patient-centered care. Many of these patients have received a life-altering diagnosis that impacts them and their families daily. As the oncology NP, you must be patient in answering their questions, providing them resources, and supporting them. The oncology NP must also display leadership skills, including strong communication skills, which will help deliver care to the patient, communicate the plan with the patient and their family, and work with the interdisciplinary team. These skills will ensure the entire patient is cared for and they are receiving the best care possible.

The Oncology Nursing Society discusses the importance of the following skills and competencies that will enhance the knowledge of the oncology NP, leading to the delivery of high-quality care. For more information, visit the Oncology Nursing Society website.

1. Teamwork: Teamwork is necessary between the oncology team and the interprofessional team to ensure the patient receives the essential care and treatment. The interprofessional team may consist of outpatient services such as dietary/nutrition, physical therapy, occupational therapy, surgeon (if needed), and primary care provider. More disciplines may be involved in the inpatient setting, depending on the location of cancer and symptoms experienced. Regardless of who makes up the interprofessional team, the oncology NP will play a critical role in ensuring all team members communicate and consider all aspects of the patient's care.
2. Professional Development: The oncology NP must also display a desire for personal growth. Professional growth is achieved through establishing professional goals, which are evaluated periodically to measure progress.
3. Clinical Care: It is vital that the oncology NP practice evidence-based medicine and stay current on healthcare trends. Practicing evidence-based medicine ensures the NP is delivering high-quality care to the patient. Delivering appropriate clinical care is achieved by being competent in caring for patients across the cancer trajectory and using critical thinking skills when providing care.
4. Financial: The oncology NP should be financially responsible in their nursing practice. The oncology NP needs to know how to bill and code appropriately and use supplies wisely. Also, providing the patient resources to help with the financial burden that appointments, diagnostic tests, and treatment plans may create.
5. Quality: The oncology NP should have the goal to deliver high-quality care consistently. Providing high-quality care includes being aware of guidelines, standards, and requirements to ensure the patient is receiving high-quality care. This is frequently achieved through collaboration with the interprofessional team.


Where Do Oncology Nurse Practitioners Work?


An oncology nurse practitioner can work in a variety of settings, including both inpatient and outpatient settings. In the inpatient setting, the oncology NP may work on a designated oncology unit or care for patients diagnosed with cancer/receiving chemo in any other department, including medical-surgical, step-down, or intensive care unit (ICU). Oncology NPs who work in the inpatient setting will collaborate with other healthcare providers daily to ensure all patient health needs are met. An oncology NP who works in the outpatient setting may work in a clinic, infusion center, or cancer treatment center. They may also work in hospice or palliative care and may even deliver home healthcare to specific patients. Like in the inpatient setting, the oncology NP working outpatient will also collaborate with other healthcare providers to ensure care is provided to the person as a whole.


What Is The Typical Work Schedule For An Oncology NP?


Becoming an oncology nurse practitioner can be very rewarding and have many benefits. One benefit is a more regular or consistent work schedule. The typical work schedule for an oncology nurse practitioner depends on the setting they work. An oncology NP who works in a clinic setting will primarily work five days a week and work 8 am-5 pm. An oncology NP who works in a clinic will not typically work weekends or holidays. An oncology NP may also work in the hospital setting. An inpatient oncology NP may have to work 10 or 12 hour days but only be required to work 3-4 days a week. They may also have to work weekends or holidays, depending on their place of employment. Regardless of the setting employed, there is a chance of having to be on-call.


What Is The Difference Between Oncology NP And Oncology Nurse?


An oncology registered nurse (RN) delivers care to oncology patients in inpatient or outpatient settings. They can work in various locations, just like the oncology NP, and it may include clinics, infusion centers, cancer centers, or different inpatient floors. They assess oncology patients and inform the oncology nurse practitioner or physician of their findings. They will also implement orders and initiate treatment plans based on the orders from the physician or advanced practice provider (APP). Lastly, they continually evaluate the patient to assess if the treatment worked and how the patient is doing. The oncology nurse also places significant emphasis on education, including educating the patient and family about the diagnosis, medications prescribed, and treatment provided.

The oncology nurse practitioner has a different role, as they have the capability to assess, diagnose, treat, and evaluate the oncology patient. Just like the RN, the NP can work in various settings, including inpatient, outpatient, and cancer centers. The oncology NP will collaborate with other healthcare providers and the interdisciplinary team to ensure the patient receives the appropriate and best care possible. The oncology NP also communicates frequently with the nursing staff, therapy staff, and others involved in the patient’s care to ensure appropriate care is delivered, receive updates on the patient, and confirm the appropriate treatment is provided to the patient.


