Oncology Nurse Job Description Template

Job Overview

The Oncology Nurse provides specialized nursing care to patients across the cancer care continuum, from newly diagnosed patients navigating treatment decisions to those in active chemotherapy and immunotherapy regimens, reporting to the Oncology Nurse Manager or Clinical Director. Cancer treatment carries a level of pharmacological complexity and psychological weight that sets this specialty apart. Every shift, oncology nurses manage hazardous medications, assess for life-threatening treatment toxicities, and maintain therapeutic relationships with patients who may be experiencing the most terrifying chapter of their lives. Success is defined by treatment adherence rates, early detection of toxicity signals before they become hospitalizations, and patient-reported experience scores. This role requires equal mastery of clinical precision and human compassion.

Key Responsibilities

• Administer chemotherapy, biotherapy, and immunotherapy agents according to ONS (Oncology Nursing Society) Chemotherapy and Biotherapy Certificate guidelines, verifying orders against protocol prior to every administration.

• Assess patients for treatment-related toxicities using CTCAE (Common Terminology Criteria for Adverse Events) grading and document findings for oncology team review.

• Manage central venous access devices including ports, PICCs, and tunneled catheters, performing flushes, blood draws, and dressing changes per policy.

• Monitor for and respond to acute treatment reactions including anaphylaxis, cytokine release syndrome, and chemotherapy extravasation per emergency protocol.

• Conduct comprehensive symptom assessments using validated tools (ESAS, FACT-G) at each visit and implement evidence-based interventions for nausea, fatigue, pain, and mucositis.

• Educate patients and families on treatment regimens, expected side effects, self-management strategies, and criteria for contacting the oncology team between visits.

• Coordinate care across the oncology team including medical oncology, radiation, pharmacy, social work, and palliative care services.

• Administer and monitor blood product transfusions, growth factors, and supportive care medications per protocol.

• Participate in clinical trial administration when applicable, maintaining protocol compliance and accurate research documentation.

• Handle hazardous drugs safely following USP 800 standards, including proper PPE use, disposal procedures, and spill management protocols.

• Support patients through goals-of-care conversations by providing accurate information and emotional presence without overstepping into the physician's role.

• Maintain continuing education in evolving treatment modalities including CAR-T cell therapy, checkpoint inhibitors, and targeted agents.

Required Qualifications

• Active, unrestricted RN license in the state of practice; BSN preferred.

• ONS Chemotherapy and Biotherapy Certificate required prior to independent chemotherapy administration.

• Current BLS certification; ACLS preferred for inpatient oncology settings.

• 2-5 years of oncology or medical-surgical nursing experience with direct chemotherapy administration exposure.

• Demonstrated proficiency in central venous access device management.

• Working knowledge of CTCAE toxicity grading and oncology emergency management including neutropenic fever protocols.

• Comfort with hazardous drug handling per USP 800 guidelines.

• Proficiency with oncology-specific EHR workflows; Epic Beacon or Cerner Oncology experience preferred.

Preferred Qualifications

• OCN (Oncology Certified Nurse) credential from ONCC.

• Experience with immunotherapy (checkpoint inhibitors) and associated immune-related adverse events (irAEs).

• Clinical trial nurse experience with GCP (Good Clinical Practice) training.

• Palliative care or hospice nursing background as a complement to active treatment experience.

• CPHON (Certified Pediatric Hematology Oncology Nurse) for roles in pediatric oncology settings.

Essential Skills and Competencies

Technical Skills

• Chemotherapy and immunotherapy administration per ONS standards

• CTCAE toxicity grading and adverse event documentation

• Central line and port access management

• Hazardous drug handling per USP 800

• Symptom assessment using validated oncology-specific tools (ESAS, FACT-G)

• Blood product administration and transfusion reaction management

• EHR navigation in oncology platforms (Epic Beacon, Cerner)

Soft Skills

• Therapeutic presence with patients facing life-altering diagnoses

• Clear, compassionate communication about difficult clinical realities

• Resilience and grief processing capacity for repeated patient losses

• Boundary maintenance while sustaining genuine therapeutic relationships

• Interdisciplinary collaboration across complex oncology care teams

Salary Range and Benefits

Salary Overview

Oncology nurses earn $84,000 to $108,000 annually, with the national RN median anchored at $86,070 (BLS, May 2023). OCN certification from ONCC typically adds 7-12% to base pay and is increasingly treated as a minimum requirement at NCI-designated cancer centers. Nurses with immunotherapy and CAR-T cell experience command a growing premium as these complex modalities expand. Source: U.S. Bureau of Labor Statistics, May 2023; PayScale, 2025.

