Being a nurse is a demanding yet gratifying career since nurses work long hours, often on their feet, and care for vulnerable individuals as they experience some of the most challenging moments of their lives. Pediatric oncology, which involves caring for children diagnosed with cancer, is a particularly difficult but immensely fulfilling career option for registered nurses.
This nursing specialty requires nursing expertise coupled with compassion and strength. Caring for children as they undergo cancer treatments often involves bonding with patients and their families—and while it can involve incredible joys when sharing the news that a child is cancer-free, it can also usher grief and loss to the lives of families and professionals alike.
If you're already working in pediatric nursing and are considering specializing in oncology for children, this ultimate guide provides background information to help you decide. Keep reading to learn more about what this role entails, who is best suited to a career in oncology nursing, how to become a pediatric oncology nurse, what certifications are available, and more.
What Is Pediatric Oncology?
Pediatric oncology is a medical field that specializes in diagnosing and treating cancer in children. It focuses on cancer among those under 18, including teenagers, children, and infants.
If you’re interested in oncology but would rather not work with children, read our Ultimate Guide to Oncology Nursing.
Pediatric Oncology: Statistics, Symptoms, and Treatment
Globally, childhood cancer continues to be a significant concern as every year, according to the World Health Organization, an estimated 400,000 children and adolescents develop cancer. While 80 percent of children with cancer from high-income countries are cured, that number is fewer than 30 percent for children from low- and middle-income countries.
In 2023, across the US, approximately 9,000 new cancer cases are estimated to be diagnosed in children under 14. Additionally, about 1,000 children will die from cancer, making it the leading cause of death in children.
Unlike cancer in adults, childhood cancer generally cannot be prevented or identified through screening. It is also often not linked to environmental or lifestyle factors. Some children may face increased risks of contracting cancer due to specific genetic dispositions inherited from their parents. Additionally, some chronic infections, such as HIV, pose additional risks for childhood cancer. In these cases, children should have regular medical check-ups, and parents and health practitioners are advised to monitor any signs or symptoms of childhood cancer.
Possible signs and symptoms of cancer in children overlap with other common illnesses or injuries. However, if the following symptoms are inexplainable or do not go away, it is recommended that the child see a doctor. These symptoms include the following:
- Unusual lump or swelling
- Unexplained paleness
- Loss of energy
- Easy bruising or bleeding
- Ongoing pain in one area of the body
- Limping
- Unexplained fever or illness
- Frequent headaches, paired with vomiting
- Sudden changes in vision
- Sudden unexplained weight loss
For diagnosed children, their cancer can be treated or cured with medicine and other treatments, including chemotherapy, surgery, stem cell transplant, immunotherapy, and radiation therapy. Later in this guide, we will explore the role of pediatric oncology nurses in these treatments.
What Is Pediatric Hematology Cancer?
Pediatric hematology is a medical field specializing in diagnosing and treating blood disorders in teenagers, children, and infants. Physicians in this area are called pediatric hematologists—and they diagnose, treat, and manage children with cancers such as leukemias, lymphomas, brain tumors, bone tumors, and solid tumors.
Common Types of Childhood Cancer
Children can develop types of cancer that are found in adults; however, the most common types of childhood cancers include the following:
- Leukemia: These are cancers affecting blood cells and that manifest as abnormal growth of blood cells in the bone marrow, where blood is made.
- Lymphoma: This is one of the most common types of childhood cancer, which develops in the cells of the immune system.
- Osteosarcoma: This cancer affects the knees and arms, and symptoms include fatigue, bone pain, weight loss, anemia, redness, mass around the bone, swelling, and weak bones.
- Neuroblastoma: This rare cancer affects nerve tissue and is usually detected in children below five years of age.
- Retinoblastoma: This type of cancer impacts the retina and is the most common type of eye cancer in children.
- Brain and spinal cord tumors: These include several types of cancers, including gliomas, which refer to cancers starting in the glial cells. Other brain and spinal cancers include schwannomas, choroid plexus tumors, pineal tumors, craniopharyngiomas, meningiomas, and germ cell tumors.
Who Cares for Children in Pediatric Oncology?
A wide range of specialists are involved in treating and caring for children with cancer, including the following professionals:
- Pediatric oncologists
- Pediatric hematologists
- Pediatric oncology nurses
- Surgeons
- Radiologists
- Psychologists
- Physiotherapists
- Teachers and play specialists
Together, these professionals—with combined backgrounds in medicine, health, psychology, and childhood education—provide holistic support to children undergoing cancer treatment. Treatment plans often include these professionals working together to ensure each diagnosed child gets the best possible care and is as comfortable as possible.
In addition, professionals, including psychologists and social workers, may support children's families, as this is typically an excruciating time for parents and other family members, including siblings. Families sometimes travel far distances to receive specialized treatment from oncology specialists and facilities. They may need additional support from facilities, such as connecting them to local resources and support groups.
What Are the Responsibilities of a Pediatric Oncology Nurse?
Pediatric oncology nurses' roles and responsibilities include clinical and supportive care aspects. The most crucial aspect of peds nursing jobs is caring for children battling cancer, which is performed in a variety of ways:
- Performing assessments: Pediatric oncology nurses assess cancer patients’ physical conditions, tracking their symptoms and any side effects that need addressing during treatment.
