How To Become an Oncology Nurse (Steps, Duties & Salary)

Oncology nurses care for cancer patients through treatment. The work is intense and demands compassion and resilience. Here is a snapshot before the details.

Where you'll work: Hospitals, cancer centers, palliative care centers, extended-care facilities, physician offices and clinics, home health, and hospice.

What you'll do: Provide care through chemotherapy, immunotherapy, and other treatments, often serving as the liaison between the patient and the care team.

Minimum degree: ADN or BSN, though many employers require a BSN.

Who it fits: Oncology changes constantly as cancer treatment advances, so you need to keep learning. There is no cure for cancer, so you also need emotional resilience.

Certification: The Oncology Certified Nurse (OCN) credential is optional but demonstrates expertise and makes you more competitive. Other options include Certified Pediatric Oncology Nurse (CPON) and Certified Breast Care Nurse (CBCN).

Median annual salary: $93,600

How to become an oncology nurse

1. Decide if it fits. Working with serious and life-threatening illness takes emotional intelligence and mental stamina.
2. Earn your degree. Complete an ADN or BSN. Online programs are available.
3. Graduate from an accredited program. This qualifies you for the licensing exam.
4. Get licensed. Pass the NCLEX-RN, then apply for licensure with your state board.
5. Consider certification. An oncology credential can advance your career and strengthen your applications.

What oncology nurses do

Oncology nurses care for cancer patients through chemotherapy, immunotherapy, and other treatments. Patients may be newly diagnosed, transitioning to survivorship, or terminally ill. Nurses often serve as the point person between patients and the rest of the medical staff. Their main responsibilities include:

• Administering chemotherapy, radiation, and immunotherapy
• Tracking patient responses to treatment and medication
• Educating patients and families on treatment protocols and expectations
• Collaborating with the care team on plans and progress
• Connecting patients to clinical and community resources as a nurse navigator
• Conducting research and staying current on oncology advances

Is oncology nursing a good fit for you?

The work calls for natural caregivers who can adapt under pressure. Strong oncology nurses are:

• Knowledge seekers. The field is complex and changes fast, so you have to keep learning.
• Strong communicators. Care comes from a full team, so you need to relay treatment plans clearly.
• Compassionate. Empathizing with patients and families facing life-threatening illness is essential.
• Resilient. The emotional toll is real, so a support system and interests outside work matter.
• Problem solvers. From managing side effects to arranging transportation, you constantly remove barriers to timely care.

Where you'll work

Your day-to-day shifts with the setting and your specialty:

• Hospitals: Coordinate care across ages and treatment stages
• Cancer centers: Treat patients with a formal cancer diagnosis
• Clinics: Handle non-emergency and routine care
• Physician offices: Provide minimally invasive procedures and followup education
• Hospice centers: Care for patients with terminal cancers
• Palliative care centers: Relieve symptoms and improve quality of life in advanced cases
• Extended-care facilities: Treat long-term illness outside the hospital
• Home care: Treat patients in their own homes

A day in the life

Because the settings vary, so do the days, says Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS, an oncology nursing specialist. Many nurses work in infusion, administering chemotherapy or immunotherapy: starting IVs, accessing central lines like PICCs or implanted ports, running infusion therapy, and watching for reactions. They also teach patients what to expect at home and when to call.

Others coordinate care, making sure the plan is authorized, scheduled, and ordered correctly, educating patients and families, and fielding calls about symptoms and side effects. Some work in research, screening and enrolling patients for clinical trials, running assessments, and collecting accurate, timely data while making sure the protocol is followed.

Education

You need an ADN or a BSN to become an RN and pursue oncology. A BSN tends to open more leadership opportunities.

Associate Degree in Nursing

An associate degree prepares nurses for entry-level positions after they pass the NCLEX and earn state licensure, says Weimer.

