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6 Pros and Cons of Being a Pediatric Oncology Nurse + Salary + Steps to Become
Written By: Pattie Trumble, MPP, MPH
Becoming a pediatric oncology nurse is one of the toughest career tracks open to a registered nurse. In any given year, pediatric malignancies account for only 1 percent of all diagnosed cancers in the U.S., but caring for a child with cancer is enormously difficult: Even though the five-year survival rate for children with cancer is 85 percent, treatments take a huge physical, psychological and emotional toll on kids who, for the most part, are not developmentally mature enough to comprehend that their survival is at stake. Keep reading for a deep dive into the career of a pediatric oncology nurse – what is it, how to become, salary, and the pros & cons.
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WHAT DOES A PEDIATRIC ONCOLOGY NURSE DO?
As a pediatric oncology nurse, you’ll care for patients younger than 18 who are being treated for a cancer diagnosis. That means in addition to being competent at clinical nursing techniques, you must understand growth and developmental milestones so that you can interact with your patients at the appropriate level. Since routine bloodwork irregularities are often the earliest cancer warnings, pediatric oncology is frequently coupled with pediatric hematology, so your responsibilities may include the care of children with sickle cell anemia and other pediatric blood disorders as well. Occasionally, you may also care for older patients who are experiencing a relapse of a cancer or a blood condition that was first diagnosed in childhood.
Important Pediatric oncology nurse duties include:
• Monitoring vital signs:
Vital signs are clinical measurements that include temperature, pulse and respiration rates, and blood pressure. If a cancer patient is receiving a special medication, procedure or treatment, you may need to monitor their vital signs more often than every four hours.
• Assessing physical condition:
Physical assessment is a tool that allows the pediatric oncology nurse to pick up on potential or existing issues that need to be addressed in treatment. Information obtained from tracking symptoms can be used to adjust a nursing care plan so that symptoms and side effects can be better relieved.
• Recording and communicating observations:
Observations are useless unless they are communicated to the physicians who can act upon them. You’ll also communicate observations to other nurse caregivers both verbally and by including them as part of your nursing notes.
• Inserting peripheral IV lines:
Most pediatric oncology patients will have a central venous catheter through which medications, fluids, blood and parenteral nutrition are administered. Occasionally, however, vascular access may demand the insertion of a peripheral intravenous line, and starting one will often be the responsibility of the pediatric oncology nurse.
• Assisting with diagnostic tests:
You may be asked to assist with a variety of diagnostic tests, including biopsies, blood draws, lumbar punctures, imaging procedures, and bone marrow aspirations.
• Administering chemotherapy: As of 2019, the U.S. Food and Drug Administration (FDA) had approved 37 drugs for the treatment of childhood cancers
, and you may be responsible for administering many of them.
• Administering other medications:
The pediatric oncology RN may also be responsible for administering other medications such as chemoprotective agents, steroids, antibiotics, and immunosuppressants.
• Administering palliative care:
Palliative oncological care is focused upon relieving symptoms associated with both cancer and chemotherapy. Your palliative care duties here could range from administering medications for pain and nausea to coming up with creative head coverings to disguise hair loss.
• Communicating with and educating family:
Continuity of care is very important in the treatment of a child with cancer. You can expect to be assigned the same patient throughout the duration of his or her hospitalization and possibly throughout subsequent hospitalizations. You will get to know your patient’s family extremely well, and they will come to rely upon you for information and clarification.
• Participating in interprofessional conferences:
Pediatric oncology nurses are part of a treatment team that also includes your patient’s oncologist, radiologist, pathologist, pharmacist, clinical nurse specialist, medical social worker and ancillary health professionals such as physical therapists and respiratory therapists.
WHERE DOES A PEDIATRIC ONCOLOGY NURSE WORK?
Pediatric oncology nurses work in a variety of professional settings, including:
• Hospitals and medical centers:
Pediatric oncology nurses are employed both in hospital-operated inpatient units and outpatient clinics. Pediatric oncology units are most often found in dedicated children’s hospitals.
• Oncologist private practices:
You may also find employment in an oncologist’s private practice where you may help conduct physical assessments of patients, create treatment plans and administer chemotherapy.
• Radiation center:
Pediatric oncology nurses who work at radiation centers are responsible for evaluating patients before treatment, educating patients and families about treatment side effects and management, and caring for patients during radiation treatments.
• Pediatric hospices:
If you work in a pediatric hospice, you’ll be providing end-of-life care aimed at alleviating pain, breathing problems, nutritional deficits and the like.
• Patients’ homes:
Pediatric oncology nurses in home-based settings do physical assessments, administer medications and provide education about ongoing treatments and their potential side effects.
WHAT ARE THE TYPICAL WORKING HOURS OF A PEDIATRIC ONCOLOGY NURSE?
Your working hours as a pediatric oncology nurse will depend upon the practice setting where you work. Most hospital-employed pediatric oncology nurses will work three 12-hour shifts in a week, but in hospitals that still use 8-hour shifts, you’ll work either four or five shifts a week. Since hospitals never close, it’s likely you’ll be called in to work some weekends and holidays, and possibly even evenings and nights.
Pediatric oncology nurses affiliated with private physician practices, radiation centers and hospices typically have 36- to 40-hour workweeks that don’t include weekends or holidays. Home-care pediatric oncology nurses can work as much or as little as they like.
WHAT ARE THE PERSONALITY TRAITS OF A SUCCESSFUL PEDIATRIC ONCOLOGY NURSE?
