From a practical standpoint, it is fairly easy to understand why a registered nurse (RN) might decide to pursue oncology as a specialty. The jobs are plentiful with no signs of slowing down, and the salary for an oncology nurse is competitive. Specializing in oncology translates to promising job security for many RNs, and it makes sense to choose this field if your goals are related to long-term career prospects.
On the other hand, it can be difficult for some to fathom why any RN would choose this specialty, which brings inevitable grief and heartache, as compassionate nurses share the emotional burdens of cancer with their patients and patients’ families.
Sharing that burden is what ultimately makes the oncology nursing job rewarding for some RNs. If you are passionate about patient care and especially attuned to the needs that patients (and their families) face in treatment and end-of-life issues, you may be well suited to an oncology role in nursing.
This is an especially taxing position, where a nurse needs to be highly skilled in terms of the science of nursing and extremely resilient and empathetic. It would not be uncommon in a single shift for an oncology nurse to experience the highest of highs alongside the lowest of lows.
An oncology nurse may find one patient responding well to treatment and given a positive outlook, whereas another patient learns during the same shift he has exhausted all possible treatments available with no success.
This work can be grueling indeed, but it is also among the most rewarding of nursing careers, and we will explore everything you need to know about oncology nursing, including education, training, salaries, and more.
How to Become an Oncology Nurse
Most people are familiar with the term oncology to mean the study of cancer. Still, beyond that basic definition, there are some important ways we distinguish different types of oncology in practice. Registered nurses work to assist oncologists in all of these areas, performing different tasks related to these specific types of oncology:
Medical Oncology is the practice of treating cancer using chemotherapy and other medications such as immunotherapy.
Surgical Oncology involves surgeries where tumors and tissues are removed, as well as biopsies that are performed to diagnose cancer.
Radiation Oncology is the treatment of cancer patients using radiation therapy.
Those are the three main areas of oncology practice, and a few other specialty areas in terms of treating cancer patients include
- Pediatric oncology, focused specifically on the treatment of children
- Gynecologic oncology focused on gynecologic cancers (uterine, ovarian, and cervical)
- Hematology-oncology focused on the treatment of blood cancers (leukemia, lymphoma, and myeloma)
What Are the Educational and Certification Requirements to Become an Oncology Nurse?
A nurse who specializes in oncology must first work through all of the standard requirements to become a registered nurse (RN) and then work in the field to gain hands-on experience in oncology.
The first step toward becoming a registered nurse is a nursing degree. RNs can earn an Associate’s Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). The latter is preferred for those nurses who expect to transition into an oncology specialty.
An ADN can be earned in two years, and a BSN typically takes four years to complete, but the extra time pays off in the long run as nurses with BSNs will typically find more opportunities for advancement, especially in oncology. Additionally, those already working as licensed practical nurses (LPNs) can enroll in bridge programs that enable students to earn an accelerated BSN.
Once a nursing student has successfully completed an ADN or BSN, the next step is to sit for the National Council Licensure Examination (NCLEX-RN). This exam must be passed before you can work as a registered nurse. It ensures that nursing school graduates are competent and capable of caring for patients, handling the job pressures, and providing high-quality care overall.
The NCLEX-RN is one of the most important pieces of becoming an oncology nurse; therefore, it makes good sense for students to choose nursing programs with the highest pass rates you can find. Any nursing school should be able to provide this information for you before you enroll. Nursing schools with the highest pass rates should be at the top of your list.
After successfully passing the NCLEX-RN test, you may apply for jobs as a registered nurse. It may not be possible to get hired in an oncology setting right after school; new nurses may need to build up some experience first in any number of settings where RNs work, from hospitals to smaller medical offices, urgent care centers, pediatric practices, primary care centers, and more.
After you have gained some practical experience working directly with patients in one of these settings, you may want to look for any ways you can volunteer shifts in oncology units or cancer centers. This will give you exposure to the specific role oncology nurses play in the treatment of cancer patients. Continuing education is also advised to learn more about the field, and finally, you will need to earn a certification as an oncology nurse.
