What is Nursing Practice?

ONCC's Full Statement on Nursing Practice

EFFECTIVE JANUARY 1, 2021

What is Nursing Practice?

The ONCC Board of Directors has revised its definition of Nursing Practice for purposes of ONCC certification initial and renewal eligibility criteria. Beginning January 1, 2021, nursing practice may be work experience that is direct and/or indirect patient care in clinical practice, nursing administration, education, research, or consultation in the specialty represented by the credential. The position must be one that may be filled by a Registered Nurse. A position that may also be filled another licensed care provider may qualify as nursing practice so long as the position may be filled by an RN.

ONCC Position Statement on Experience and Nursing Practice

Nurses specializing in cancer care may gain recognition by earning certification denoting they have the knowledge needed to competently provide quality care to this unique patient population. Certifications offered by the Oncology Nursing Certification Corporation (ONCC) “promote health and safety by validating competence and ensuring lifelong learning in oncology nursing and related specialties.” These certifications include the Advanced Oncology Certified Nurse Practitioner (AOCNP®), Bone Marrow Transplant Certified Nurse (BMTCN®), Certified Breast Care Nurse (CBCN®), Certified Pediatric Hematology Oncology Nurse (CPHON®), and Oncology Certified Nurse (OCN®); as well as the Advanced Oncology Certified Clinical Nurse Specialist (AOCNS®), Certified Pediatric Oncology Nurse (CPON®), and Advanced Oncology Certified Nurse (AOCN®) available only for renewal.

Certification also promotes the specialty practice by establishing and maintaining minimal competency standards. Certification validates that the nurse has met all elements of eligibility established for each credential, and renewal requirements ensure maintenance of knowledge and practice. A core component of the decision to award initial certification is based on a passing score on an examination. However, additional criteria complement the exam and mitigate the risks inherent in relying solely on the exam to make the decisions on initial certification. Moreover, additional criteria are paramount in making renewal decisions. Eligibility criteria should be fair and equitable, defensible, data-informed, practical, balanced, acceptable to stakeholders, and appropriate to the maturity of the profession and credential(s) (Certification: The ICE Handbook, 3rd Ed., ICE, 2019, pages 159-160).

In 2020, the ONCC Board of Directors charged the ONCC Task Force on Defining Nursing Practice to explore and make appropriate recommendations on how ONCC defines “nursing practice” for initial eligibility and renewal requirements. The task force conducted an extensive review of 25 scholarly and practice documents, credentialing best practices and standards, requirements of 44 nursing credentials offered by more than 15 credentialing organizations, and research into 26 medical board programs. Additionally, the group worked with three ONCC Role Delineation Task Forces to pose a set of questions on the 2020 RDS surveys for the OCN® (n=1189), BMTCN® (n=330), and CBCN® (n=198) programs. The task force made recommendations to the ONCC Board of Directors based on the literature and practice reviews, survey data analysis, and content expert discussions which lead to the following position.

It is the position of the ONCC that:

• Experience is essential to competency and, therefore, to certification and renewal eligibility. According to the Institute for Credentialing Excellence, experience or actual job performance in the role to be certified is a common eligibility requirement and can be thought of as a measure of a candidate’s ability to perform the job and to integrate and apply the profession’s knowledge base (Certification: The ICE Handbook, 3rd Ed., ICE, 2019, page 160).
• Experience is not limited to tasks or time in a role. It is the sum of and synergy between the tasks, participants, and time invested that results in, and serves as evidence of, the ability to apply knowledge specific to oncology nursing. 
• The role of nurses within cancer care continues to evolve, and changes to state practice acts and consortia like the LACE Network increasingly allow nurses to practice to the fullest extent of their licensure. Further, job descriptions are becoming more generalized—less specific to RN-only personnel—to lessen the administrative workload for institutions and provide greater flexibility in staffing.
• Nursing practice as eligibility criteria for certification and renewal requires a broad definition to reflect rapidly evolving roles across the cancer care continuum.

Upon these positions, ONCC has revised its definition of Nursing Practice for purposes of ONCC certification initial and renewal eligibility such that job descriptions no longer must require only an RN to be able to hold the position. That the position also may be filled by another licensed care provider should not be an exclusion factor for nursing practice hours eligibility so long as the position may be filled by an RN. The ONCC definition of Nursing Practice now states: Nursing practice may be work experience that is direct and/or indirect patient care in clinical practice, nursing administration, education, research, or consultation in the specialty represented by the credential.