Pediatric oncology nurses are a select cadre. Working with critically ill children is not a job that many people can do because it calls for the ability to remain calm and collected in the face of personal tragedies that frequently threaten to become overwhelming. Here are some personality traits to cultivate if you’re thinking of becoming a pediatric oncology nurse:
• Executive functioning:
Cancer is a complex, multifactorial disease; treatment often relies upon precise timing and the ability to prioritize. Pediatric oncology nurses must be able to focus, follow directions and handle their emotions in a constructive manner.
• Emotional resilience:
Helping children and their families through a cancer diagnosis and subsequent treatment is an enormous emotional challenge. You’ll have to be comfortable dealing with the grief and loss of others while retaining as optimistic an outlook as circumstances warrant.
Flexibility is crucial when you’re caring for a child with cancer because you’ll be asked to handle a variety of different roles. In the morning, when you hang a bag of intravenous chemotherapy medication, you’ll be acting as an infusion specialist, but later that afternoon, when you’re teaching your patient’s parents how to mitigate treatment side effects, you’ll be acting as a nurse educator. You need to be equally good at wearing all these different hats.
Even a small error in medication dosage or timing can have devastating effects on a child with cancer. As a pediatric oncology RN, you’ll need to pay attention to the tiniest details.
As a pediatric oncology nurse, you’ll be interacting with families at their most vulnerable. Be careful not to betray their confidence by sharing information inappropriately.
• Emotional sensitivity:
Family members of children with cancer may have a hard time communicating. It’s may fall to you to intuit what they really want to say and to help them say it.
Compassion is sympathy for others and the desire to help alleviate other people’s pain. It’s one of the most important personality traits a pediatric oncology nurse can have.
WHAT ARE THE KEY SKILLS NEEDED TO WORK AS A PEDIATRIC ONCOLOGY NURSE?
Pediatric oncology nurse skills are a very specific set of competencies. They include:
• Clinical competencies:
As a pediatric oncology nurse, you must be able to administer chemotherapy, blood components, fluid and electrolyte replacements, and other oncology treatments as prescribed. You should have a thorough understanding of oncology treatment equipment and procedures.
• Infection control standards and techniques:
You’ll need to implement protective measures for immunocompromised patients and understand the requirements, standards and guidelines related to safe nursing practice for all patients.
• Ability to perform physical assessments:
Accurate and comprehensive physical examinations can help assess response to treatment, narrow the parameters of differential diagnosis and target diagnostic testing more specifically.
• Knowledge of pediatric cancer protocols:
Your patients’ families will rely upon you to answer questions and explain what they don’t understand about treatment protocols.
• Ability to provide support:
As a pediatric oncology nurse, you’ll develop close relationships with your patients and their families. You’ll be called upon often to provide emotional and psychological reassurance, but you’ll have to learn to do this within sustainable boundaries so you don’t succumb to burnout.
• Communication skills:
Pediatric oncology nursing requires top-notch communication skills. Not only will you be answering questions your patients and their families have, you will also be acting as an advocate on their behalf with other healthcare professionals.
• Team player:
A pediatric oncology nurse is a member of a team that also includes family members, other caregivers and professionals such as oncologists, radiologists, pathologists, pharmacists, medical social workers, and other ancillary medical personnel. It’s vitally important that you know how to function well as part of that team.
HOW TO BECOME A PEDIATRIC ONCOLOGY NURSE?
What Education Is Required To Become A Pediatric Oncology Nurse?
In order to become a pediatric oncology nurse, you’ll need to earn either an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). You’ll need a high school diploma to enter either one of these degree programs. Some ADN and BSN programs may require you to have a certain number of high school credits in math and basic sciences like chemistry and biology. ADN programs can be found at two-year community, technical and vocational colleges as well as online. Programs that award BSN degrees are generally four-year programs offered through campus-based and online colleges and universities. Nursing programs typically require the completion of clinical rotations, and you’ll gain valuable experience if you can arrange to do your clinical rotation on a pediatric unit or an oncology unit.
If you’re certain that pediatric oncology is the career path for you, you also have the option of pursuing further education and completing an advanced practice RN degree (APRN). This will enable you to become either a pediatric acute care nurse practitioner with a concentration in oncology or an oncology clinical nurse specialist with a concentration in pediatrics. At present, the terminal APRN degree is the Masters of Science in Nursing (MSN) degree, but this may change if the Doctor of Nursing Practice (DNP) degree becomes the terminal degree for APRNs
as recommended by the American Association of Colleges of Nursing. According to the nursing education website nursingprocess.org, top schools with strong pediatric NP programs include the University of Washington, the University of Pittsburgh, Yale University, Duke University, and Rush University.
What Licensure Is Required To Become A Pediatric Oncology Nurse?
In order to become a pediatric oncology nurse, you’ll need to be a registered nurse (RN). This entails passing the National Council Licensure Examination (NCLEX-RN)
administered by the National Council of State Boards of Nursing
and applying for licensure in the state in which you hope to work. NCLEX-RN is primarily a multiple-choice exam that utilizes computerized adaptive testing
so that the computer selects questions based upon your answers to previous questions. The examination can contain anywhere between 75 and 145 questions, and you are given five hours to complete it. The exam fee is $200. As of April 1, 2020, the passing standard on the exam is zero
Licensing requirements vary by state. Find out more by referring to your state Board of Nursing.
What Certifications Are Required OR Recommended For A Pediatric Oncology Nurse?
No state requires a specific certification for an RN who is thinking of becoming a pediatric oncology nurse, but employers may require it.