Pros And Cons Of Becoming An Oncology Nurse Practitioner


There are many pros of becoming an oncology nurse practitioner. As an oncology nurse practitioner, you develop relationships with your patients and their families. These relationships may last for a lifetime and leave a positive impact on both theirs and your lives. You provide support to patients and families who have received life-altering news and may be struggling to cope with some of the pending changes. You get to be a part of a team whose goal is to deliver the most current evidence-based practice to ensure the patient's needs are met. While this may lead to challenges, it may also lead to joyous celebrations when goals are achieved, positive news is received, and remission is achieved.

I do not believe there are many cons to becoming an oncology NP, but there may be challenges just like any career path. You must have a passion for this specialty and enjoy what you do. While you have the opportunity to develop relationships with your patients, it can also be challenging, especially if the patient has an unexpected outcome or is given a terminal diagnosis. It may also be challenging to help the patient and their families process the diagnosis as it can be very emotional. Still, with patience, competence, and strong communication skills, you can reach the patient and help them, and their family, determine the next steps and make decisions in their treatment plan. If you have a true passion for the specialty, the pros often outweigh the challenges of the career.


How Long Does It Take To Become An Oncology Nurse Practitioner?


The path to becoming an oncology nurse practitioner takes several years. On average, it takes between 7-10 years and if you choose to pursue your doctorate of nurse practice (DNP) it will take an additional 1-2 years. It takes four years to obtain your BSN. Then an additional 2-4 years is required to receive your master's of science in nursing (MSN) depending if you attend part-time or full-time. Another 1-2 years will be added on if you choose to go on and complete your doctorate of nurse practitioner (DNP), which is a terminal degree. Lastly, you may obtain a post-master or post-graduate oncology certificate, which takes another 1.5-2 years, or attend an oncology fellowship program which is usually 12 months.


How Much Does It Cost To Become An Oncology Nurse Practitioner?


There are many variables when determining the cost of becoming an oncology nurse practitioner. Regardless, if you are choosing a school for your undergraduate or graduate studies, the city, state, and program selected will affect cost. For example, you must obtain your BSN, and if you choose the traditional path in achieving this degree, it will take 4 years and between $40,000 to $200,000. Selecting an in-state public university is cheaper than a private university and a private university may cost very similar to paying out-of-state tuition for a public university/college. Lastly, choosing part-time status versus full-time status will also impact the cost in some universities.

On a side note, there is another option in achieving your BSN, and that is getting your associate’s degree (ADN) and then completing an RN-BSN program. The second option may be cheaper, but you would have to discuss further with the school(s) you choose to attend to get specifics regarding the cost. Also, some hospitals and healthcare facilities have tuition reimbursement programs with specific schools and therefore should be considered prior to selecting and applying for schools.


Step-By-Step Process Of Becoming An Oncology Nurse Practitioner


To be an oncology NP will take time to achieve as there are multiple steps required. Below, you will find a step-by-step process on how to become an oncology nurse practitioner.

1. Graduate from an accredited nursing program and obtain your BSN: Obtain your bachelor of science nursing (BSN) from an accredited nursing program. This can be achieved by either getting your associate’s degree and pursuing your RN-to-BSN or starting directly with a BSN program.

2. Pass NCLEX-RN and apply for licensure: Once you graduate from a BSN program, you must apply for and pass the NCLEX-RN before applying for state licensure through your state board of nursing.

3. Gain oncology nursing experience: Experience is not needed to apply for most NP programs. I do though, highly recommend it, especially for the oncology NP since it is specialized and it will help build your confidence in oncology nursing and help you build your resume, be accepted into an oncology NP program or fellowship, and will help with future certifications.

4. Apply for an Accredited NP school: Before applying to NP school, be sure to review the requirements needed before enrollment/acceptance into the program. Once completed, apply to the NP school(s) of your choice and await acceptance.

5. Graduate from an accredited Nurse Practitioner Program: For the role of an oncology nurse practitioner, there are a couple of paths to take. First, you may graduate with a general specialty such as Family Practice, Acute Care, Pediatrics, or Adult-Gerontology. If this path is selected, most oncology NP positions will require you to go on and complete the advanced oncology certified nurse practitioner exam (discussed below) to demonstrate your knowledge and proficiency in oncology nursing. Another option is to achieve a post-graduate certification specializing in oncology to verify your knowledge and competency in oncology. Lastly, some schools offer an oncology NP route, and some of these programs are discussed below on this page.

6. Pass your board certification exam and obtain state licensure certified NP through passing the national certification exam: Upon completing your graduate studies, you must take and pass the appropriate certification exam based on the program you completed. Once you pass the exam, you can apply for state licensure as an NP in your state of practice. You must follow the requirements to obtain licensure that are determined by your state board of nursing. You must maintain good status with your RN license to receive your NP license and you will carry both licenses for the remainder of your nursing career. For more information, visit your state board of nursing website.