• Prerequisites: High school diploma or GED; high school biology and chemistry recommended
• Core curriculum: Microbiology, nursing foundations, chemistry, communications, biology, statistics
• Clinical requirements: About 700 clinical hours, ideally as many in oncology settings as possible
• Time to complete: Two years of full-time study

Bachelor of Science in Nursing

A bachelor's degree adds training in critical thinking, research appraisal, and professional practice leadership, Weimer says. Many hospitals prefer BSN-prepared nurses for specialty units like oncology, and roles with added responsibility, such as nurse navigators and clinical coordinators, often require a BSN plus certification like the OCN.

• Prerequisites: High school diploma or GED; strong science grades and volunteer experience recommended
• Core curriculum: Psychology, sociology, public health, health policy, healthcare administration, plus business, ethics, and data analysis
• Clinical requirements: 860 or more hands-on hours, ideally in oncology settings
• Time to complete: Four years of full-time study

Online programs

Online nursing programs suit students who need flexibility. Coursework happens online, but clinical and hands-on training must be in person. Accelerated online programs exist for those who already hold an ADN or a bachelor's in another field, applying prior learning toward a BSN to save time and money.

What to look for in a school

• Accreditation from the Accreditation Commission for Education in Nursing (ACEN) or the Commission on Collegiate Nursing Education (CCNE). Without it, you cannot get federal financial aid and may not be able to take the NCLEX-RN.
• Job placement and career counseling, including relationships with local facilities and an active alumni network.
• A high first-time NCLEX-RN pass rate, which signals how well the program prepares students.

Licensure

State boards license nurses. To get your RN license, pass the NCLEX-RN, a pass/fail exam with question types including multiple-choice and fill-in-the-blank.

• Format: Computerized and adaptive; questions adjust based on your previous answers, and the test ends when the computer reaches 95% certainty you passed or failed
• Knowledge tested: Safe and effective care management, health promotion and maintenance, psychosocial integrity, and physiological integrity
• Number of questions: 75 minimum, 265 maximum
• Time: Up to six hours

After you pass, apply for licensure through your state board with proof of graduation, your test results, and sometimes a background check.

Gain experience

New grads commonly start in general nursing before moving into oncology. "Inpatient units that care for general medical-surgical patients with cancer are a common starting place," says Weimer. Units treating critically ill patients or running intensive treatments may want experience first. Outpatient oncology can be a tough transition for new nurses, she adds, since the routine differs from what nursing school teaches, but with the right preceptor and a longer orientation, new nurses succeed.

Certification

Certification is optional but demonstrates expertise, qualifies you for more opportunities, and can raise your pay. The core credential is the Oncology Certified Nurse (OCN). To qualify you must have:

• Two years of RN experience within the past four years
• At least 2,000 hours of adult oncology nursing practice
• At least 10 contact hours of oncology continuing education within the past three years

The computer-based exam has 165 multiple-choice questions over up to three hours, covering the care continuum, oncology nursing practice, treatment modalities, symptom management and palliative care, oncologic emergencies, and psychosocial care. You need at least 97 correct to pass.

Specialty certifications

• Certified Pediatric Oncology Nurse (CPON): Treating children with cancer
• Certified Pediatric Hematology Oncology Nurse (CPHON): Treating children with blood cancers
• Certified Breast Care Nurse (CBCN): Treating breast cancer patients
• Blood and Marrow Transplant Certified Nurse (BMTCN): Treating cancers requiring transplants
• Advanced Oncology Certified Nurse (AOCN): Deep experience plus extensive continuing education

Salary and job outlook

Registered nurses earn a median annual wage of $93,600 as of May 2024, according to the BLS. The agency does not break pay down by nursing type, but specialized nurses tend to earn more.

The BLS projects about 5% job growth for registered nurses from 2024 to 2034, close to the average for all occupations. Job prospects are strong, and the BLS notes that nurses with a specialty or a BSN have a competitive edge.

"All nursing roles are in demand right now, including oncology," says Weimer. "It's an exciting, rapidly changing field with many practice settings where you can work at the top of your license."

Professional resources

• Oncology Nursing Society: Conferences and career resources
• Clinical Journal of Oncology Nursing: A bimonthly peer-reviewed journal on cancer patient care
• International Society of Nurses in Cancer Care: International networking and leadership development
• The Oncology Nursing Podcast: A biweekly show from the Oncology Nursing Society