At a minimum, get the American Heart Association’s Basic Life Support (BLS) certification. This requires taking a four-hour course and passing a 25-question multiple-choice exam administered by the instructor at the end of the course. Basic life support is the care provided by first-responders at the scene of a medical emergency. The passing score for this test is 70 percent.
The American Heart Association’s Pediatric Advanced Life Support (PALS) certification focuses upon preparing RNs and other healthcare providers to intervene in pediatric emergencies involving respiratory failure, shock, and cardiopulmonary arrest. Candidates must pass a multiple-choice exam at the end of the course with a minimum score of 84% to qualify for certification.
The American Heart Association’s Pediatric Emergency Assessment, Recognition and Stabilization certification (PEARS) is designed for nurses and other healthcare providers who may encounter pediatric emergencies during the course of their work. To obtain the certification, candidates must pass a video-based written exam with a minimum score of 84 percent.
The Certified Pediatric Hematology-Oncology Nurse (CPHON)
accreditation is offered by the Oncology Nursing Certification Corporation
. In order to qualify for this certification, you must pass the qualifying exam. You must also have a current, unencumbered RN license; a minimum of two years of RN experience within the last four years; a minimum of 2,000 hours of pediatric oncology hematology practice within the last four years; and 10 hours of continuing education coursework with an oncology focus. The test consists of 165 multiple choice questions, but only 125 of these questions contribute towards your score. A passing CPHON score is 55.
What Additional Training And Experience Is Required To Become A Pediatric Oncology Nurse?
Additional training is not a requirement for employment as a pediatric oncology nurse at most hospitals and private physician practices. Prospective employers generally have a marked preference for nurses with some background in the field, however.
If you’re a first-time employee, consider attending the lectures and in-services on pediatric cancer care and treatment offered by local medical centers in your area or take relevant continuing education classes. Pediatric oncology is not a field that appeals to everyone, so many hospitals may be willing to hire you even if you’re a new grad. Look for hospitals with strong orientation programs and experienced RNs who will be eager to mentor you.
What Are The Continuing Education Requirements For A Pediatric Oncology Nurse?
Continuing education classes are a requirement in order to maintain an active RN license in all 50 states and the District of Columbia, but the number of contact hours necessary for license renewal varies from state to state. While the state you work in won’t require your CEUs to be in the field of pediatric oncology, your employer may.
TIME & COST ASSOCIATED WITH BECOMING A PEDIATRIC ONCOLOGY NURSE
How Long Does It Take To Become A Pediatric Oncology Nurse?
There are no specific time intervals associated with becoming a pediatric oncology nurse. Completing a nursing program can take anywhere from two to four years, depending upon whether you’re pursuing an ADN or a BSN degree. Recommended study times for the NCLEX-RN vary from 4 to 12 weeks. If an employer is interested in hiring you, you can begin working as soon as you receive your RN license. However, in order to obtain the CPHON certification, you will have to have a minimum of 2,000 hours of pediatric oncology hematology practice under your belt (as noted above.)
How Much Does It Cost To Become A Pediatric Oncology Nurse?
No specific costs are associated with becoming a pediatric oncology nurse beyond the costs of your nursing education, the NCLEX-RN exam, and your nursing license. Two-year ADN degree programs can cost anywhere between $10,000 to $40,000 while four-year BSN degree programs can cost anywhere between $40,000 and $100,000. As noted above, you will spend $200 when you register to take the NCLEX-RN exam. Nursing license fees vary from state to state
CAREER ADVANCEMENT OPPORTUNITIES FOR PEDIATRIC ONCOLOGY NURSES
Pediatric oncology nurses who are interested in advancing their careers to the next professional level have several opportunities available to them, including:
• Nurse practitioner:
Nurse practitioners are advanced practice registered nurses who’ve earned either a Master of Science in Nursing (MSN) degree or a Doctor of Nursing Practice (DNP) degree. Pediatric oncology nurses with a hospital background may be most interested in the pediatric acute care NP track. Several university-level nursing programs offer an oncology concentration within this track.
• Clinical nurse specialist:
Another APRN option is the clinical nurse specialist track. Clinical nurse specialists don’t provide patient care in hospital settings but instead, work behind the scenes, improving care plans, analyzing patient outcomes and providing support education and support to nurses and other members of the healthcare team. Oncology and pediatrics are both APRN Consensus Model
-approved specialties for clinical nurse specialists.
WHAT ARE THE TOP CONS OF BEING A PEDIATRIC ONCOLOGY NURSE?
Like all jobs, there are pluses and minuses associated with working as a pediatric oncology nurse. Here are the top cons of being a pediatric oncology nurse.
1. Occupational stress:
Most nurses develop relationships with patients over time. Since continuity of care is such an important aspect of pediatric oncological care, pediatric cancer RNs have more opportunity than most nurses to develop strong connections with those they care for. One of the biggest disadvantages of being a pediatric oncology nurse is how heartbreaking it can be if one of those patients loses their battle with cancer.
2. Exposure to toxic chemotherapeutic agents:
Chemotherapeutic drugs are known health hazards. Although the nursing profession in conjunction with professional organizations and government agencies has developed guidelines to minimize handling risks, accidents can and do happen. Oncology nurses exposed to chemotherapeutic drugs are at greater risk for miscarriages and leukemia
3. Difficulty maintaining work-life balance:
Many nurses have a problem with codependency, but that’s particularly true of pediatric oncology nurses because their patients are so physically and emotionally vulnerable. It’s all too easy to make potentially self-sabotaging concessions—like agreeing to work overtime, even though you don’t really want to, when the charge nurse tells you the next shift is short-staffed.
