When Nick Escobedo DNP, RN, OCN, NE-BC, director of Inpatient Oncology at Houston Methodist Hospital, started his nursing career, he didn’t expect to land in oncology nursing. During May’s recognition of Oncology Nursing Month, Escobedo says the career has offered distinctive opportunities for personal and professional growth.
“I went into a basic acute care setting right out of nursing school because I wanted to get a good, solid foundation for myself in practice,” Escobedo, a former president of the Oncology Nursing Certification Corporation, says. But the learning process opened up new, and appealing possibilities. “I had an opportunity to learn the skill of chemotherapy,” he says, “and the more I got to learn about it and spend time working with patients, I quickly learned this specialty was for me, and I wanted to do that full time. It chose me.”
What sets it apart from the science and the practice part of nursing, he says, is that cancer affects every body system. Oncology nurses treat patients through a span that lasts from cancer diagnosis to remission or to end of life.
“I got to use my critical thinking skills, and I got to have knowledge of all the latest and greatest therapies available,” he says. Escobedo, a dedicated lifelong learner, says it’s imperative that he stays on top of understanding new technology and the range of cancer drugs and treatment options available to patients and the safest ways to administer them.
Thankfully, oncology nursing is very collaborative, he says, and so nurses work with physicians, frontline providers, therapists, chaplains, nutritionists, clinical pharmacists, and volunteers to understand how the different pieces help drive the care of a patient. Escobedo says a nurse might check in with a clinical pharmacist to find out more about a particular drug to learn about interactions, how a patient might respond to it, and how to use it safely.
Additional education is essential for oncology nurses, he says. “My journey toward certification was big,” he says. “That was one of my ways at looking at my competence as a clinician, to say I was an expert in the care of oncology patients. So my journey to pursue that certification and have knowledge to be successful was key. I’m a big advocate for certification.”
To balance the intensity of understanding the drugs and treatments used for cancer, Escobedo says the relationships oncology nurses develop with their patients is special. “You develop long-term connections with patients and their family members,” he says. “They give so much of themselves.”
Those strong connections can help nurses and patients through the celebrations of successfully completing cancer treatment or the more difficult prognosis or outcome. “This is very hard work,” says Escobedo. “The reward is that we get to do that work, but we need to balance that with resilience. This is tough work and we have to promote and champion a little of that balance. We try to look at the celebrations that happen.”
The success stories are uplifting and have a lasting impact on nurses. “We hear from patients who were treated years ago, and they come back to check in,” he says. Patients relay news of celebrating weddings and anniversaries and the arrival of children and grandchildren. Some have even paid it forward and after being treated for cancer, have embarked on fundraising campaigns to help others.
“Our patients push us to have that drive,” he says, “And we see lots of really good outcomes.” Patients can go through treatment that is long term and so being able to go through the process with them is something oncology nurses find so rewarding, says Escobedo.
Escobedo encourages nurses who are interested in exploring oncology nursing to find a way. “If you think you could be good at it, why don’t you try it?” he says. Find good mentors and be sure to seek out projects and opportunities that will get you out of your comfort zone. “Nurses don’t get lots of oncology nursing experience through training or nursing programs,” he says. “This is a full and rewarding specialty.”
The annual recognition of Certified Nurses Day on March 19 honors the nurses who go the extra step to achieve certification in their specialties. But the day also helps raise awareness in the nursing community about the importance of certification and the benefits it brings to a nursing career.
Certification is an excellent career advancing move; after all gaining more knowledge and skills in your nursing specialty is only going to help you be a better nurse. But many nurses overlook another important result of gaining certification–the confidence boost it gives you and the new peer recognition of your advanced knowledge.
Clara Beaver, MSN, RN, ACNS-BC, AOCNS, and president of the Oncology Nursing Certification Corporation (ONCC) says certification brings better patient care, but also changes a nurses relationship with patients. “The best part [of nursing] is the buildup of trust with patients,” she says, “and having certification shows you have that commitment to oncology and that you have that knowledge. You both care about it and you know about it.”
Each certification is different, so look into one that that matches your specialty area. For example, ONCC offers five certifications: Oncology Certified Nurse, Certified Pediatric Hematology/Oncology Nurse, Certified Breast Care Nurse, Blood and Marrow Transplant Certified Nurse, and Advanced Oncology Certified Nurse Practitioner. Beaver says the bone marrow and breast care certifications are newer and were industry driven as a result of many nurses specializing in oncology subspecialties.
Some nursing specialties are starting to require certification as the advanced and most current skills are required for patient care. Many Magnet hospitals require certification for some nurses as do many cancer centers.
“We’re always trying to find the value in increasing knowledge and commitment,” says Beaver. “Certification says to the community that those nurses are staying up-to-date on what’s going on and their skills may be higher.” Beaver says when she became certified it made her think about patient care differently. “I looked at my patient differently because I had increased knowledge,” she says. :I looked at the entire background and not just at the task in front of me.” With certification, Beaver says she understood more of how things worked and could explain what was going on to the patient a little more.
Nurses who are certified are proud to show their certification, says Beaver, because it is instant recognition that you’ve gone above and beyond what’s required. “I feel like certification takes you up a little higher and they become like the informal leaders. They have raised confidence.” And their success with becoming certified shows other nurses that they can also achieve the same thing.
Nurses do find one of the biggest roadblocks to certification is test anxiety. “Nothing is as bad as the NCLEX,” says Beaver with a laugh. Before each of her three certification exams, Beaver says she had to overcome major test anxiety, so she understands why it can be a deterrent. “I just had to remember this is what I do every day,” she says. “Test taking is scary.”
Before each exam, she studied the test blueprints. She also pulled all the resources that were referenced to study those as well. That’s what the questions are based on, she says, so review all that information carefully. “Pull the statistics and the references,” she says and find out your weakest areas so you can focus on those places intensely. Reading information out loud helped Beaver retain the information, and she encourages nurses to find a method that works best for them.
When you sit for the test, Beaver suggests that you read the entire question, then read all the answers, and then go back and read the question over again. This will help you slow down and comprehend exactly what is being asked.
If paying for the exam is a barrier, see if your organization will help pay for it or if a professional organization will help.
“Certification is an important part of our job as nurses,” Beaver says. “And it’s attainable. It expands your knowledge base and your skill set. And it shows a commitment to what you are doing.”
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