Jan 18, 2021 1:00 PM


group of nurses

Oncology nurses face a unique set of challenges, such as managing treatment complications, symptoms, and end-of-life care. These challenges can contribute to compassion fatigue, which affects a nurse’s physical and emotional wellbeing and can lead to burnout and turnover. Research suggests that building personal resilience is a strategy for bouncing back after difficult experiences in the workplace and should be incorporated into nursing education.

To help our nurses learn to manage the challenges of oncology nursing and to build resiliency, Huntsman Cancer Institute (HCI) implemented the Huntsman Oncology Nurse Residency (HONR) Program. This 12-month nurse residency is for all newly graduated nurses hired at HCI.

Through oncology-specific instruction, the HONR Program provides tools and resources to help nurses be successful in their first year of clinical practice. Curriculum topics include the following:

  • Site-specific cancers
  • Oncologic specialties
  • Treatment modalities
  • Symptom management
  • Oncologic emergencies

The program also includes high-fidelity simulation, a structured mentorship program, question-and-answer panels with physicians and other experts, professional development, and an evidence-based practice project to improve patient outcomes. The HONR Program promotes a strong sense of team and community through networking, which is linked to increased job satisfaction and decreased stress. In addition to developing clinical skills and formulating a lifelong commitment to professional nursing, HONR nurse residents are on the fast track to clinical leadership at HCI. Since 2013, 148 nurse residents have graduated from the program, and many have since moved into nurse leadership positions in the hospital.

The HONR curriculum also threads resiliency topics throughout, such as practicing mindfulness and managing emotional contagion. This purposeful intervention helps new graduates develop personal resiliency skills that allow them to cope while meeting the challenges inherent to oncology nursing. By being proactive instead of reactive, nurse residents can build their coping skills from the beginning.

At three points during the year-long program, HONR nurse residents take the Professional Quality of Life survey, a standardized tool used to measure compassion satisfaction, compassion fatigue, burnout, and secondary traumatic stress. Scores in all of these categories generally improve over the course of the residency year, with changes in burnout scores being the most statistically significant in our most recent cohorts. We also measure retention at one, two, and three years from initial employment. Since we began resiliency training within HONR in 2015, the nurse resident retention rate is 98% at two years, and 94% at three years.

Adapting during COVID-19

The COVID-19 pandemic has not only transformed how patient care is provided, but also how education is delivered. In response to growing challenges of the pandemic, oncology nurses are improvising and finding innovative ways to create safer learning environments. Given live in-person education restrictions in 2020, the HONR Program was tasked with identifying new ways to teach clinical staff. With the support of nursing leadership, a refreshed HONR curriculum was developed, which includes a blended hybrid approach with limited in-person class time and new online learning components. Live education is now delivered in large auditorium settings to allow for social distancing, and virtual learning is facilitated through an online classroom that includes videos, evidence-based articles, games, discussion boards, and interactive modules. Zoom meetings are scheduled routinely throughout the program to assist with impactful discussion and cohort cohesion. These virtual check-ins consist of student-led group dialogue, meaningful storytelling, mentorship, and sharing of experiences.

Evaluations show nurse residents still demonstrate high program satisfaction rates, a life-long commitment to oncology nursing, and a strong desire to stay within the organization. Emotionally connected learning is possible online, and it starts with relationships. While framing this challenge as an opportunity to innovate, nurse residents have been able to connect with their peers and leaders, while emerging as oncology professionals, despite masks, computer screens, and social distance.

The HONR Program fulfills a dual purpose of recruitment and retention, while aiming to improve knowledge among oncology nurses at HCI. Through proactive measures, nurse residents are also able to develop personal resilience, and the ability to face inevitable challenges with strength and adaptability.

For more information about the Huntsman Oncology Nurse Residency (HONR) program, contact the Nurse Residency Coordinator, Cassidy Kotobalavu.

Cassidy Kotobalavu BSN, RN, OCN
Cassidy Kotobalavu BSN, RN, OCN

Cassidy Kotobalavu BSN, RN, OCN
Nursing Professional Development Practitioner
Huntsman Oncology Nurse Residency (HONR) Coordinator
Huntsman Cancer Institute
Office: 801-587-4431
cassidy.kotobalavu@hci.utah.edu

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