4. Angry families:
The parents of children with cancer are frequently angry. Of course, they’re angry at the situation, not at you. But they may take their anger out on you just the same. It can be very difficult not to personalize these types of reactions.
5. Burnout: Oncology nurses in general have one of the highest burnout rates among all nurses
. Nurse burnout can have negative repercussions on a personal level because it’s linked to sleep issues, depression, and compassion fatigue. But it can also have negative repercussions for the workplace since burnt-out nurses make more errors
6. Limited professional opportunities:
Most pediatric oncology units are affiliated with dedicated children’s hospitals. If you don’t live in an area with a children’s hospital, you may have to look for a while before you find an employment opportunity that’s right for you.
WHAT ARE THE TOP PROS OF BEING A PEDIATRIC ONCOLOGY NURSE?
There are many rewards associated with the decision to become a pediatric oncology nurse. Here are some of the top pros of being a pediatric oncology nurse:
1. Intellectual challenge:
Pediatric oncology nursing is an intellectually stimulating discipline. There’s always new information to synthesize and new techniques to learn. You’ll never be bored.
2. Clinical experience:
As a pediatric oncology nurse, you’ll get many opportunities to expand your clinical horizons. You may have the opportunity to work with procedures like chemotherapy, immunotherapy, radiation therapy, and innovative genetically based therapies. You’ll get plenty of experience with central lines, IV lines, percutaneous endoscopic gastrostomy (PEG) tubes and blood draws.
3. Job satisfaction:
Knowing that you’ve helped a family navigate one of the toughest times they’ll ever have to face can be immensely gratifying. Eighty-five percent of children diagnosed with cancer have a five-year or more survival rate
, and seeing a child that you’ve cared for move on with his or her life makes your job immensely rewarding.
4. High salary:
One of the biggest advantages of being a pediatric oncology nurse is the high salary you’ll command. On average, pediatric oncology nurses make $108,704 a year. This is 55 percent more than the average salary for nurses in the U.S. across all specialties ($70,335
5. Multiple practice settings:
As a pediatric oncology nurse, you’ll be able to work in a variety of inpatient and outpatient practice settings. Don’t want to work evening, nighttime, or weekend shifts? Your specialized skills working with pediatric patients will make you a welcome addition to an oncologist’s private practice.
6. High demand:
Pediatric oncology nursing is a niche specialty that requires a very specific skill set. The incidence of childhood cancers has risen over the past few decades: Experts project that nearly 10,500 children under the age of 15 will be diagnosed with cancer in 2022
. Mortality rates associated with childhood cancers have dropped, however, and the excellent care provided by pediatric oncology nurses is a factor in that. There’s a high demand for this area of expertise.
PEDIATRIC ONCOLOGY NURSE SALARY + BENEFITS
What Is The Starting Salary Of A Pediatric Oncology Nurse?
The starting salary of a pediatric oncology nurse throughout all parts of the U.S. is $34.88 an hour, $6,050 a month or $72,560 a year, which is 33 percent less than the average pediatric oncology nurse salary throughout all parts of the U.S. Entry-level salaries are typically low so that medical facilities that hire inexperienced RNs into this role can recoup some of their onboarding costs.
What Is The Average Salary Of A Pediatric Oncology Nurse?
The average salary of a pediatric oncology nurse is $52.26 an hour, $9,060 a month, or $108,704 annually. Pediatric oncology RNs usually reach this milestone sometime during their 10th year of practice. Average salaries are heavily influenced by relative costs of living. Hence, in California, where the cost of living is high, average pediatric oncology nurse salaries are more than twice what they are in Alabama, where the cost of living is low.
How Much Does The Pediatric Oncology Nurse Salary Grow With Experience?
The more experience a pediatric oncology RN has, the higher his or her salary. Pediatric oncology nurses with one to four years of experience make 15 percent more than their entry-level colleagues while pediatric oncology nurses with five to nine years of experience make 41 percent more. Note, however, that in most medical centers, the pay scale is determined by seniority. Salaries are calculated on the basis of continuous employment at a specific facility rather than on the basis of experience.
| Level of Experience || Annual || Monthly || Hourly |
| Entry-Level || $72,560 || $6,050 || $34.88 |
| 1-4 Years of Experience || $83,730 || $6,980 || $40.25 |
| 5-9 Years of Experience || $102,350 || $8,530 || $49.21 |
| 10-19 Years of Experience || $127,150 || $10,600 || $61.13 |
| 20 Years or More Experience || $157,910 || $13,160 || $75.92 |
What Benefits And Perks Can A Pediatric Oncology Nurse Expect?
In addition to salary, full-time pediatric oncology nurses typically receive benefits as part of their employment compensation package. In addition to legally mandated benefits like unemployment insurance, workers’ compensation and COBRA, benefits may include:
Comprehensive health insurance, including medical, dental, and vision coverage
Paid time off, including vacation days and sick leave
Contributions to retirement funds such as 401(k)s
Tuition reimbursement for continuing education classes
Although such benefits may represent a substantial cash value, pediatric oncology nurses won’t have to pay any taxes on them.
