Pediatric oncology orientation and inservice education: pathways toward excellence in clinical nursing practice.

Gretchen Almquist, RN, MSN, is a Nurse Educator and Jo-Anne Tierney, RN, MSN, PNP, is a Pediatric Nurse Practitioner at Memorial Sloan-Kettering Cancer Center, New York, New York. At the time this article was written, Jeannie Couper, RN, BSN, was a Clinical Nurse III on the Pediatric In-patient Unit at the same institution. This article describes a staff development program (orientation and inservice education) for pediatric oncology nurses in a comprehensive cancer center. The goal of staff development is to maintain and upgrade nurses’ skills in order to provide quality patient care, enhance professional development and promote job satisfaction. Hospital nursing education programs for pediatric oncology nurses are influenced by factors related to the current health care milieu and by factors inherent in the specialty of pediatric oncology. Rapidly changing technology, increasing patient acuity, cost containment, accreditation requirements, flexible work schedules and turnover of nursing personnel are all issues that impact upon staff development activities.1,2 The specialty of pediatric oncology offers nurses opportunities for developing expertise in various areas: medical/surgical nursing, intensive care, bone marrow transplantation and ambulatory care. Family-centered care provides pediatric nurses with additional challenges in the areas of psychosocial support, growth and development and child/family education. Emphasized in this staff development program is the use of adult learning principles facilitated by collaboration among nursing educators, clinicians and administrators. Actively involving learners in their educational experiences, according to Malcolm Knowles3, includes acceptance of the following characteristics of adult learners: capability of selfdirection, previous experience, readiness to learn, and a problem-centered orientation to learning. An atmosphere of continual dialogue among nurse educators, clinicians and administrators facilitates mutual satisfaction with educational activities and enhances rapport between education and practice. In this era of cost containment and high technology, collaborative practice is a vital component of successful staff development.