7. Obtain oncology-related certifications if needed: There are numerous oncology nurse practitioner jobs, and once you accept one of these jobs, it is important to obtain the required certificates determined by your place of employment. It is very likely they will require the Advanced Oncology Certified Nurse Practitioner (AOCNP), discussed below. Most organizations and private practices will require additional education to be completed before practicing as an oncology NP.

8. Lastly, you may obtain your DNP if you choose: A Doctor of Nursing Practice (DNP) degree is an option for all NPs who have completed their MSN program. A DNP is a terminal degree and may open the door to more opportunities or possibly even higher pay. A DNP can still deliver direct patient care, but may also work in various leadership roles or even teach for a University.


Top Oncology Nurse Practitioner Programs


There are various programs to assist you in becoming an oncology NP throughout the United States directed towards both adult and pediatric nurses and advanced practice registered nurses (APRNs). Before applying for a program, it is best to review the pre-requisites and their curriculum to see if it fits you and your goals of becoming an oncology nurse practitioner.

Columbia University in New York: Columbia University offers an oncology nurse practitioner program that prepares the NP to become a leader and deliver high-quality care to oncology patients and their families. Students learn to care for patients throughout their journey with cancer, including both physical and psychological care. The program achieves these outcomes through specific courses directed at caring for oncology patients. The program prepares the NP to sit for their board certification and obtain the Advanced Oncology Certified Nurse Practitioner after completing the required hours.

Duke University: Duke University offers an oncology nurse practitioner program designed to prepare NPs to deliver care to oncology patients. Students will learn to care for patients at various stages in their disease process, and they have courses dedicated to this specifically. The courses include both lecture and clinic hours. By completing this program, the NP is one step closer to becoming board-certified and sitting for the Advanced Oncology Certified Nurse Practitioner certification.

Loyola University: Loyola University in Chicago offers two different pathways for the oncology nurse practitioner. First, you can complete the Adult-Gerontology Primary Care Nurse Practitioner with Oncology Specialization, a BSN-DNP program. This program does take six years, but again, it has a specific curriculum dedicated to delivering care to oncology patients. You can also obtain a certificate in oncology nursing. This certificate is available for nurses who hold a baccalaureate degree or are an APRN. The program is designed for nurses who wish to advance their knowledge of oncology care. The curriculum is broad and covers everything from genetic testing, genetic risk assessment, acute care, and palliative care.

If you are interested in learning more about these and other oncology NP programs, please click here.


Recommended Certifications To Enhance Your Job Role As An Oncology NP


There are a few certifications available for the oncology nurse practitioner and achieving these certifications will make you more marketable for oncology nurse practitioner jobs. There is a main certification that is strongly recommended you should obtain before you become an oncology nurse practitioner or obtain it within your first year of practicing.

Advanced Oncology Certified Nurse Practitioner (AOCNP): This certification is fundamental for an oncology NP to obtain as it solidifies the NPs knowledge of oncology and provides credibility to their professional practice. This certification is obtained after completion of an MSN or DNP program. There are two pathways to achieve this certification. The primary difference is completing a specific oncology NP program or a more generic NP program such as family practice, adult-gerontology, or pediatrics. For more information regarding the specifics of obtaining this certification, please visit the Oncology Nursing Certification Corporation website.

Other certifications you can complete are more generic but are oftentimes required based on your place of employment and population served. These include your Basic Life Support Certification (BLS), Advanced Life Support Certification (ACLS), and Pediatric Advanced Life Support (PALS). Most jobs, if not all NP positions will require BLS before you can start. In regards to ACLS or PALS, it is dependent on the population and environment you work in.


List Of Fellowships & Residency Programs For Oncology Nurse Practitioners


There are numerous fellowship and residency programs for an APRN to complete to become an oncology nurse practitioner. The need and desire for fellowship programs in oncology NP are driven by the lack of oncology nursing education in the traditional NP graduate courses. There are programs directed towards oncology NPs. However, most NP programs are more generic and focus on the adult, pediatric, or family practice specialty. Therefore, a post-graduate certificate in oncology is available, and for some jobs required, for the NP to feel competent and comfortable in delivering oncology care. Below I have listed and described two fellowship and residency programs for the oncology NP.

• The University of Texas MD Anderson Program: This post-graduate program is for advanced practice registered nurses (APRNs) who desire to complete a 12-month post-graduate fellowship in oncology nursing. The curriculum of this program is comprehensive and includes all oncology care ranging from prevention to end of life. The University of Texas MD Anderson Cancer Center is one of the top-ranked cancer centers in the United States. The program’s goal is to educate and prepare the nurse practitioner to become an expert in oncology care. The space is limited for the program as they currently have fellowship positions open in a 12-month program. Visit the University of Texas MD Anderson post-graduate fellowship in nursing website for more information.

