The Master s Degree With a Specialty in Advanced Practice Oncology Nursing (4th Edition) APN Retreat Project Team Editor/Project Team Leader Linda A. Jacobs, PhD, CRNP, AOCN, BC Authors Meghan O Regan Coleman, RN, APN, C. NP Raymond J. Scarpa, MA, CNS, AOCN, APN Julia A. Smith, MSN, ANP-BC, AOCN Reviewers Emily Antle, BSN, MPH, AOCN, CFNP Marilyn L. Haas, PhD, RN, CNS, ANP-C Joanne L. Lester, MSN, RNC, CNP, AOCN Field Reviewers Catherine M. Bender, PhD, RN Kyle-Anne Hoyer, RN, MSN, AOCN Virginia M. Krawiec, MPA Joan Such Lockhart, PhD, RN, CORLN, AOCN, FAAN Kathi Mooney, PhD, RN, FAAN, AOCN Kathleen Murphy-Ende, RN, PhD, AOCN Lisa Schulmeister, RN, MN, CS, OCN Oncology Nursing Society Pittsburgh, PA
ONS Publishing Division Publisher: Leonard Mafrica, MBA, CAE Technical Editor: Barbara Sigler, RN, MNEd Production Manager: Lisa M. George Staff Editor: Lori Wilson Creative Services Assistant: Dany Sjoen ONS Education Cancer Care Issues Team Director of Education: Laura Fennimore, RN, MSN Education Associate: Laurl Matey, RN, MSN The Master s Degree With a Specialty in Advanced Practice Oncology Nursing (4th ed.) ISBN: 1-890504-38-6 Copyright 2003 by the Oncology Nursing Society All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form, electronic or mechanical, including photocopying, recording, or by an information storage and retrieval system, without written permission from the copyright owner. For information, write to the Oncology Nursing Society, 125 Enterprise Drive, Pittsburgh, PA 15275-1214. Publisher s Note This book is published by the Oncology Nursing Society (ONS). ONS neither represents nor guarantees that the practices described herein will, if followed, ensure safe and effective patient care. The recommendations contained in this book reflect ONS s judgment regarding the state of general knowledge and practice in the field as of the date of publication. The recommendations may not be appropriate for use in all circumstances. Those who use this book should make their own determinations regarding specific safe and appropriate patient-care practices, taking into account the personnel, equipment, and practices available at the hospital or other facility at which they are located. The editors and publisher cannot be held responsible for any liability incurred as a consequence from the use or application of any of the contents of this book. Figures and tables are used as examples only. They are not meant to be all-inclusive, nor do they represent endorsement of any particular institution by ONS. Mention of specific products and opinions related to those products do not indicate or imply endorsement by ONS. ONS publications are originally published in English. Permission has been granted by the ONS Board of Directors for foreign translation. (Individual tables and figures that are reprinted or adapted require additional permission from the original source.) However, because translations from English may not always be accurate and precise, ONS disclaims any responsibility for inaccurate translations. Readers relying on precise information should check the original English version. Printed in the United States of America Oncology Nursing Society Integrity Innovation Stewardship Advocacy Excellence Inclusiveness
The Master s Degree With a Specialty in iii Contributors Editor/Project Team Leader Linda A. Jacobs, PhD, CRNP, AOCN, BC Clinical Assistant Professor Coordinator, Living Well After Cancer Program University of Pennsylvania Cancer Center Philadelphia, Pennsylvania Authors Meghan O Regan Coleman, RN, APN, C. NP Adult Oncology Nurse Practitioner Central Jersey Oncology Center New Brunswick, New Jersey Raymond J. Scarpa, MA, CNS, AOCN, APN Advanced Practice Nurse, Department of Surgery Division of Otolaryngology Head and Neck Surgery University of Medicine and Dentistry of New Jersey Newark, New Jersey Julia A. Smith, MSN, ANP-BC, AOCN Program Instructor Oncology Track Adult Advanced Practice Nurse Program Yale University School of Nursing New Haven, Connecticut Reviewers Emily Antle, BSN, MPH, AOCN, CFNP Hematology/Oncology Nurse Practitioner Lovelace Health Systems Albuquerque, New Mexico Marilyn L. Haas, PhD, RN, CNS, ANP-C Nurse Practitioner Mountain Radiation Oncology Asheville, North Carolina
iv The Master s Degree With a Specialty in Joanne L. Lester, MSN, RNC, CNP, AOCN Oncology Nurse Practitioner Ohio State University/A.G. James CHRI James Cancer Hospital Solove Research Institute Columbus, Ohio Field Reviewers Catherine M. Bender, PhD, RN Assistant Professor University of Pittsburgh School of Nursing Pittsburgh, Pennsylvania Kyle-Anne Hoyer, RN, MSN, AOCN Oncology Clinical Nurse Specialist Deaconess Billings Clinic Billings, Montana Virginia M. Krawiec, MPA Director, Health Professional Training Grants American Cancer Society Atlanta, Georgia Joan Such Lockhart, PhD, RN, CORLN, AOCN, FAAN Professor and Associate Dean Duquesne University School of Nursing Pittsburgh, Pennsylvania Kathi Mooney, PhD, RN, FAAN, AOCN Professor University of Utah Salt Lake City, Utah Kathleen Murphy-Ende, RN, PhD, AOCN Nurse Practitioner Clinical Assistant Professor University of Wisconsin Hospital and Clinics and School of Nursing Madison, Wisconsin
