Key Responsibilities and Required Skills for Oncology Nurse

🎯 Role Definition

An Oncology Nurse delivers specialized nursing care to patients across the cancer care continuum — from diagnosis and active treatment through survivorship and end-of-life care. This role includes safe preparation and administration of cytotoxic and biologic therapies, close clinical monitoring for acute toxicities, comprehensive patient education on side effects and self-care, coordination with physicians and allied health professionals, documentation in the electronic health record (EHR), and participation in quality improvement and clinical research. The Oncology Nurse balances high-acuity clinical skills with empathetic communication and patient advocacy.

📈 Career Progression

Typical Career Path

Entry Point From:

Registered Nurse (Medical-Surgical, Ambulatory Care, or Emergency Department) transitioning into oncology/infusion
Oncology/Infusion Nurse Trainee or Nurse Residency program focused on oncology
Licensed Practical Nurse (LPN) or Nursing Assistant with oncology exposure moving into RN roles

Advancement To:

Oncology Nurse Manager or Clinical Nurse Leader
Oncology Clinical Nurse Specialist (CNS) or Nurse Practitioner (Oncology NP)
Clinical Nurse Educator (Oncology) or Infusion Center Director

Lateral Moves:

Infusion Nurse (ambulatory or home infusion)
Hematology Nurse, Bone Marrow Transplant Nurse
Clinical Trials/Research Nurse or Oncology Case Manager

Core Responsibilities

Primary Functions

Administer chemotherapy, immunotherapy, targeted agents and supportive medications safely and accurately according to physician orders, institutional protocols, and current oncology standards, including dose calculations and double-check procedures.
Prepare, handle and dispose of hazardous cytotoxic drugs following USP <797>/<800>, OSHA, and facility policies to protect patients, staff and the environment.
Assess patients before, during and after treatment for infusion reactions, hematologic or metabolic abnormalities, dehydration, infection and other acute toxicities; initiate appropriate nursing interventions and escalate to the oncology provider when indicated.
Access, maintain and troubleshoot venous access devices (peripheral IVs, ports, PICCs, tunneled central lines), including sterile dressing changes, port access/flushes and blood draws per protocol.
Perform comprehensive symptom assessment and evidence-based symptom management for pain, nausea/vomiting, mucositis, neuropathy, fatigue, febrile neutropenia and psychosocial distress; implement nonpharmacologic and pharmacologic interventions.
Provide individualized patient and caregiver education on chemotherapy regimens, expected side effects, self-care, infection prevention, when to call the clinic, and safe handling of bodily fluids when required.
Triage telephone calls and oncology clinic visits, prioritize acuity, provide clinical advice within scope, and arrange urgent evaluations or emergency department referrals for serious complications.
Document all patient care, assessments, medication administration, patient teaching and care coordination in the EHR (Epic, Cerner or equivalent) in a timely, accurate and regulatory-compliant manner.
Reconcile and verify chemotherapy orders, cross-check calculations and supportive care orders (antiemetics, growth factors, prophylactic antibiotics) and collaborate with pharmacy to ensure timely, safe drug delivery.
Monitor laboratory results and coordinate rapid interventions for critical values such as severe neutropenia, thrombocytopenia, electrolyte disturbances or organ dysfunction.
Manage blood product administration (transfusions) in line with transfusion protocols, monitoring for reactions and documenting outcomes.
Coordinate multidisciplinary care including physicians (medical, surgical, radiation oncology), social work, nutrition, pharmacy, palliative care and rehabilitation services to ensure seamless patient-centered care plans.
Participate in tumor boards, case conferences and multidisciplinary care planning meetings to support individualized treatment strategies and continuity of care.
Support enrollment and conduct of clinical trials and research protocols by following investigational drug handling procedures, collecting data per protocol, obtaining informed consent as appropriate and documenting study visits.
Provide end-of-life nursing care, symptom palliation and family support; assist with goals-of-care conversations and integrate palliative care resources into the plan of care.
Lead or participate in quality improvement initiatives, safety audits, root cause analyses and policy development to improve oncology nursing practice and patient outcomes.
Educate, precept and mentor newer nurses, nursing students and ancillary staff on oncology-specific skills, infusion safety and institutional policies.
Maintain competency through continuing education, mandatory training, oncology certifications (OCN, CBCN) and attendance at relevant conferences or in-service sessions.
Coordinate prior authorizations, insurance verifications and referrals for specialty services to reduce treatment delays and optimize access to care.
Maintain medication and supply inventories for chemotherapy and infusion areas, ensure proper storage conditions and coordinate restocking with pharmacy and supply chain.
Participate in emergency response for infusion-related anaphylaxis, hemodynamic instability or cardiopulmonary arrest by providing immediate interventions including BLS/ACLS measures and rapid communication with resuscitation teams.
Implement infection control and isolation precautions for immunocompromised patients, educate patients and families on infection prevention and monitor for healthcare-associated infections.
Deliver culturally competent, trauma-informed and age-appropriate care for diverse adult and geriatric oncology populations, adapting education and communication to health literacy levels.
Document and report adverse events, near misses and medication errors following facility incident reporting procedures; participate in corrective action planning.
Facilitate survivorship planning, including long-term follow-up education, surveillance scheduling, and referrals to rehabilitation and supportive care programs.
Collaborate with case management and social work to address psychosocial barriers, coordinate home health services, durable medical equipment and community resources.