The Oncology Certified Nurse exam may be taken when the following eligibility requirements have been met:
- You have completed at least one year of experience working as an RN
- You have completed 1,000 hours of adult oncology nursing practice
- You have completed 10 contact hours of nursing education in oncology OR taken an elective in oncology nursing
Responsibilities of an Oncology Nurse
An oncology nurse utilizes all of the basic RN skills learned through a nursing program of study and experience in the field, and on top of that, it applies specific and unique skills to cancer treatments.
Oncology nurses not only provide a high level of care in terms of managing treatments and symptoms, but they also act as a guide and resource for patients and their families in what can often be an incredibly difficult and emotional journey.
What Are the Typical Duties of an Oncology Nurse?
An oncology nurse works to manage and supervise the overall care of cancer patients. In conjunction with the oncologist, developing a care plan is one of the most important duties. The oncology nurse helps develop this plan and is also responsible for communicating it clearly to the patients and their families, addressing their questions and concerns as needed.
RNs in any setting, be it oncology or pediatrics, or cardiology, have to make informed assessments about a patient’s condition, taking into account the patient’s overall physical and mental health before developing a care plan.
Determining the best course of treatment involves a thorough assessment and research, and consultation with other medical professionals. This is one reason oncology nurses are often continually pursuing more education to ensure they are always learning about new treatment methods and cancer patient care developments.
The typical duties of an oncology nurse include the following:
- Develop individualized patient care plans
- Assess and treat all cancer-related issues
- Research to broaden knowledge of new and developing treatments available to help current or future patients.
- Collaborate with all other medical professionals involved in patient care, both in oncology units and other fields that may be involved, such as physical therapy, reconstructive surgery, or home health providers.
- Educate patients and their families regarding resources available to cancer patients and what to expect before, during, and after specific treatments or surgeries.
- Monitor and consistently document patient responses to various medications and treatments.
In addition to these duties, oncology nurses have an ongoing commitment to patient issues and records confidentiality.
What Is a Typical Day Like for an Oncology Nurse?
Most oncology nurses would tell you that no two days are ever the same. Certain elements will probably happen in every shift (for example, an oncology nurse might administer chemotherapy at every shift), but with patients coming in and out of treatment, there can be a great deal of change. This also means oncology nurses face many highs and lows.
On some days, you might be cheering alongside a family when a patient is “ringing the bell” to mark his last treatment, and on other days you may be consoling the mother of a cancer patient who has just been given grim news about her daughter’s outlook.
Oncology nurses need to be resilient when adapting to these changes, shifting quickly between being a cheerleader and simply offering an ear and a shoulder when needed.
These shifts are exhausting, and oncology nurses need healthy coping mechanisms in their own lives to maintain the energy level needed for the job. For some, this could mean yoga classes, or for others, it could mean a weekly movie night with friends.
Oncology nursing is not a job you can “take home with you” every day without eventually hitting a wall, and those who are most successful in this field strike a positive balance between dedication to a rewarding profession but also being able to turn it “off” when needed.
Average Salary for an Oncology Nurse
Nursing is a fantastic career path in terms of job security and salary, and there seems to be no slowing down when it comes to demand. Many RNs look for areas in which to specialize, such as oncology, as a way to increase their earning potential.
When so many graduates are strapped with student loan debt, nurses can pay off loans thanks to plentiful jobs and competitive salaries. This is not to say the path is easy by any stretch of the imagination; nursing is hard work. For those who are willing to put the work in, there is room to advance and grow in the field while seeing your salary grow, too.
What Factors Can Affect the Salary of an Oncology Nurse?
Oncology nursing salaries can vary based on a number of factors, including:
- The number of years you have worked as an RN, both in total and specifically in the field of oncology
- Any special skills, certifications, or expertise you bring to the table
- The location in which you are working (city, state), as well as the type of practice
According to PayScale, oncology nurses earn an average salary of $70,727. This is higher than the standard RN average salary of $63,263, illustrating that specialties can pay off in nursing.
Within the range of oncology nursing salaries, there are a few factors known to drive up pay. Nurses with pediatric oncology experience, telemetry experience, and stem cell transplantation experience, to name a few, may earn more than their peers without those skill sets. These “specialties within a specialty” can mean a significant bump in salary, with skills increasing salaries sometimes by 10% or more.