AVERAGE SALARY OF A PEDIATRIC ONCOLOGY NURSE IN YOUR STATE
At $163,800 annually, California-based pediatric oncology nurses earn the highest salaries in the nation. Alabama-based pediatric oncology nurses earn the lowest ($81,830). The distribution of salaries follows a distinct pattern: Northeastern states (like Massachusetts and New York) and western coastal states (like California and Oregon) offer the highest salaries while southeastern states (like Tennessee and Arkansas) offer the lowest.
| State || Hourly || Monthly || Annual |
| Alabama || $39.34 || $6,820 || $81,830 |
| Alaska || $62.23 || $10,790 || $129,440 |
| Arizona || $52.50 || $9,100 || $109,210 |
| Arkansas || $41.57 || $7,210 || $86,460 |
| California || $78.75 || $13,650 || $163,800 |
| Colorado || $50.86 || $8,820 || $105,780 |
| Connecticut || $55.42 || $9,610 || $115,280 |
| Delaware || $48.55 || $8,420 || $100,990 |
| Florida || $45.40 || $7,870 || $94,440 |
| Georgia || $46.71 || $8,100 || $97,160 |
| Hawaii || $68.48 || $11,870 || $142,430 |
| Idaho || $46.79 || $8,110 || $97,330 |
| Illinois || $48.70 || $8,440 || $101,300 |
| Indiana || $44.08 || $7,640 || $91,690 |
| Iowa || $40.87 || $7,080 || $85,010 |
| Kansas || $41.93 || $7,270 || $87,220 |
| Kentucky || $42.28 || $7,330 || $87,940 |
| Louisiana || $44.42 || $7,700 || $92,400 |
| Maine || $46.40 || $8,040 || $96,520 |
| Maryland || $53.29 || $9,240 || $110,850 |
| Massachusetts || $62.87 || $10,900 || $130,770 |
| Michigan || $48.32 || $8,380 || $100,510 |
| Minnesota || $52.88 || $9,170 || $109,990 |
| Mississippi || $40.01 || $6,940 || $83,220 |
| Missouri || $43.04 || $7,460 || $89,530 |
| Montana || $46.07 || $7,990 || $95,820 |
| Nebraska || $45.38 || $7,870 || $94,400 |
| Nevada || $58.63 || $10,160 || $121,940 |
| New Hampshire || $49.63 || $8,600 || $103,220 |
| New Jersey || $55.99 || $9,710 || $116,460 |
| New Mexico || $49.45 || $8,570 || $102,850 |
| New York || $58.63 || $10,160 || $121,950 |
| North Carolina || $45.04 || $7,810 || $93,680 |
| North Dakota || $45.48 || $7,880 || $94,600 |
| Ohio || $45.56 || $7,900 || $94,760 |
| Oklahoma || $43.50 || $7,540 || $90,480 |
| Oregon || $62.86 || $10,900 || $130,740 |
| Pennsylvania || $48.45 || $8,400 || $100,770 |
| Rhode Island || $54.08 || $9,370 || $112,480 |
| South Carolina || $43.86 || $7,600 || $91,220 |
| South Dakota || $39.82 || $6,900 || $82,820 |
| Tennessee || $41.88 || $7,260 || $87,120 |
| Texas || $50.16 || $8,700 || $104,340 |
| Utah || $45.97 || $7,970 || $95,610 |
| Vermont || $47.12 || $8,170 || $98,010 |
| Virginia || $48.58 || $8,420 || $101,050 |
| Washington || $59.64 || $10,340 || $124,060 |
| West Virginia || $42.54 || $7,370 || $88,490 |
| Wisconsin || $48.83 || $8,460 || $101,570 |
| Wyoming || $47.42 || $8,220 || $98,640 |
HIGHEST PAID PEDIATRIC ONCOLOGY NURSES
What Are The 10 Highest Paying States For Pediatric Oncology Nurses?
California is the top-paying state for pediatric oncology nurses. Pediatric oncology RNs in the Golden State make 15 percent more than pediatric oncology RNs in Hawaii, the second-highest paying state in terms of pediatric oncology RN salaries. In part, this reflects California’s high cost of living, which is 50 percent higher than the cost of living in the nation as a whole
. In part, it reflects the strength of California’s nurses union. Numerous studies have found that unions are associated with higher pay
| Rank || State || Average|
| 1 || California || $163,800 |
| 2 || Hawaii || $142,430 |
| 3 || Massachusetts || $130,770 |
| 4 || Oregon || $130,740 |
| 5 || Alaska || $129,440 |
| 6 || Washington || $124,060 |
| 7 || New York || $121,950 |
| 8 || Nevada || $121,940 |
| 9 || New Jersey || $116,460 |
| 10 || Connecticut || $115,280 |
What Are The 10 Highest Paying Metros For Pediatric Oncology Nurses?
All ten of the cities where pediatric oncology nurses earn the highest salaries are in California. There is a considerable amount of salary variation throughout the Golden State, nonetheless. Salaries in the San Francisco Bay Area, for example, are 33 percent higher than salaries in Redding, the capital of sparsely populated Shasta County. This is probably due to regional differences in cost of living indices: The cost of living in the San Francisco Bay Area
is nearly two and a half times the cost of living in Redding
| Rank || Metro || Average|
| 1 || San Francisco-Oakland-Hayward, CA || $202,710 |
| 2 || San Jose-Sunnyvale-Santa Clara, CA || $199,540 |
| 3 || Vallejo-Fairfield, CA || $193,120 |
| 4 || Sacramento--Roseville--Arden-Arcade, CA || $182,530 |
| 5 || Salinas, CA || $179,560 |
| 6 || Santa Rosa, CA || $169,610 |
| 7 || Modesto, CA || $164,520 |
| 8 || Stockton-Lodi, CA || $157,410 |
| 9 || Los Angeles-Long Beach-Anaheim, CA || $153,690 |
| 10 || Redding, CA || $151,980 |
PEDIATRIC ONCOLOGY NURSE JOB OUTLOOK
Is There A Demand For Pediatric Oncology Nurses?
