How to Become an Oncology Nurse Practitioner

The American Cancer Society estimates in 2022 there will be 1.9 million new cancer cases diagnosed and 609,360 cancer deaths in the United States. Oncology nurse practitioners have the very important job of caring for those cancer patients and their families. 

If you’re considering becoming an oncology nurse practitioner, this guide will explain what an oncology nurse practitioner does, how much they make, how to become one, and more!

An oncology nurse practitioner is a specialized Advanced Practice Registered Nurse (APRN) who provides comprehensive care to patients who have been diagnosed with cancer. 

Oncology NPs collaborate with other healthcare providers including physicians to develop treatment plans for cancer patients. 

As we stated above, oncology nurse practitioners work with patients undergoing cancer treatment. Your duties will vary based on where you work and what area of oncology you focus on (more on that in a bit) but some of the general oncology np duties are:

1. Communicating with referring and primary health care providers
2. Conducting comprehensive or episodic health history and physical assessments
3. Developing pain management regimens
4. Educating patients and families on treatment plans and prevention strategies
5. Maintaining clinical documentation 
6. Ordering, performing, and interpreting diagnostic tests such as lab work and x-rays
7. Overseeing treatment infusions 
8. Participating in medical oncology-specific clinical quality and research projects
9. Prescribing medications and other treatments
10. Writing specific orders including chemotherapy and radiation
11. Oncology Treatment Areas

An oncology nurse practitioner’s duties will vary depending on the type of oncology area you focus on. There are multiple areas of oncology that an NP can practice. These include:

1. Bone marrow transplantation
2. Breast Oncology
3. Chemotherapy/infusion
4. Genetic counseling
5. Gynecologic oncology
6. Hematology
7. Immunotherapy
8. Radiation oncology
9. Surgical oncology

Where Can Oncology Nurse Practitioners Work?

Oncology NPs can also work in a variety of settings. Most commonly they are found in the following areas:

1. Ambulatory care centers
2. Cancer treatment center
3. Community health centers
4. Extended care facilities
5. Government agencies
6. Home care agencies 
7. Hospice
8. Hospital
9. Infusion center
10. Palliative care
11. Private practice

What’s an Oncology Nurse Practitioner’s Schedule Like?

An oncology NP’s schedule will vary based on where they work. Schedules will vary and might involve 40 hours a week with a set schedule or work a rotating shift schedule. It is important to speak to the employer to determine the schedule that is expected.

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Oncology Nurse Practitioners can be either salary-based or earn an hourly rate. This will vary based on the place of employment. Those paid on an hourly scale are able to earn overtime pay whereas salary employees would need to discuss that with the hiring committee. 

According to the Bureau of Labor Statistics (BLS), the median pay for nurse practitioners in 2022 was $121,610 per year with salary ranges from $91,250 to $208,080. Unfortunately, the BLS does not differentiate between different types of nurse practitioners. 

Highest Paying States for Oncology Nurse Practitioners

The BLS reports that in May 2022  the highest paying states for nurse practitioners were:

1. California - $158,130
2. New Jersey - $143,250
3. Massachusetts - $138,700
4. Oregon - $136,250
5. Nevada - $136,230

Highest Paying Cities for Oncology Nurse Practitioners

The BLS also reported that the top five metropolitan cities for nurse practitioner pay were:

1. New York-Newark-Jersey City, NY-NJ-PA- $170,320
2. Los Angeles-Long Beach-Anaheim, CA- $ 149,110
3. Chicago-Naperville-Elgin, IL-IN-WI - $126,020
4. Miami-Fort Lauderdale-West Palm Beach, FL - $101,870
5. Boston-Cambridge-Nashua, MA-NH - $141,120

Oncology Nurse Practitioner Salary by Years of Experience

As with all jobs in the nursing field, earning potential increases with additional education and experience. Specifically, oncology NPs can earn a higher annual salary with increased years of experience.

• Less than 1-year of experience earn an average annual salary of $94,939
• 1 to 4 years of experience earns an average annual salary of $99,398
• 5 to 9 years of experience earns an average annual salary of $104,567
• 10 to 19 years of experience earns an average annual salary of $110,850
• 20 years of experience earns an average annual salary of $113,581

Oncology Nurse Practitioner Benefits 

Regardless of the workplace setting, full-time and part-time nurses enjoy similar benefits.

While actual benefits may vary depending on the institution most include the following:

1. Health, dental and vision insurance
2. Certification Reimbursement      
3. Retirement Options
4. Family and maternity leave
5. Paid time off
6. Relocation assistance
7. Childcare
8. Bereavement leave            
9. Discounts       
10. Advanced certification and education reimbursement
11. Attendance at nursing conferences

Becoming a certified oncology nurse practitioner can be a long and daunting task; however, it is possible and worth it. Columbia University and Duke University offer specialty programs for those interested in oncology. These programs are ideal because the didactic information and clinical rotations are specific to oncology. This provides the first-hand experience needed to care for this specific group of patients. 

To become an oncology NP, you must first have your Bachelor of Science in Nursing (BSN). If you only have an Associate Degree in Nursing (ADN), you must first obtain a bachelor’s degree. This is a must before any graduate program can be started. 

If you know that you want to become an oncology NP, it is important to start classes for your BSN as soon as possible. This education will take several years to complete, depending on the program, and will ultimately delay applying for your NP courses.

To become an oncology nurse practitioner, take the following steps, starting with becoming a registered nurse (RN).