Top-Paying Areas

• San Francisco Bay Area, CA ($112,000 - $134,000)

• New York Metro, NY ($106,000 - $128,000)

• Boston, MA ($104,000 - $126,000)

• Houston, TX ($95,000 - $115,000)

• Seattle, WA ($100,000 - $122,000)

Benefits Package

Oncology nursing positions typically include medical, dental, and vision coverage, 401(k) with employer matching, 3-4 weeks PTO, and OCN exam fee reimbursement. NCI-designated cancer centers often offer robust continuing education budgets, clinical trial exposure, and dedicated oncology nursing professional development programs. Many institutions also provide Employee Assistance Programs (EAPs) with counseling support given the emotional weight of the specialty.

Warning Signs When Evaluating Oncology Nurse Candidates

• No ONS Chemotherapy and Biotherapy Certificate or unclear timeline to obtain it: This is a non-negotiable safety requirement before administering chemotherapy. Organizations that allow uncertified nurses to administer chemo face serious regulatory and liability exposure.

• Cannot describe the difference between cytokine release syndrome and anaphylaxis: These are both infusion reactions but require different management. Conflating them suggests insufficient immunotherapy training as this modality becomes central to oncology treatment.

• No experience or comfort with patients in advanced illness: Oncology nurses regularly care for patients receiving concurrent curative and palliative intent treatment. Candidates unprepared for end-of-life conversations create gaps in care.

• Cannot explain USP 800 hazardous drug handling requirements: Safe chemotherapy handling protects the nurse and their colleagues. Unfamiliarity with these standards indicates insufficient safety training.

• Lack of self-care or burnout prevention strategies: Compassion fatigue in oncology nursing is well-documented. Candidates without explicit strategies for this may not sustain long-term performance in the specialty.

Frequently Asked Questions

Q What does an oncology nurse do?
A An oncology nurse administers chemotherapy, immunotherapy, and biotherapy to cancer patients; monitors for treatment toxicities; manages central venous access devices; assesses symptoms; and educates patients and families throughout the cancer care continuum. They coordinate care across oncology, pharmacy, palliative care, and social work teams.

Q What qualifications do you need to be an oncology nurse?
A You need an active RN license, an ONS Chemotherapy and Biotherapy Certificate (required before independent chemo administration), BLS certification, and 2-5 years of nursing experience including chemotherapy exposure. BSN is preferred. The OCN credential from ONCC is the recognized specialty certification for oncology nurses.

Q How much does an oncology nurse make?
A Oncology nurses earn $84,000 to $108,000 annually, anchored by the national RN median of $86,070 (BLS, May 2023). OCN certification typically adds 7-12% to base pay. Nurses with immunotherapy and CAR-T cell experience command a growing premium in 2025 and 2026 as these modalities expand.

Q What skills are required for an oncology nurse?
A Oncology nurses need chemotherapy administration per ONS standards, CTCAE toxicity grading, central line management, USP 800 hazardous drug handling, and oncology EHR proficiency. They also need therapeutic presence with seriously ill patients, resilience through repeated patient losses, and strong interdisciplinary collaboration skills.

Q What is the career path for an oncology nurse?
A Oncology nurses advance to charge nurse, oncology navigator, or OCN-certified clinical lead roles. With an MSN, options include Oncology Nurse Practitioner, Clinical Nurse Specialist, and Oncology Program Director. Research-focused nurses can pursue clinical trial coordination and oncology research nursing careers.

Q What are the biggest challenges facing oncology nurses today?
A The rapid expansion of immunotherapy and CAR-T cell therapy requires constant retraining as new agents reach clinical practice. Compassion fatigue and moral distress remain serious concerns in a specialty where patient losses are frequent. Staffing shortages at cancer centers are intensifying workload, with OCN-certified nurses in particularly short supply.