Demand for pediatric oncology nurses is high, but because of the specialized nature of the services they provide, pediatric oncology RNs may have to search to find employment opportunities that are the right fit for their particular expertise.
Why Is There A Demand For Pediatric Oncology Nurses?
While pediatric cancers only account for 1 percent of all diagnosed cancers within the U.S. in any given year, that number is rising even as the number of adult cancers is declining. The good news is that deaths from pediatric cancer are falling: Between 1975 and 2018, the cancer rate among children under 19 declined by more than 50 percent
The types of cancer that children get are different from the types that adults get, and children’s bodies respond quite differently to them, too. Childhood cancers are aggressive, and children tend to be diagnosed at a later stage of the disease, so they need aggressive treatment. Optimal treatment must also consider the child’s psychosocial needs.
The primary reason why the prognosis for children with cancer has improved so dramatically over the past four decades is treatment protocols that are customized to the unique needs of children. Pediatric oncology nurses are familiar with these unique needs and unique protocols in a way that oncology nurses who chiefly care for adults are not. The demand for pediatric oncology nurse services will continue to be high.
MOST COMMON INTERVIEW QUESTIONS AND ANSWERS FOR PEDIATRIC ONCOLOGY NURSING JOBS
Pediatric oncology is a field that’s filled with multiple challenges, rooted both in the complexity of the care that’s offered and the uncertain prognosis of so many of the patients you’ll encounter. You can expect pediatric oncology nurse interview questions to delve deeply into these areas. The trick is to highlight your positive qualities clearly and concisely while emphasizing your understanding of nursing standards and guidelines.
Question #1: Tell us about a time when you had a difficult interaction with the parent of a child who was your patient?
What the Interviewer Really wants to Know:
The interviewer wants to know whether you are professional enough to understand that the parent’s anger is not aimed personally at you but at the situation.
How to Answer:
Show that you kept your cool without being manipulated into an inappropriate response. Never speak negatively about a patient or a patient’s family members; instead, demonstrate empathy. And never reveal any medical details that might be a HIPAA
Question #2: How would you explain a leukemia induction protocol to a 14-year old without resorting to a lot of medical terminology?
What the Interviewer Really wants to Know: The interviewer wants to know how good you are at therapeutic communication techniques and whether you can tailor your patient education efforts appropriately to your patient’s developmental stage.
How to Answer: Instead of using terms like “leukocytes” and “erythrocytes,” say “white blood cells” and “red blood cells.” Note that you initiated the conversation in a casual manner: Adolescents prefer informal chats to formal sit-downs.
Question #3: How would you respond if you were asked to switch patient assignments in the middle of a shift?
What the Interviewer Really wants to Know: The interviewer wants to know how adaptable you are and how much of a team player.
How to Answer: You want to showcase your flexibility, but you also want to emphasize that you’re someone who can function effectively with others in a group. To that end, explain the ways you made it easier for the other nurse to pick up your patients.
Question #4: How do you deal with difficult coworkers?
What the Interviewer Really wants to Know: This is another question that addresses your ability to function as part of a team. Additionally, it yields information about how adept you are at conflict resolution.
How to Answer: Never trash-talk a professional colleague. Instead, offer an analysis of a challenging situation that came up during the course of your dealings with this coworker, how you enlisted his or her support in resolving this situation, and what you learned that you were able to use in future interactions with this coworker.
Question #5: Pediatric oncology is a high-pressure job. How will you handle stress and prevent burnout?
What the Interviewer Really wants to Know: Orienting a new employee can be a very expensive proposition. The interviewer wants to know if the hospital will receive a good return on its investment if it decides to orient you.
How to Answer: Burnout is an inherently negative subject, so you don’t want to spend too much time with this question. As succinctly as possible, list the ways that you strive to maintain a work-life balance and mention some of the self-care activities that help you relieve stress.
USEFUL RESOURCES FOR PEDIATRIC ONCOLOGY NURSES
Organizations And Associations
The Association of Pediatric Hematology/Oncology Nurses (APHON) is the premier professional organization for pediatric oncology nurses. Dues are $120 a year. APHON offers continuing education and sponsors an annual conference every fall. APHON also publishes The Journal of Pediatric Oncology Nursing
. Although active members are primarily nurses, the organization is also open to allied healthcare workers such as child life specialists, social workers, and pastoral care providers.
The Institute of Pediatric Nursing (IPN) is the nonprofit arm of the Pediatric Certification Board
, which administers the Certified Pediatric Nurse credential
. IPN is primarily an outreach organization dedicated to increasing awareness of the pediatric nursing profession. Membership is free.
The Society of Pediatric Nurses (SPN) is a professional association for pediatric nurses. It represents more than 3,600 nurses in 28 pediatric subspecialties. It provides continuing education classes, hosts an annual conference every April, and publishes The Journal of Pediatric Nursing
. Regular memberships are $115 annually.
The Oncology Nursing Society (ONS) is a professional community for oncology nurses. It has more than 35,000 active members. Its professional publications include The Clinical Journal of Oncology Nursing, The Oncology Nursing Forum, and The ONS Voice. It also sponsors continuing education classes, certifications and an annual conference each spring. RN memberships are $125 a year.