The Master s Degree With a Specialty in v Lisa Schulmeister, RN, MN, CS, OCN Oncology Nursing Consultant New Orleans, Louisiana The Oncology Nursing Society would like to thank the following individuals for their work on the previous edition of this publication: Revision Committee Chair Kathi Mooney, PhD, RN, FAAN, AOCN Contributors Anne E. Belcher, RN, PhD Barbara A. Given, RN, PhD, FAAN Patricia M. Grimm, RN, PhD, CS Rebecca Hawkins, RN, ANP, MSN, OCN Judy Holcombe, RN, DSN Patricia J. Larson, RN, DNSc, FAAN Ruth McCorkle, RN, PhD, FAAN Susan C. McMillan, RN, PhD, FAAN Mary Nowotny, RN, PhD Linda P. Sarna, RN, DNSc, OCN, FAAN Kathleen P. Shurpin, RN, ANP, PhD, OCN Diana J. Wilkie, RN, PhD M. Linda Workman, RN, PhD, OCN, FAAN American Cancer Society Staff Terri Ades, RN, BSN, OCN ONS Staff Bridget Culhane, RN, MN, OCN
The Master s Degree With a Specialty in vii Table of Contents Foreword... ix Guidelines for Use... xi Historical Perspective of Oncology Nursing Education...1 Government Commitment...1 American Cancer Society Commitment...2 Oncology Nursing Society Commitment...3 Association of Pediatric Oncology Nurses Commitment...4 Factors Influencing Oncology Nursing Practice and Education...5 Oncology Advanced Practice Nursing...6 Historical Perspective...6 Advanced Practice Nursing Roles in Oncology...8 Advanced Practice Oncology Nursing Roles and Opportunities...9 Graduate Program Characteristics...9 Faculty...9 Content...10 Student Guide to School Selection...10 Curriculum Guide...11 Bibliography...11 Competencies...13 I. Clinical Practice...13 II. Education...15 III. Consultation...15 IV. Collaboration...15 V. Systems...16
viii The Master s Degree With a Specialty in VI. Professional Roles...16 VII. Research and Outcomes Evaluation... 17 VIII. Program Development... 17 IX. Leadership...18 Course Content...19 I. Clinical Practice...19 II. Ethical and Legal Aspects of Oncology Practice... 23 III. Education... 23 IV. Consultation... 24 V. Collaboration... 24 VI. System... 24 VII. Role Competency... 25 VIII. Research and Outcomes Evaluation... 25 IX. Program Development... 26 X. Leadership... 26 References...27 Appendix A. Curriculum Guidelines... 29
The Master s Degree With a Specialty in ix Foreword The education of oncology advanced practice nurses (APNs) has been a focus of debate and controversy for many years. In 1994, the Oncology Nursing Society (ONS) coordinated the State of the Science Conference on Advanced Practice Nursing in order to explore the issues facing oncology APNs, including concerns over the educational process, and provide global recommendations (Belcher & Shurpin, 1995). In 2000, the ONS Survey Project Team was formed by the ONS Steering Council to conduct a survey of critical issues perceived by oncology APNs. The APN Survey Project Team evaluated the survey results in the context of the recommendations made at the 1994 State of the Science Conference and determined that the major issues in oncology nursing had not changed significantly (Lynch, Cope, & Murphy-Ende, 2001). In 1994, Redding wrote that the National League for Nursing and the Division of Nursing of the Public Health Service, U.S. Department of Health and Human Services, had agreed that by 2010, the roles of the clinical nurse specialist (CNS) and nurse practitioner (NP) would be merged. In 2003, APNs continue to be educated in separate CNS and NP roles, with a few graduate programs offering a blended role option. Some organizations and institutions, including the American Nurses Association (ANA), the American Association of Colleges of Nursing (AACN), and the National Council of State Boards of Nursing (NCSBN), have adopted the term APN to include any and all of the roles listed, and many continue to use the role-specific terms CNS, NP, nurse anesthetist, and nurse midwife (AACN, 1994; ANA, 1996; NCSBN, 1993). This publication is the fourth edition of the guide that was first published in 1979 as the Master s Degree With a Specialty in Cancer Nursing: Curriculum Guide and Role Definition by the American Cancer Society (ACS). The second edition, The Master s Degree With a Specialty in Oncology Nursing, was published in 1986 and was the result of a joint effort by ONS and ACS. The third edition, The Master s Degree With a Specialty in Advanced Practice Oncology Nursing, was published in 1994
x The Master s Degree With a Specialty in through the joint efforts of ONS and ACS, and the 2001 ONS APN Standards Project Team revised the fourth edition by the same name for publication in 2003.
The Master s Degree With a Specialty in xi Guidelines for Use This publication provides a historic perspective on oncology nursing education, including the history of oncology advanced practice nursing. It also describes factors that influence nursing practice and education and outlines suggested graduate program characteristics. General curriculum guidelines are provided, and a summary of competencies and course content that are recommended for the curricula in graduate- or master s-level programs that educate oncology nurses in the roles of CNSs, NPs, and the blended role of a CNS and NP is outlined. It is intended for use by educators developing and revising programs and by prospective students so that they can evaluate and select programs. This guide provides students and educators with a very general curriculum that is designed to prepare graduates for varied positions in cancer care settings.