Preparing Nurses for Cancer Survivor Care-a Growing Need

Joan Such Lockhart, PhD, RN CORLN, AOCN, CNE, ANEF, FAAN

Joan Such Lockhart, PhD, RN CORLN, AOCN, CNE, ANEF, FAAN

Joan Such Lockhart is a clinical professor at Duquesne University School of Nursing, Pittsburgh, Pennsylvania.

In The Future of Nursing: Leading Change, Advancing Health, the Institute of Medicine (IOM) emphasized the need for all nurses to assume leadership roles within their healthcare organizations, lead change to promote the health of Americans, function within the scope of their educational preparation, participate in learning throughout their nursing careers, and attain higher levels of education and training.¹ More recently, the IOM addressed the chronicity of cancer and the need to ensure quality cancer care to an increasing aging population.^2,3

While oncology nurses have undoubtedly led quality cancer care and patient education initiatives, the current and projected growth of cancer survivors in the United States⁴ demands increased attention to developing oncology nurses in the educator role. Cancer survivors, who receive their healthcare services in various clinical settings over their lifetimes, are likely to be cared for by nurses without additional preparation in oncology nursing.⁵

A recent study that investigated cancer content included in the curricula of nearly 250 US prelicensure RN programs revealed gaps between the depth of cancer content taught and its perceived importance.⁵ Cancer content was viewed as being more important than the depth at which it was taught. Barriers attributed to this gap included lack of time, an already full curriculum, and lack of access to oncology experts, clinical sites, and cancer resources. Similarly, a recent investigation to identify the educational needs of RNs who care for cancer survivors in nononcology clinical settings provided evidence from the perspectives of both oncology (N = 313) and medical-surgical nurses (N = 331).⁶ Barriers reflected those cited by schools of nursing.⁵

Given these reports and trends in cancer care, oncology nurses should be prepared as educators who are able to identify the learning needs of diverse professionals, develop educational interventions targeted to meet these needs, and evaluate their impact on patient care. They must also design creative ways to share their expertise with colleagues new to cancer care. Finally, oncology nurses need to realize opportunities within nursing professional development in which their expertise can be integrated.

Understanding the Educator Role

Expectations for all nurses to assume the role and responsibilities of an educator is evident in Nursing: Scope and Standards of Practice.⁷ Nurses engaged in clinical specialty practices, like oncology nurses, are also guided by standards published by their professional nursing organizations.⁸ Although documents exist that describe how oncology nurses should be prepared for their caregiving role,⁹ similar guidelines are lacking that can help us prepare nononcology nurses who care for cancer survivors. Specific educator competencies are also included in test blueprints for oncology certification at both generalist and advanced levels.¹⁰

Oncology nurses can gain guidance from the Nursing Professional Development: Scope and Standards of Practice.¹¹ In the “Nursing Professional Development Specialist Practice Model,” throughputs can help oncology nurses identify possible avenues in which they can share their cancer expertise with colleagues who are less familiar with oncology nursing. For example, they can present cancer care content in residency programs offered to newly hired nurses, sponsor continuing education (CE) programs on cancer, initiate unit-based journal clubs about oncology topics, or author educational resources to disseminate best practices in cancer care.

Accessing Available Resources

Various formal and informal educational resources are available to help oncology nurses gain comfort in their educator role. For example, baccalaureate-prepared nurses may pursue a formal academic graduate degree in nursing education. In addition to offering core courses on topics like evidence-based practice, pharmacology, and pathophysiology, these MSN programs include nursing education specialty courses in which nurses learn creative teaching strategies integrating the latest technology in face-to-face and virtual classrooms, simulation laboratories, and clinical settings. Attention is also paid to designing innovative curricula and evaluating the performance of learners using tests and competency assessments. Dedicated time is paid to expanding nurses’ clinical skills in the advanced practice clinical and educator roles, providing hands-on experience as an educator prior to graduation. Nurses who already possess an MSN can enroll in post-master’s nursing education certification programs.

Other less formal resources can help oncology nurses strengthen their educator skills. For example, ONS hosts a fee-based website “Educator Resource Center” (https://erc.ons.org/) that contains a variety of evidence-based teaching resources to prepare student nurses and clinical nurses. ONS members can join the Staff Educator Special Interest Group (http://staffeducation.vc.ons.org/) and network with other oncology nurse educators.

Other professional nursing organizations like the Association of Nurses in Professional Development (NPD; http://www.anpd.org/) that support the work of NPD specialists may be helpful. Specialty and education journals (ie, Journal for Nurses in Professional Development and The Journal of Continuing Education in Nursing), nursing professional development books, and CE programs can provide additional support.

Current and future growth in cancer survivors and cancer as a chronic disease present a need for students enrolled in schools of nursing and clinical nurses in nononcology settings to strengthen their cancer care competencies. Oncology nurses are in a prime position to lead cancer care education for nurses who care for cancer survivors.

References

1. Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: National Academies Press. 2010.

2. Institute of Medicine. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis. Washington, DC: National Academies Press. 2013.

3. Institute of Medicine. Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population. Washington, DC: National Academies Press. 2013.

4. Eheman C, Henley SJ, Ballard-Barbash R, et al. Annual report to the nation on the status of cancer, 1975-2008, featuring cancers associated with excess weight and lack of sufficient physical activity. Cancer. 118(9):2338-2366.

5. Lockhart JS, Galioto M, Oberleitner MG, et al. A national survey of oncology content in prelicensure registered nurse programs. J Nurs Educ. 2013: 52(7), 383-390.

6. Lockhart J, Oberleitner M, Felice T, Vioral, A. Are nurses without oncology preparation ready to care for cancer survivors? Recommendations for evidence-based professional development. Presented at: International Conference on Cancer Nursing, July 8-11, 2015; Vancouver, BC, Canada.

7. American Nurses Association. Nursing: Scope and standards of practice (2nd edition). Silver Spring, MD: American Nurses Association. 2010.

8. Brant JM, Wickham R. Statement on the scope and standards of oncology nursing practice: Generalist and advanced practice. Pittsburgh, PA: Oncology Nursing Society. 2013.

9. Jacobs LA. Statement on the scope and standards of advanced practice nursing in oncology (3rd edition). Pittsburgh, PA: Oncology Nursing Society. 2003.

10. Oncology Nursing Certification Corporation. Resource Center: Preparing for certification. Retrieved from http://www.oncc.org/resource-center/preparing-certification. 2015.

11. American Nurses Association & National Nursing Staff Development Organization. Nursing professional development: Scope and standards of practice. Silver Spring, MD: American Nurses Association. 2010.