Oncology Clinical Nurse Specialists

1
Oncology Clinical Nurse Specialists

• Cyndi Miller Murphy, RN, MSN, CAE
• Oncology Nursing Certification Corporation
• Executive Director

2
Historical Perspective

• University of Pittsburgh offered an oncology
  tract in the medical-surgical masters degree
  program in nursing
• First oncology graduate program in nursing
  offered at Rush University
• 1990 44 graduate programs in oncology nursing in
  USA

3
Historical Perspective

• Oncology Nursing Society (ONS) published the
  Standards of Advanced Practice in Oncology
  Nursing
• defined the structure, process, and outcome
  criteria for advanced practice nursing
• Oncology Nursing Certification Corporation
  (ONCC) survey of ONS members with graduate
  education indicated that 69 were interested in
  obtaining advanced oncology certification

4
Historical Perspective

• 1993-1994 First role delineation study (RDS) of
  advanced clinical oncology nursing practice was
  conducted by ONCC
• 1,349 masters prepared ONS members in clinical
  roles were surveyed
• Instrument based on the CNS role
• Responses CNS 58
• NP 6
• Other 36

5
Historical Perspective

• First AOCN Certification Examination
  Administered
• First ONS Position Statement on Advanced
  Oncology Nursing Practice published
• 1997 ONS published Statement on the Scope and
  Standards of Advanced Practice in Oncology Nursing

6
Historical Perspective

• Second RDS of Advanced Oncology Nursing Practice
  conducted by ONCC
• Significant shift in roles of Oncology APN

7
ONS Membership
CNS NP 1994 1660 269 1998 1417 633
8
Historical Perspective
1998 Second RDS of Advanced Oncology Nursing
Practice
1200 Oncology APN surveyed 1998 1994 NP 41 6 C
NS 36 58 Combined 11 Other 12 36
9
Historical Perspective
1998 RDS

• Significant changes in practice from 1994
• Significant changes to the Test Blueprint
• Few significant differences were found between
  the NP and CNS groups with regard to knowledge
  and job responsibilities (lt 10 items)

10
Historical Perspective
1999 Revised AOCN Certification Examination
administered
11
Historical Perspective

• ONS Position on The Role of the Advanced Practice
  Nurse in Oncology Care revised
• Third RDS of Advanced Oncology Nursing Practice
  conducted by ONCC
• Response to changing demographic

12
ONS Membership
CNS NP 1994 1660 269 1998 1417 633 2004 833 1283
13
Results of Third RDS
2003 Oncology CNS and Oncology NP share a
substantial core of knowledge important to both
roles. However, there are discernable differences
in work responsibilities for NP and CNS in
oncology.
14
Results of Third RDS
2003 Task-knowledge linkages were used to develop
relative weights of the test specifications
(blueprints) for separate role specific
examinations.
15
AOCNS, AONP Test Blueprints
16
2005 Administration of new AOCNS, AOCNP
Certification Examinations
17
Care Setting
1994 1998 2003 In Patient 58 34 31 Out
Patient 37 63 61 Home 5 3 1 Other 7
18
AOCN Certified Nurses
NP 470 CNS 436 Administrator 196 Educator 133 Othe
r 250
19
AOCN Certification Recognized for CNS Role in 13
states
20
Specialization vs. Subspecialization

• Oncology meets the ABNS definition of a specialty
  and all related ABNS standards
• Definition and Scope of Nursing Specialty
• Research Based Body of Knowledge

21
Specialization vs. Subspecialization

• Specialty Oncology
• Examples of Subspecialties within oncology
• Specific diseases or categories of diseases
• Leukemias
• Gynecologic Cancers
• CNS Tumors
• Endocrine Tumors
• Specific treatment entities
• Blood and Marrow Transplantation
• Radiation Oncology
• Surgical Oncology