What Competencies Are Required for Oncology Nurse Generalists?

To help standardize the competency requirements for oncology nurse generalists, ONS formed a project team to identify, define, and provide a framework for best practice in patient care to ensure quality outcomes. In their article in the December 2017 issue of the Clinical Journal of Oncology Nursing (https://cjon.ons.org/cjon/21/6/oncology-nurse-generalist-competencies-oncology-nursing-society-s-initiative-establish), Gaguski et al. reported the results of the project team’s work.  

Competencies’ Role in the Future of Nursing

In 2011, the Institute of Medicine (IOM), now called the Health and Medicine Division of the National Academies of Sciences, published a report called The Future of Nursing: Leading Change, Advancing Health. In it, IOM emphasized the importance of educating nurses and assessing their competency to ensure high-quality care. Nurses provide a continuum of services, IOM explained, including direct patient care, health promotion, patient education, and care coordination. See sidebar for a list of areas IOM identified for nursing competencies.  

Oncology Nurse Generalist Competencies

“Training programs that focus on increasing and building competency can strengthen and multiply the workforce of nurses who deliver high-quality care to patients with cancer,” Gaguski et al. reported. Here are the core areas that oncology nurse training and other professional development and growth opportunities should include, according to the ONS Oncology Nurse Generalist Competencies.

Teamwork: As a key member of the cancer care team, oncology nurses define the core principles of the interprofessional care team and outline the role and contributions of each member in the care of patients with cancer across the disease trajectory. They participate in coordination of care, and they use therapeutic communication skills to interact with patients, caregivers, and other members of the interprofessional team. When conflict occurs among interprofessional teams, oncology nurses use leadership strategies to problem solve and address the issues. 

Professional development: Oncology nurses establish learning and performance goals for themselves and engage in learning opportunities to achieve those goals. They participate in formal and informal performance evaluation to improve practice, and they plan for specialty certification. They advocate for the delivery of high-quality, patient-centered care, and they participate in mentorship and leadership opportunities to grow individually as well as guide the next generation of oncology nurses.

Clinical care: All of the following clinical care competencies imply evidence-based care. Oncology nurses integrate patient-centered care across the cancer trajectory. They understand the biology of cancer as it relates to care, and they use critical thinking skills based on their nursing experience. They apply evidence-based practice guidelines, symptom management tools, standards, and protocols in patient evaluation and care.

Oncology nurses demonstrate knowledge of: 

• Treatment modalities used in cancer care
• Implementation of symptom management and monitoring parameters for cancer therapies
• Interventions associated with clinical procedures
• Maintenance of access devices
• Protective measures for immunocompromised patients
• Identification and management of oncologic emergencies 
• Primary, secondary, and tertiary preventive measures for cancer and its treatment
• Integrating genetic and genomic information into practice
• Patient and caregiver education and resources
• Holistic nursing care that incorporates the physical, psychosocial, and spiritual needs of patients and caregivers
• Integrating culturally sensitive interventions for patients and caregivers
• Resources for legal issues in oncology nursing practice and patient care
• Strategies for ethical situations in patient and caregiver care
• Methods to decrease professional and caregiver burden.

Financial: Oncology nurses have a responsibility to be fiscally aware of their nursing practice, such as when selecting supplies, billing and coding, and quality monitoring. Additionally, they provide resources for patients and caregivers to cope with the financial impact of cancer care and collaborate with interprofessional teams to address access and financial needs.

Quality: Oncology nurses know and understand the purpose of requirements, standards, and guidelines related to nursing practice and providing safe, quality cancer care. They identify patient access barriers and provide solutions to ensure seamless, quality care. Finally, they collaborate with interprofessional experts to support quality initiatives, including patient safety, performance improvement, accreditation, and infection prevention.

Applying Competencies to Nursing Practice

Oncology nurses and managers can apply the competencies listed in many ways, including:

• Developing job descriptions
• Defining expected qualifications and skills for recruitment and job postings
• Providing competency-based training programs to increase the quantity and quality of the workforce
• Providing orientation and guidance for preceptors
• Establishing benchmarks for performance
• Developing skills checklists
• Identifying educational gaps and resource needs
• Planning staff and career development goals
• Assisting nurses in progressing from novice to expert
• Promoting lifelong learning.

A variety of measurement methods can be used to evaluate nurses for the competencies listed, including evidence of daily work, presentations, case studies, peer review, self-assessments, discussion, reflective groups, exemplars, group participation, functioning in expert roles, technical skills, reflection, critical thinking, journaling, quality monitoring, return demonstration, and interpersonal strategies. 

For more information on ONS’s identified competencies for oncology nurse generalists, refer to the full article (https://cjon.ons.org/cjon/21/6/oncology-nurse-generalist-competencies-oncology-nursing-society-s-initiative-establish).

This monthly feature offers readers a concise recap of full-length articles published in the Clinical Journal of Oncology Nursing (CJON) or Oncology Nursing Forum. This edition summarizes “Oncology Nurse Generalist Competencies: Oncology Nursing Society’s Initiative to Establish Best Practices,” by Michele E. Gaguski, MSN, RN, AOCN^®, CHPN, NE-BC, APN-C, Kim George, MSN, APRN, ACNS-BC, AOCN^®, Susan D. Bruce, MSN, RN, OCN^®, AOCNS^®, Edi Brucker, MSN, MPH, AGPCNP-BC, Carol Leija, MSN, RN, OCN^®, Kristine LeFebvre, MSN, RN, AOCN^®, and Heather Thompson Mackey, RN, MSN, ANP-BC, AOCN^®, which was published in the December 2017 issue of CJON. Questions regarding the information presented in this article should be directed to the CJON editor at CJONEditor@ons.org. Photocopying of this article for educational purposes and group discussion is permitted.