OncologyNurseAdvisor is a website that offers news of interest to the oncology nurse community. Topics include late-breaking oncology news, safe handling and administration of chemotherapy drugs, side effect management, and new developments in specific cancers.
Pediatric Oncology News is another current events website but one that’s specifically customized for pediatric oncology professionals. It’s particularly valuable for its updates on the latest breakthrough discoveries presented at regional conferences both in the U.S. and around the world.
While, the National Children’s Cancer Society (NCSS) is primarily a resource for the families of children with cancer, families may never learn about it if their pediatric oncology nurse doesn’t tell them about it. NCSS offers financial assistance for low-income families who need assistance with transportation expenses.
Pediatric Oncology Branch: Children with cancer participate in far more clinical trials than adults with cancer do because childhood cancers are so relatively rare. This website provides valuable information on the availability of clinical trials.
This 12-minute video produced by APHON features a series of interviews with working pediatric nurses as well as glimpses of those RNs in their work settings. Production values are high.
This four-minute clip is more of a slideshow than a video. It’s a gallery of striking photographs of pediatric oncology nurses and the children they care for. It was produced by APHON.
This clip is a two-minute interview with a pediatric oncology nurse named Kelly who describes what a typical workday is like for her. Kelly is very informative and speaks articulately about the challenges and rewards of her position.
This 47-minute video is a Q&A with a pediatric oncology RN named David who talks about all aspects of his training and his work experiences. While it’s not visually stimulating, it’s very informative since David gives in-depth answers to the questions he’s asked.
Host Dr. Timothy Cripe is chief of the Division of Hematology/Oncology and Bone Marrow Transplantation at Nationwide Children's Hospital in Columbus, Ohio. His weekly podcast explores emerging issues in pediatric cancer care. Episodes are 35 minutes long. The podcast is distributed through the Apple network.
When 4-year-old Davis was diagnosed with Rhabdomyosarcoma, his family’s life changed dramatically. This podcast, produced by Davis’s parents, chronicles this journey in a candid, unflinching but often humorous manner. Each episode is approximately 40 minutes long. The podcast is distributed through the Feedspot network.
This podcast is a series of interviews with oncologists, nurses, recovered patients, parents and other individuals whose lives have been touched in some way by childhood cancer. Each episode is approximately 50 minutes long, and two episodes drop each week. The podcast is distributed through the Feedspot network.
Every pediatric oncology nurse needs a reference library, and this informative tone is available both as a textbook and a Kindle download. It was written by two Canadian RNs, but pains have been taken to make the information it contains relevant to pediatric oncology nurses in the U.S. as well. Its five sections cover the essentials of pediatric cancers, hematologic disorders, treatment of childhood cancer, side-effects of treatment and disease, and supportive and palliative care.
A Core Curriculum: This book was published by APHON and is a particularly good resource for CPHON exam prep. Eleven chapters contain information on pediatric oncology nursing practice, childhood cancer treatments, treatment side effects, psychosocial issues, and much more. APHON members can purchase this book at a discounted price.
BONUS! A TYPICAL DAY IN THE LIFE OF A PEDIATRIC ONCOLOGY NURSE
There are no “typical” days when you’re a pediatric oncology nurse! But here’s the inside skinny from Marjorie who works 8-hour day shifts in an oncology unit affiliated with a children’s hospital in a major northeastern city:
Arrive at work. I check my assignment. I only have three patients today, which means I’m first admit. There’s just enough time to grab a cup of coffee before I sit down for the change-of-shift report during which the night shift nurses update us about the status of our patients. In addition to listening to the report, I am also making a cheat sheet of the medications and procedures my patients have scheduled today.
7:30 a.m. to 9:30 a.m.:
I make initial rounds on my three patients. I have medications to administer. Nursing assistants are responsible for taking vital signs, but I do the physical assessments.
Billy, age four, had a Wilms tumor surgically removed from his left kidney a few days ago. He may be going home today, but he will be coming back on an outpatient basis for chemotherapy, and his parents have many questions about that.
Gabe is a 13-year-old who developed a fever during consolidation chemotherapy for his acute lymphoblastic leukemia, which was performed on an outpatient basis. He was admitted to the hospital yesterday. He’s not running a fever now, and he’s very anxious to go home!
Sophie, aged 10, is a patient who was admitted yesterday afternoon following weeks of unexplained bruising and a blood count that showed abnormal numbers of white blood cells and too few red blood cells. My unit’s attending oncologist suspects leukemia and has scheduled a bone marrow aspiration for later in the day.
9:30 a.m. to 10:00 a.m.:
I work at a teaching hospital. While the attending and residents finish their patient rounds, I catch up on charting. Many pediatric oncology nurses leave charting to the end of the day, but I’ve found I’m more efficient if I chart at intervals throughout the day.
10:00 am to 11:00 a.m.:
While I’m in the process of administering another round of medications, I get the news that Gabe is about to be discharged. I sit down with Gabe’s parents to review the discharge instructions and make sure they have a follow-up visit scheduled with the Hematology/Oncology Clinic.
11:00 a.m. to 12:30 p.m.:
I assist with Sophie’s bone marrow aspiration. It can be a scary and uncomfortable procedure for a child even with sedation and topical numbing agents, and this time, the procedure takes longer than it ordinarily does. I make sure another nurse is available to give my noon meds since oncology medications must be precisely timed for optimal effect.
12:30 p.m. to 1:00 p.m.:
I grab my lunch break. As a pediatric oncology nurse, there’s always a temptation to skip lunch breaks because there’s always so much to do. But self-care is an important part of avoiding professional burnout. Okay, I’ll confess: While I’m eating, I’m also catching up on charting.