1. Graduate with a Bachelor of Science in Nursing (BSN) from an accredited nursing program
2. Become a Registered Nurse by passing the NCLEX examination
3. Gain at least 2-3 years of relevant oncology nursing experience
4. Graduate with your NP from an accredited  Master of Science in Nursing (MSN) Nurse Practitioner program
5. Become a certified NP after passing your national examination
6. Earn a post-NP certification specializing in Oncology

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For nurses that have a BSN, there are two main types of NP programs offered both in-person and online for aspiring oncology nurse practitioners.  

MSN-NP Programs

One of the most common options for NP programs, the MSN-NP is for students who already have their BSN and want to enroll directly into the program at the graduate level. 

Basic requirements: Applicant must possess a BSN degree. 

DNP Programs

Doctorate Nurse Practitioner programs allow students to receive their doctorate degrees while meeting the requirements to become an NP. The DNP is generally suited for nurses who plan on working more in an academic or research-based setting, 

Basic requirements: Applicant must possess a BSN degree. 

Post-graduate Certificate Programs

If you earn an NP degree but are interested in specializing in oncology, then you can search for a school that offers a post-graduate certification option. 

Basic requirements: Post-grad certificate programs require you to either possess a master’s in nursing or have a Nurse Practitioner qualification in another specialty.

The Oncology Nursing Certification Corporation (ONCC) offers the Advanced Oncology Certified Nurse Practitioner (AOCNP) to qualified individuals. This certification is available to APRNs that meet the following criteria on one of the two pathways:

Pathway 1

• Current license as a registered nurse
• Graduate degree from accredited NP program with a concentration in oncology
• 500 hours supervised clinical practice as an adult oncology nurse practitioner within the past five years
• One graduate-level oncology course of at least 2 credits or 30 hours oncology continuing education within the past five years

Pathway 2

• Current license as a registered nurse
• Graduate degree from accredited nurse practitioner program with concentration in adult (primary or acute), family (across the lifespan), gerontology, or women’s health
• 1000 hours practice as an adult oncology nurse practitioner obtained within the past five years
• One graduate-level oncology course of at least 2 credits or 30 hours oncology continuing education within the past five years

Oncology Certification Exam

Additional exam information includes: 

• Three-hour, 165 multiple-choice test
• $296 fee for ONS/APHON member
• $416 fee for non-member

A breakdown of the exam is as follows:

• Cancer Continuum - 35%
• Cancer Treatment and Supportive Care - 45%
• Oncologic Emergencies - 10%
• Psychosocial Issues - 5%
• Professional Practice and Roles of the APRN - 5%

According to the U.S. Bureau of Labor Statistics (BLS), the career outlook for NPs is excellent, with an expected 38% growth rate from 2022 to 2032.

While the BLS does not differentiate between the different types of NPs, oncology NPs will always be in need since cancer remains the leading cause of death worldwide. The National Cancer Institute estimates that there will be more than 1.9 million new cancer cases in the U.S. in 2022 alone. 

Furthermore, the National Center for Workforce Analysis (NCHWA) reported an estimated 20,000 primary care physician shortfall by 2025. Orthopedic NPs will help fill this void. 

Continuing education requirements (CEU) hours will vary based on the state of licensure. For each state an individual is licensed, CEU hours will be required. Generally, NPs are required to have a minimum of 75 contact hours of continuing education in the specialty area.

Board-certified oncology NPs can utilize continuing education hours for both the certification renewal and NP renewal. It is important to confirm with the state board of nursing to determine the specific number of hours required for renewal.

Additionally, even though they are functioning in an APRN role, they must maintain their RN certification. In order for an individual to renew their RN license, they will need to fill out an application, complete a specific number of CEU hours, and pay a nominal fee. Each state has specific requirements and it is important to check with the board of nursing prior to applying for license renewal.

A detailed look at Continuing Nurse Education hours can be found (here). 

1. Advanced Practitioner Society for Hematology and Oncology
2. American Association of Nurse Practitioners
3. Association of Pediatric Hematology-Oncology Nurses
4. Doctors of Nursing Practice 
5. International Society of Nurses in Cancer Care
6. Oncology Nursing Certification Corporation 
7. Oncology Nursing Society
8. Society of Gynecologic Nurse Oncologists

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• Do oncology nurse practitioners get paid more?

  • According to payscale.com the average salary for an oncology NP as of May 2021 is $123,780 or $59.51 per hour.

• How long does it take to become an oncology nurse practitioner?

  • Conservatively, it takes nine years to become an oncology NP. Four years to earn a BSN, a minimum of two years of bedside oncology experience, and three years to earn an oncology NP degree. 

• What does an oncology NP do?

  • Oncology NPs treat patients with cancer including conducting physical exams, prescribing medications, counseling patients and families regarding their disease, and conduct research regarding new cancer treatment options. 

• Is Oncology Nursing hard?

  • Oncology nursing is extremely difficult emotionally, physically, and mentally but extremely rewarding. Oncology NPs deal with dying patients regularly, but also get to celebrate with patients when they are in remission. 

1. General Nurse Practitioner
2. Aesthetic Nurse Practitioner
3. Family Nurse Practitioner
4. Psychiatric Nurse Practitioner
5. Pediatric Nurse Practitioner
6. Acute Care Nurse Practitioner
7. Neonatal Nurse Practitioner
8. Women's Health Nurse Practitioner
9. Orthopedic Nurse Practitioner
10. Emergency Nurse Practitioner
11. Adult-Gerontology Nurse Practitioner

$100,000+ Masters Doctorate Oncology Bedside NP