Future nurses should also bear in mind when mapping out career plans that pay will also be determined in many ways by location; an oncology nurse in San Francisco will be paid more than one in Knoxville, Tennessee. Cost of living plays into the salaries, as does the size of the practice, hospital, or treatment center.
What Do the Highest-Paid Oncology Nurses Make?
If you make your way to the top of the oncology nursing ladder, through years of experience as well as added skills, you could certainly see a six-figure income in larger metropolitan areas.
The top 10th percentile of oncology nurses earn $97,000, and the salaries can be higher where the cost of living is greater. Longevity in the field pays off, and nurses with 20+ years of experience are paid considerably more than their less experienced peers.
Additionally, when nurses say in the field that long they often transition into new roles that pay more, whether that means becoming a nurse practitioner or a critical care nurse. In other cases, after a significant time working in hands-on settings with patients, some nurses opt to pursue a doctorate and move on to teaching. That can also be a path to a six-figure salary for nurses.
What Is the Average Salary for an Entry-Level Oncology Nurse?
Once you have earned your degree, license, and certification to work as a registered nurse, you would likely earn around $27 per hour as an entry-level oncology nurse (or around $54,000 per year).
You can expect that hourly figure to go up several dollars per hour for each year you work. Nursing salaries recognize the value of experience, which is reflected in the way oncology nurses are paid.
Where Can I Work as an Oncology Nurse?
Because cancer is everywhere and does not discriminate based on location, there are opportunities for oncology nurses worldwide. However, those wishing to specialize in certain fields within oncology or those looking for the highest possible salaries will need to narrow their job searches geographically. Larger cities will have cancer treatment centers and hospitals not found in small, more rural parts of the country.
Where Is the Highest Demand for Oncology Nurses?
One of the primary reasons we see a growing demand for oncology services throughout the country is because we are living longer. An older population simply means more cancer cases are detected, and we need more oncologists and oncology nurses to keep up with this growing patient population.
Therefore, demand will often be greater in areas where a high percentage of seniors or retirees live (think Florida) and will also be greater in large cities.
Who Do Oncology Nurses Work with to Treat Cancer Patients?
Oncology nursing is a collaborative experience, and nurses must be able to work well with various other health professionals to ensure the highest level of care for cancer patients.
Cancer patients are typically treated by a care team, including the oncology nurse and radiologists, oncologists, surgeons, and primary care physicians. Oncology nurses also work closely with their peers to manage the same patients on different shifts.
Constant and open lines of communication are necessary between the nursing staff and the rest of the care team to react quickly to changes in a patient’s medications, treatments, or prognosis.
What Types of Hospitals and Facilities Need Oncology Nurses?
There are a variety of settings where oncology nurses may be employed. While large hospital systems are the main employer that comes to mind, you will also find oncology nursing staff employed by ambulatory care clinics, radiation therapy centers, home health agencies, and private oncology practices.
Outpatient settings and home health care have increased roles for oncology nurses in recent years, as have roles in cancer genetic counseling and risk assessment. Many experienced oncology nurses also pursue leadership and administrative positions after years of hands-on nursing work. They lead cancer service centers and admissions offices, and more.
Are Travel Oncology Nurse Jobs Available?
Travel nursing roles appeal to those who want to couple a passion for nursing with a desire to see new places and experience different parts of the country. This type of work has plentiful opportunities when it comes to oncology roles, and many RNs find it rewarding to help cancer patients in many different areas.
Travel oncology nursing also allows a nurse to set a schedule based on when and where they want to work, and the compensation is extremely competitive. Travel oncology nursing salaries are typically higher than those offered in traditional nurse settings, with many travel RNs earning six figures between salary, stipends, per diems, and other benefits.
Travel nursing contracts can also come with signing, retention, and referral bonuses, all of which lead to even more money for those willing to stay on the go. While these roles are challenging for individuals with young families or other responsibilities at home, they can be ideal for younger nurses who are just getting started or even older nurses who no longer have kids at home.
