Becoming a Chemotherapy Nurse: Gaining Fundamental Knowledge Through Education

By Kate B. Hubbard, MSN, RN, OCN®, NPD-BC - February 8, 2023

Highly trained oncology nurses are essential to the care of patients with cancer, especially those receiving systemic therapy. New oncology nurses may be unfamiliar with the fundamentals of systemic therapy (chemotherapy, immunotherapy, and targeted therapy) administration, which are key in today’s cancer treatments. Due to the complexity of these agents, all oncology nurses should receive specialized education before administering these therapies to ensure safe patient care.

Is There a Chemotherapy Certification?

It is a common misconception that registered nurses (RNs) must obtain a chemotherapy certification to administer chemotherapy and immunotherapies to patients. There are no chemotherapy certifications, instead, there is a chemotherapy validation. Sometimes, the terminology is confusing because there is a notable oncology certification, the Oncology Certified Nurse (OCN®) examination. This certification signifies that an oncology nurse has mastered a broad body of oncology nursing knowledge. However, it does not validate the comprehensive knowledge required to administer chemotherapy. Each health care organization is responsible for determining the competency requirements for administering systemic cancer therapy in their facility.

What Are the Different Options for Chemotherapy Education?

Before new chemotherapy nurses can administer systemic therapy, they need both didactic learning and a practicum. Organizations can choose to use chemotherapy administration courses developed by national cancer organizations or build their own internal instruction.

External Courses

The Oncology Nursing Society’s (ONS) Chemotherapy Immunotherapy Administration Courses are widely recognized options since the ONS also sets the standards and guidelines for chemotherapy and immunotherapy administration. ONS offers 2 on-demand, self-paced options depending on the volume of chemotherapy and biotherapy agents a nurse will administer. These options are the Fundamentals of Chemotherapy Immunotherapy Administration and the ONS/ONCC Chemotherapy Immunotherapy Certificate Course. The American Society of Clinical Oncology (ASCO) also offers an on-demand course called Chemotherapy Administration and Safety. Courses from both organizations are comprehensive and address the ASCO/ONS Chemotherapy Safety Standards, which are the cornerstone standards for safe administration. In addition, learners of both ONS and ASCO courses earn nursing continuing professional development (NCPD) credit.

Internal Courses

Organizations may choose to develop their own instructor-led chemotherapy course. These courses, taught by pharmacists, nurse educators, or experienced chemotherapy nurses, draw from national standards and guidelines and often incorporate institutional policies and protocols. They allow learners to share clinical experiences, ask questions, and discuss patient cases to enhance learning. Some instructors incorporate hands-on simulation activities to allow learners to apply the course knowledge immediately.

Finally, organizations may also choose alternative learning activities, such as reviewing online learning modules, journal articles, policies, and case studies. Learners should always have an experienced chemotherapy nurse available to answer questions about the educational activities.

What Should Chemotherapy Education Include?

To ensure comprehensive chemotherapy education, learners and organizations can refer to the ONS’s Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice. These guidelines outline critical components of chemotherapy education, including topics such as:

Types, classifications, and routes of administration
Pharmacology of agents
Principles of safe preparation, storage, labeling, transportation, and disposal of agents
Administration procedures
Appropriate use and disposal of personal protective equipment (PPE)
Assessment, monitoring, and management of patients receiving therapy
Patient and family education for agents, including specific side effects, symptom management, and process for urgent and ongoing follow-up
Post-treatment care and follow-up

Whether a health care organization uses an outside course, teaches its own, or provides other learning activities, the content should always be comprehensive, current, and evidence based. All options should allow learners to validate their knowledge from the educational activity through an evaluation such as an examination.

In addition to didactic learning, health care organizations are responsible for determining how a nurse will demonstrate hands-on competency after completing a chemotherapy course/education. Completing chemotherapy education is only the first step to becoming a chemotherapy nurse, and creating a foundation of knowledge is essential to provide safe care to oncology patients.