Secondary Functions

Support oncology program operational needs including scheduling, throughput optimization and infusion chair/unit flow to maximize patient safety and clinic efficiency.
Contribute to the development and review of oncology nursing policies, chemotherapy order sets and emergency protocols.
Serve on institutional committees (safety, medication use, oncology steering) to represent frontline nursing perspectives and promote best practices.
Assist with orientation and competency assessment programs for new staff and help maintain unit-specific training records.
Engage in outreach, patient education events and community screening initiatives to promote cancer prevention and early detection awareness.
Participate in electronic health record optimization efforts by providing user feedback, testing order sets and suggesting documentation improvements for oncology workflows.

Required Skills & Competencies

Hard Skills (Technical)

Proficient chemotherapy and biotherapy administration, including infusion pump programming and management.
Strong venous access skills: peripheral IV insertion, port access/maintenance, PICC/central line care.
Knowledge of oncology pharmacology, drug interactions, dose-limiting toxicities and neutropenia management.
Competency with EHR systems (Epic, Cerner, MEDITECH) for order entry, documentation and result review.
Ability to perform triage and clinical assessment via telephone and in-person oncology clinic settings.
Experience with sterile technique, USP <797>/<800> handling and safe disposal of hazardous drugs.
Blood product administration and transfusion reaction recognition/management.
Basic and advanced cardiac life support certifications (BLS required; ACLS preferred or as applicable).
Familiarity with clinical trial procedures, investigational drug handling and regulatory documentation.
Laboratory interpretation skills pertinent to oncology (CBC trends, chemistry panels, tumor markers).

Soft Skills

Empathetic, patient-centered communication with the ability to explain complex treatments in plain language.
Strong clinical judgment and critical thinking under high-acuity conditions.
Excellent teamwork and interdisciplinary collaboration skills.
Time management and prioritization in fast-paced infusion/clinic environments.
Attention to detail and a commitment to patient safety and regulatory compliance.
Resilience and stress tolerance when supporting patients and families through serious illness.
Cultural competence and ability to deliver care respectful of diverse backgrounds and values.
Coaching and mentoring ability for precepting new nurses and educating patients/caregivers.
Problem-solving mindset and willingness to lead process improvements.
Advocacy skills to support patient needs across the healthcare system (insurance, social supports).

Education & Experience

Educational Background

Minimum Education:

Active Registered Nurse (RN) license in state of practice with ADN or BSN degree (BSN preferred).

Preferred Education:

Bachelor of Science in Nursing (BSN); Master’s degree (MSN) or specialty advanced practice (for advanced roles) is an asset.
Oncology Nursing Certification (OCN, CBCN) or Chemotherapy/Biotherapy Provider certification preferred.

Relevant Fields of Study:

Nursing (BSN, ADN, MSN)
Oncology Nursing / Hematology Nursing
Nursing Education or Clinical Leadership
Public Health or Patient Education (beneficial for survivorship and community programs)

Experience Requirements

Typical Experience Range: 1–5 years of nursing experience, with at least 1–2 years in oncology, infusion, hematology or related specialty preferred.

Preferred:

2–4+ years of direct oncology/infusion nursing experience, including chemotherapy administration and central line management.
Experience with ambulatory infusion centers, oncology inpatient units, or hematopoietic stem cell transplant programs.
Demonstrated experience with electronic health record workflows, clinical trials, or quality improvement projects.