• Mayo Clinic—College of Medicine and Science: The Mayo Clinic in Minnesota offers a post-graduate hematology/medical oncology fellowship for nurse practitioners and physician assistants (PAs). The fellowship is 12 months long and provides education and training in either hematology or medical oncology. The program will prepare the NP to deliver high-quality care in either hematology or medical oncology. It will provide the NP with the skills and clinical judgment to practice confidently in both the autonomous and collaborative/multidisciplinary team setting. For more information about this program, visit the Nurse Practitioner or Physician Assistant Hematology/Medical Oncology Fellowship (Minnesota) website.


Continuing Education Requirements For Oncology Nurse Practitioners


Continuing education requirement (CEU) hours are determined by the state you are licensed in, and if you are licensed in more than one state, you will need to be aware of each state’s CEU requirements. CEU requirements are generally non-specific, but when renewing your APRN license, many states will require CEUs that are pharmacology based, including a specific amount of controlled substance CEUs. To be an oncology NP, you should hold a certification, such as the Advanced Oncology Certified Nurse Practitioner (AOCNP) to demonstrate your competency in oncology nursing. There are specific requirements to maintain this certification as well.

As I have stated above, to hold an APRN license, you must maintain your RN license. Therefore, when relicensing, you must look at the state guidelines for NP and RN state license requirements. For specific information regarding the CEU requirements for your state of practice, visit your state board of nursing website or contact them for more details.


Starting Salary Of An Oncology Nurse Practitioner


The starting oncology nurse practitioner salary is variable, based on where the NP lives and the environment they work. The hourly pay for a starting oncology NP is $40.97. The annual salary for an entry-level oncology NP working 40 hours a week is $85,220.

Per Hour $40.97
Per Month $7,100
Per Year $85,220


Average Salary Of An Oncology Nurse Practitioner


After reading about the starting salary of an oncology NP, are you wondering what is the average salary of an oncology nurse practitioner? The average salary of an oncology NP is $56.29 an hour and the annual average wage for an oncology NP working 40 hours a week is $117,074. As I previously stated, this number is variable and may be slightly higher or lower depending on the city you reside in, and the environment worked.

Per Hour $56.29
Per Month $9,760
Per Year $117,074
(Source: Ziprecruiter.Com)


Job Outlook For Oncology Nurse Practitioners


There are several oncology nurse practitioner jobs available, and the job outlook for an oncology nurse practitioner is promising. This is due to the unfortunate fact that cancer is becoming more prevalent in the United States and worldwide. The National Cancer Institute has a few interesting statistics that support the need for oncology NPs in both the United States and worldwide.

One of the leading causes of death worldwide is cancer
There were 16.9 million cancer survivors in the United States in 2019, and by 2030 there are expected to be 22 million.

The oncology NP is usually board-certified in a more broad specialty such as family practice, pediatrics, or adult-gerontology, and then pursues a fellowship or certificate to indicate they specialize in oncology. Therefore, due to their training being broader, as the current NP population age, retire or choose a different career path, there will be an ongoing need for new oncology NPs to deliver care to oncology patients.


Useful Organizations & Associations


There are a few organizations dedicated to educating, assisting, and supporting oncology nurse practitioners. Below, I have discussed two of these organizations and provided links to their respective websites.

Oncology Nursing Society: The Oncology Nursing Society is an association for oncology nurses. The organization provides numerous resources for the oncology nurse, podcasts, educational opportunities, and preparation for certification exams. The organization aims to enhance oncology nursing to ensure excellent oncology care is delivered at the bedside.

Oncology Nursing Certification Corporation: The oncology certification corporation offers various oncology certifications to indicate you are knowledgeable and qualified to deliver oncology nursing care. Their site discusses the various certification exams, requirements that must be completed before sitting for the exams and provides information about review courses for the certification exams. There are also opportunities for continuing education, renewal of certifications, and other resources.


Finally, Is Oncology Nursing The Right NP Specialty For You?


After reading the above information, I hope you are able to answer the questions, what is an oncology nurse practitioner and how to be an oncology nurse practitioner? The schooling is lengthy but along with oncology-specific programs, fellowship programs, and oncology certifications you are sure to enter the workforce prepared and confident in your knowledge and skills. Becoming an oncology NP is very rewarding and allows you to have a direct impact on a patient’s life and their family.


Kasee Wiesen DNP, APRN, FNP-C
Kasee Wiesen is a practicing family nurse practitioner. Her nursing background includes emergency medicine, pediatrics and peri-op. Education is a passion of Kasee’s, and she has taught BSN, RN-BSN and DNP students, and has enjoyed every moment of it!