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Oncology Nursing Takeaways
- Oncology nurses’ observations and clinical expertise can reveal meaningful gaps in care, making them powerful starting points for research, quality improvement, and evidence-based practice initiatives.
- Nurses do not need to wait for permission or hold a research doctorate to identify overlooked problems, build knowledge, and collaborate with others to improve patient care.
- Implementation science offers oncology nurses across roles a way to help close evidence-to-practice gaps by testing how proven interventions can be adopted, sustained, and scaled in real-world care settings.
What You Know Matters
When I was a newly minted staff nurse, my first job was on an inpatient oncology unit. Like many new nurses, I wasn't entirely confident that I knew what I was doing.
On my first day, a newly graduated medical intern asked what he should order for a patient experiencing constipation. I was stunned. I remember thinking, I'm the beginner nurse. Why is he asking me what to do? Shouldn't he know more than I do? At that moment, however, my confidence surged, and I suggested a stool softener.
It didn't take long for me to realize that what I knew mattered and that I could make a meaningful difference in patients' lives.
Over the next several years, I gained experience as an inpatient oncology nurse at two comprehensive cancer centers: Dartmouth in rural New Hampshire and Johns Hopkins in Baltimore, MD. Eventually, I moved into outpatient oncology settings, and that experience sparked a desire to further my education.
Turning Clinical Problems Into Purpose
After becoming a nurse practitioner, I noticed that many of my patients were experiencing poorly managed neuropathic pain. Neither I nor my physician colleagues had effective approaches for mitigating their horrible pain. That gap in knowledge motivated me to review the literature and seek solutions.
With the support of multidisciplinary collaborators, I led an implementation project to put a neuropathic pain assessment and treatment algorithm into practice. We developed the approach using best practices reported in the peer-reviewed literature. At the time, I was not a scientist and knew nothing about implementation science methods. But that didn't really matter.
What mattered was that I recognized patients were suffering, and I took it upon myself to expand my knowledge so I could better address their needs.
That was the beginning of a shift in mindset because this work extended far beyond my official job responsibilities. My primary role was to provide clinical care for patients with lung cancer. Yet I saw an important clinical problem that needed attention, and I was inspired to do more. I didn't ask permission. I simply took the lead and helped move the work forward.
This work helped me to develop expertise in a specific clinical area and eventually, I managed a referral-based caseload of patients requiring neuropathic pain management. By defining my own niche, I gained the confidence to pursue a research career.
Trust What You See
The reality is that nurses encounter problems every day that deserve attention. We witness firsthand how patients and families struggle with the consequences of cancer and its treatment. Nurses are uniquely positioned to inform, lead, and collaborate on research and quality improvement initiatives that advance patient care and outcomes.
My goal in writing this blog is to strengthen your confidence in your own observations and expertise. Trust what you see. Use what you know. Take the initiative to make a difference.
And don't spend one minute believing that being a nurse means you know less than your physician colleagues.
Creating Your Own Opportunities
Healthcare culture has been shaped by centuries of hierarchy that traditionally placed physicians above nurses. Those attitudes still influence opportunities and perceptions today. Recently, I was leading an international Zoom meeting when a participant shared that, as a nurse, she did not have the same opportunities to lead research as her physician colleagues.
I reject that idea.
We must stop waiting for opportunities to be handed to us and start creating them ourselves.
Nurses can and should do more. Although collaboration with multidisciplinary colleagues is essential, we do not need permission to shine a light on overlooked problems and begin working toward solutions.
We also need more nurses to pursue research careers. Today, only about 1% of nurses hold research doctorates. The profession desperately needs more nurse scientists to generate evidence that improves care and outcomes.
Start Small, Build Expertise
So, take that first step.
Grab hold of the clinical problem that has been on your mind. Reframe your professional responsibilities to embrace an area that aligns with your passion and purpose. Start small. Read one article a week during your lunch break instead of scrolling through social media. Over time, your knowledge and confidence will grow.
As your expertise develops, ideas for potential solutions will emerge.
Although we certainly need more nurse researchers, you do not have to be a researcher to identify a problem and help address it. You can bring together a team of clinical experts, researchers, implementation specialists, and dissemination partners to tackle meaningful challenges in a systematic way.
Using Implementation Science to Close Practice Gaps
And here's some exciting news.
The Oncology Nursing Foundation will soon launch a new grant opportunity focused on implementation science. The initiative will encourage nurse scientists, DNP-prepared nurses, clinical nurses, and nurse leaders to work together to address evidence-to-practice gaps. Funded teams will focus on understanding how to effectively adopt, implement, and sustain existing evidence-based interventions that are not consistently used in practice.
The initiative will demonstrate the unique and complementary contributions of nurses across roles while advancing evidence-based practice through collaborative nursing leadership.
Take a look. It may be the perfect opportunity to begin shaping your own research agenda.