Nicole Ferreira, MSN, RN, NPD-BC, BMTCN, OCN, Vanderbilt University Medical Center, discusses the development of a new-to-specialty registered nurses (NTS-RNs) fellowship program in order to improve practitioner competence, decrease practice turnover, and expand hematology/oncology education for (NTS-RNs) throughout a 1-year program.

Transcript:

Hi, my name is Nicole Ferreira. I'm with Vanderbilt University Medical Center and I'm the nursing professional development specialist that supports our Ambulatory Oncology Cancer Center here at Vanderbilt, which is in Nashville, Tennessee. I had the pleasure of presenting at ONS Congress a couple of weeks ago, and I'd love to share a little bit about my presentation.

I developed an oncology fellowship program for our RNs who are new to the oncology specialty at our center we noticed that we had had an increase of nurses entering the cancer center without any oncology experience. In those kinds of years when this hiring staffing trends had changed, we were noticing a higher-than-average turnover rate. When we looked into some of these evaluations on orientation, we saw that there was a gap and a need for more education opportunities for these nurses who are new to the oncology field because we know a lot of nursing schools don't cover oncology curriculum. and unless you had a clinical in an oncology unit, most of these nurses had no exposure to this highly specialized population.

I, as the NPD specialist, I developed a program and after doing a literature review. I looked at what other centers were doing and in general, just what a fellowship program is. Fellowships can be for RNs or APPs, and it's really to support the nurse who's entering a new field. On the RN side, these are nurses with experience, so not newly licensed nurses, but they've got experience, but none in this new specialized field. I did a literature review, looked at the benefits of this and presented this to our executive leadership, which was greatly supported. Luckily, we were able to move forward with our pilot program in the fall of 2023.

The way that we've structured our program is it is a yearlong program, and we space out some of these sessions throughout that year because we don't want to offer all of our information upfront and have this information overload and not have these check-ins throughout the year.

We build on prior knowledge, we build on what they've been seeing in clinic, and we were able to bring them out of staffing and come back as a cohort, see their fellow oncology nurses that are also in the same kind of transitioning to that new role. We can debrief about things that they've experienced and then we add more learning opportunities. Depending on how far along they are in that year, we have sessions more tightly spaced together.

We really want to get through the basics of what is cancer, talk about genomics and solid tumors versus heme malignancies. We also know important to look at symptom management and oncologic emergencies pretty early on. Then at about the 6- or 7- month mark, we bring them in and start to add on topics, things like sexuality, fertility and palliative care, survivorship, financial concerns.

As we round out our year, we talk about professional goals and accreditation and quality and evidence-based practice so that we can give them the structure and bones of, okay, this program's ending, but what can we do to support you and your professional development from here on out?

One thing that I added to this program—an activity they do throughout the whole time, after we meet at our first session, they get a little bit of homework, but I tell them, don't worry, it's not nursing school. We're not turning in our care plans. But I instruct them to pick a patient in their area, a newly diagnosed patient, and they're going to follow this patient for the entire year. They come back for session 2, 3, and 4, and they present on their patient. A little bit of background of age, sex, cancer, how are they diagnosed, what's their treatment plan? They continue following this patient on chart review and they give those updates each time we meet.

Because we all know in oncology, we might have a specific plan when we first start out, but there's a lot that we don't expect, a lot of things that aren't anticipated. We've got to pivot and change that initial plan. We wanted to give our nurses the opportunity to kind of see that through and really take some time to think about why are we ordering this or what does this mean if the test results showed this, or why did we pivot and change our treatment plan? We can answer questions and kind of just debrief about what's going on in their patient and really help them see that big picture. I wanted to help prevent seeing and working in silos where if I work in infusion, I don't know what's going on the medical oncology side or the radiation oncology side and we wanted them to get that big view overall picture.

Feedback has been really great. All of the nurses who participate have enjoyed this program, as well as their leaders. We have had increased retention, we have had 2 cohorts now that have completed the 1 year, and we sit at a 91% retention rate for that year.

Now we're kind of seeing the full-circle go around where we've got graduates from the program are now precepting new staff and it's great to see that excitement kind of grow as we grow our cancer center. We've got nurses who have had this dedicated time to learn and identify resources, and they're now training the newer nurses here.

We are really excited to continue and grow this program and we hope to present more in the future and publish in a journal. Thank you so much for your time. Hopefully you'll be hearing more from us at Vanderbilt, and what we've done here.

Source:

Ferreira N. Fueling Passion, Igniting Excellence: The Journey of Oncology Nurse Fellowship. Presented at Oncology Nursing Society Congress; April 9-13, 2025. Denver, CO.