Additional Opportunities for Oncology Nurses
Oncology nursing offers many different paths, including traditional roles in patient care, the travel nursing described above, or administrative and leadership work. Many RNs change their careers trajectory (and increase their salaries) by pursuing additional degrees and titles.
While the OCN certification is the primary way an RN becomes certified, there are seven other possible certifications available through the Oncology Nursing Certification Corporation.
These additional certifications include:
- Certified Pediatric Hematology-Oncology Nurse (CPHON)
- Certified Breast Care Nurse (CBCN)
- Blood & Marrow Transplant Certified Nurse (BMTCN)
- Advanced Oncology Certified Nurse Practitioner (AOCNP)
- Advanced Oncology Certified Clinical Nurse Specialist (AOCNS)
- Certified Pediatric Oncology Nurse (CPON)
- Advanced Oncology Certified Nurse (AOCN)
Nurses can earn these certifications with a valid RN license, minimum experience, education requirements, and a comprehensive exam passage.
Masters Degrees for Oncology Nurses
Oncology nurses can have successful careers after earning ADN or BSN degrees, and a Master’s degree is not necessary to work in oncology nursing. However, many nurses opt to return to school for Masters degrees because of what it means in terms of advancement opportunities and the higher salaries that come along with them.
To work as an advanced practice registered nurse (APRN), an individual must first complete a Master of Science in Nursing (MSN) degree. The APRN earns more than standard RNs after completing the MSN degree. It typically takes two to three years, and there are programs available through some nursing schools with oncology nursing specializations.
Oncology Nurse Practitioners
A Master’s or Doctorate is required before a registered nurse can move into the role of nurse practitioner; this nursing role shares many similarities with the role and duties of a physician. A nurse practitioner can provide a patient with primary care and also prescribe medication.
An oncology nurse practitioner works closely with oncologists and surgeons in cancer patients’ care, with a salary at the highest end of all oncology nursing positions.
The Advanced Oncology Certified Nurse Practitioner (AOCNP) designation is given to an RN who meets the following requirements:
- Has an active RN license
- Has at least two years of RN experience within the four years before the application for the certification
- Has a minimum of 2,000 hours of adult oncology nursing practice within the four years before the application for the certification
- Has completed at least 10 contact hours of nursing continuing education in oncology
Oncology Organizations and Associations for Nurses
All oncology nurses should utilize the resources, training, and networking opportunities available through relevant professional organizations.
These groups are fantastic resources for anyone from nursing students just beginning their career paths to experienced RNs looking for ways to advance their careers. They also provide important information to oncology nurses on the newest developments in cancer treatment and patient care.
The Oncology Nursing Certification Corporation is not only the governing body when it comes to certifications, but it also offers a tremendous resource center on its website to guide RNs through all aspects of the certification process as well as practice tests that can be incredibly helpful when preparing for exams.
The Oncology Nursing Society has a network of 35,000 members. It is one of the best resources for oncology student nurses, practicing nurses, and other medical professionals to connect with the greater oncology community. Local chapters are especially helpful with career networking, and there are links to articles, courses, and podcasts on the site that address a wide range of oncology topics.
The Advanced Nurse Practitioner Society for Hematology and Oncology comprises nurse practitioners, physician assistants, clinical nurse specialists, advanced degree nurses, and pharmacists, who all share a vested interest in advancing cancer patient care. Their member benefits offer a wide variety of ways to connect with colleagues and gain access to educational resources.
The Journal of Clinical Oncology is one of the most important continuing education tools for oncology nurses. For almost four decades, it has been the authoritative resource for the dissemination of clinical oncology research.
Oncology Nursing Careers: A Recap
The oncology nursing field offers promising opportunities for those seeking job security, a healthy salary, and continued pathways to advancement. It is possible to earn a salary of six figures in some of the highest-paid oncology nursing roles, with the right degrees and certifications.
It takes a certain type of demeanor and natural empathy to measure up to this role’s demands, which is something all nursing students should weigh heavily before setting out to work in oncology. If it is the right fit for you, it will be an incredibly rewarding role.