HomePractice ConsiderationsProfessional Development

There are a number of professional development issues the nurse practitioner faces during the transition to the oncology NP role.  The goal of this section is to identify those issues and provide guidance and direction to both the NP as well as an employer.  These include the basics of licensure, credentialing, competency assessment and competency validation. 

Entering the field as a new NP requires meeting the requirements for licensure in the state in which you will practice.  These requirements can vary slightly from state to state.  Applicants will need to inquire to the state board of nursing to obtain further direction regarding the licensure application for your state.  Once the license has been obtained the applicant can then proceed with obtaining a Medicare, NPI, and DEA number.  The links to apply are listed below.

There are oncology nurse practitioner competencies [IT Please link to http://www.ons.org/media/ons/docs/publications/npcompentencies.pdf] that should be reviewed in preparation for the development of a competency based orientation plan.    

There is a competency based orientation plan which is essentially a list of the core elements of work the NP is expected to accomplish.   Each item is then validated by the preceptor to document that training has occurred and the NP is proficient to proceed.  See attached examples (insert PDF file link here)

A collaborative agreement is another essential element that must be completed.  The requirements for these written agreements can vary slightly from state to state depending upon the regulations.  The basic requirements are that the document types of patients the nurse practitioner will manage and the frequency and degree of supervision. (insert PDF example of collaborative agreement template)

The AOCNP® credential [IT Please link to http://www.oncc.org/TakeTest/Certifications/AOCNP] should be a goal of any oncology NP.  This examination validated the advanced oncology knowledgebase of the NP.   You are encouraged to work with your employer to set this as a goal for completion by the two year mark.   There are a variety of resources from the oncology nursing society and the ONCC (Oncology Nurses Credentialing Center) [IT Please link to  http://www.oncc.org/] to help you prepare for this examination.

Training to perform procedures such as bone marrow aspirate and biopsy or intrathecal chemotherapy administration are important elements of competency validation.   It is important to establish a standard within your practice setting as to how this is accomplished.  Some practices have this written in policy format (insert example policy) as per the attached example.  When requesting this privilege at most hospital institutions you will likely be asked to provide documentation of competency.  The completion of a competency validation form for this skill is helpful to have the necessary documentation to provide for the credentialing process. 

Hospital and insurance credentialing are two other essential elements to work through.  Most practices have someone from the business side of the practice who can facilitate this process.  It is critical to obtain credentials with the insurance companies as soon as possible to facilitate billing and reimbursement. 

It is important for the NP to have some basic understanding of the business side of a practice.  The most important to this area is a thorough understanding of the current requirements for E&M (evaluation & management) coding for level of service provided.  Ingenix is a company that produces various tools regarding coding that some NP’s have found helpful. 

Annual competency validation is helpful to have ongoing documentation of continued competency.  It is required in some settings particularly those that are affiliated with hospital systems.   This typically addresses high risk procedures.