1:00 p.m. to 2:00 p.m.:
A new admission arrives on the unit and is assigned to me. Chantal is 20 years old and in the throes of a sickle cell crisis her hematologist suspects was brought on by dehydration. Although she is older than most of the patients we work with, she is still being followed by the hematologist she first started seeing as a child. Sickle cell crises are extremely painful, so the first order of business is to start an IV and manage Chantal’s discomfort. Then I make sure that all Chantal’s admission orders are carried out and lab tests scheduled.
2:00 p.m. to 3:00 p.m.:
I do one last set of rounds on my patients, administering prescribed medications, performing physical assessments, and answering questions. Billy will be staying in the hospital an extra day, so I need to explain his physician’s rationale for this to his parents. I also give the charge nurse a change-of-shift report on my patients, which she will pass on to the nurses who are coming on for swing shift.
3:00 to 3:30 p.m.:
I’m responsible for my patients’ wellbeing until the swing shift nurses come out of report. I use this time to finish my charting. Although I frequently have the sense that there’s a lot I’ve left undone, I try to leave at the end of my shift—again as a way of protecting against burnout.
My Final Thoughts
This article has presented a comprehensive look at the profession of a pediatric oncology nurse – what is it, how to become, salary, and the pros & cons. Working as a pediatric oncology nurse might be better described as a calling than a job. Pediatric oncology nursing can be an enormously rewarding profession, but it can also be extremely stressful and demanding. It’s a difficult career track for anyone who has problems maintaining boundaries between their professional and personal lives, and it’s not surprising that many nurses who make the decision to become a pediatric oncology nurse have had some type of firsthand experience with the disease and its consequences. If you have excellent clinical skills, compassion and emotional resilience, however, this is a nursing specialty that can bring you deep satisfaction.
FREQUENTLY ASKED QUESTIONS ANSWERED BY OUR EXPERT
1. Is Becoming A Pediatric Oncology Nurse A Good Career Choice?
Pediatric oncology nursing can be an excellent career choice if you have the right personality for it. You need to be able to remain compassionate while holding your immediate emotional reactions in check.
2. Is It Hard To Become A Pediatric Oncology Nurse?
Becoming a good pediatric oncology nurse entails learning many new skills. To the extent that learning new skills is difficult for you, you may find it hard.
3. Who Do Pediatric Hematology/Oncology Nurses Care For?
Pediatric hematology/oncology nurses care for infants, toddlers, children and adolescents under the age of 18 who’ve been diagnosed with cancer or blood disorders.
4. What Should I Major In To Become A Pediatric Oncology Nurse?
If you are attending a four-year college that doesn’t have a nursing degree program, and you plan to attend a nursing program after you graduate, consider majoring in biology or psychology.
5. On Average, How Much Does A Pediatric Oncology Nurse Make Per Hour?
Pediatric oncology nurses earn $52.26 an hour.
6. Can An LPN Be A Pediatric Oncology Nurse?
No. The clinical skills demanded of a pediatric oncology nurse are those of a registered nurse. As an LPN, you may be able to work in some capacity on a children’s cancer unit, but you’ll always be supervised by a registered nurse.
7. Is Pediatric Oncology Nursing Stressful?
Working as a pediatric oncology nurse can be extremely stressful.
8. Does A Pediatric Oncology Nurse Perform Surgery?
Pediatric acute care nurse practitioners who are working in a pediatric oncology unit may occasionally insert central lines. But registered nurses who are not APRNs never perform surgery.
9. How Many Hours Do Pediatric Oncology Nurses Work?
Pediatric oncology nurses typically work between 36 and 40 hours a week.
10. Do I Need To Be Certified To Work As A Pediatric Oncology Nurse?
You don’t need to be certified to work as a pediatric oncology nurse, but most employers prefer it.
11. What Is The Certification For Pediatric Oncology Nursing?
The primary certification for pediatric oncology nurses is the Certified Pediatric Hematology-Oncology Nurse (CPHON) accreditation, offered by the Oncology Nursing Certification Corporation.
12. What Is The Passing Score For the CPHON Test?You’ll need a numeric score of 55 to pass the CPHON test
13. What Types Of Questions Are On The CPHON Test?
The CPHON test consists of multiple-choice questions.
14. How Do I Get My CPHON Certification?
In order to qualify for CPHON certification, you must pass the qualifying examination. Other requirements include a current, unencumbered RN license; a minimum of two years of RN experience within the last four years; a minimum of 2,000 hours of pediatric oncology hematology practice within the last four years; and 10 hours of continuing education coursework with an oncology focus.
15. Do Pediatric Oncology Nurses Make Good Money?
Yes. The average salary of a pediatric oncology nurse is $108,704 a year.
16. Do Pediatric Oncology Nurses Get Paid More Than Other Nurses?
On average, pediatric oncology nurses earn salaries that are 55 percent higher than the average salary for registered nurses in the U.S. across all specialties.
Pattie Trumble, MPP, MPH
Pattie Trumble is a nurse who worked in both California and New York for many years as an emergency room nurse. She holds a Bachelor’s Degree in Economics from the University of California, Berkeley, and an Associate Degree in Nursing from the Samuel Merritt Hospital School of Nursing. After 10 years of providing direct care, she went back to school and earned concurrent Master’s degrees in both public policy and public health from the University of California, Berkeley. Thereafter, she worked for various public health agencies in California at both the community and state levels providing economic and legislative analysis.