- Monitoring patients: Pediatric oncology nurses monitor the vital signs of cancer patients, such as pulse, temperature, blood pressure, and respiration rate. Nurses also continuously monitor for potential complications to treatment by tracking patients' imaging results, laboratory results, and diagnostic tests.
- Managing symptoms: Cancer treatment often leads to various patient side effects, which nurses help alleviate. Pediatric oncology nurses address issues such as nausea, pain, fatigue, and other adverse effects that result from cancer-related symptoms and treatment.
- Administering medication: Pediatric oncology nurses are responsible for safely administering medication, such as steroids, antibiotics, and chemoprotective agents, as prescribed by the oncology team.
- Providing education: Pediatric oncology nurses often educate patients and their families by explaining diagnoses, treatment options, and potential side effects. They also inform caregivers about caring for the child and recognizing signs of possible complications.
- Providing emotional support: Pediatric oncology nurses offer emotional support to their young patients and their families. Building strong relationships with and providing comfort to their patients is vital. According to a study on psychological interventions by pediatric oncology nurses, nurses spend an average of three hours daily providing emotional support to their patients.
- Collaborating: As part of their role, pediatric oncology nurses collaborate with other oncology specialists, including pediatric oncologists, dietitians, social workers, and other professionals, to offer comprehensive care and improve the patient's quality of life.
- Advocating for patients: Pediatric oncology nurses advocate for patients’ best interests, ensuring they feel heard and are comfortable with their treatment plans. Nurses also support patients in navigating the healthcare system, which can be complex.
What Are the Pros and Cons of Peds Oncology Nursing?
Pursuing a pediatric oncology nursing specialty can be incredibly rewarding and personally fulfilling yet simultaneously challenging due to the sensitivity of working with young patients facing life-altering diagnoses. As you decide whether this specialty is right for you, consider the following pros and cons of pediatric oncology nursing.
The pros of pediatric oncology nursing include the following:
- Knowing you're making a difference: Working with pediatric cancer patients allows you to make a profound impact on children and their families during a critical time in their lives. You can leverage your health and medical knowledge as a registered nurse to positively impact patients' lives, whether advocating for a more suitable treatment plan or making children feel more comfortable in a medical facility.
- Connecting with families and support networks: As a pediatric oncology nurse, you'll work closely with families to provide emotional support and education as they navigate childhood cancer. Often, children diagnosed with cancer have an incredible support system from their families and broader networks, such as schools. Connecting to these networks and observing how they support young patients undergoing treatment is one of the advantages of this nursing specialty.
- Working collaboratively with dedicated teams: Pediatric oncology units often have close-knit teams dedicated to their patients' wellbeing. Being a member of these teams and having the support of colleagues who are passionate about their careers and patients is another advantage of this specialty.
- Embracing your care-giving nature and personality: As a pediatric oncology nurse, you'll spend your days providing care for children, enabling you to let your personality shine, whether that be through making patients laugh to help them de-stress or giving them encouraging feedback on their art activities. If you have a warm personality and love working with children, this may be the perfect nursing specialty for you.
The cons of pediatric oncology nursing include the following:
- Feeling emotionally strained: Pediatric oncology nursing can be emotionally taxing, as you may witness young patients undergoing physically and emotionally challenging treatments. While the joys of seeing successful treatments and cancer-free children walk out of a medical facility can be overwhelmingly positive, nurses are also privy to the incredible loss and grief of caring closely for a young patient with cancer. This grief can affect nurses, leading to emotional strain and burnout.
- Acquiring technical and specialized knowledge: Pediatric oncology nursing requires specialized knowledge and training. There are a variety of optional courses and certifications that nurses may pursue if they are interested in this specialty. Facilities often want to ensure those working in this specialty are up-to-date in their knowledge of cancer treatment and care and may require certifications in addition to providing their own training. While this is an important step to providing the best possible care to patients, it may discourage nurses who cannot pursue continuing education due to time constraints or other factors.
What Does a Pediatric Oncology Facility Look Like?
Pediatric oncology facilities look differently depending on whether they are located within hospitals or are freestanding private clinics. Pediatric oncology facilities have a variety of medical equipment used to diagnose, treat, and care for patients undergoing care. When located within pediatric hospitals, you can expect to see facilities such as pediatric operating rooms and pediatric emergency rooms.
Most facilities have robust care teams comprised of oncologists, pediatric oncology nurses, and additional specialists who provide input on a child's treatment plan regarding their diet, exercise, education, and psychological wellness.
Pediatric oncology facilities often look slightly different from the average hospital unit because they are tailored for children. This tailoring usually means facilities are colorfully decorated and offer amenities geared towards their patient demographic, such as libraries or play areas. Occasionally, special visitors may make an appearance in a pediatric oncology facility, such as a famous artist or Disney character visiting to cheer up the children. Some organizations, such as Make A Wish America, are committed to fulfilling the wishes of children with illnesses such as cancer and may play a role in livening up a facility by preparing special events for patients.
What's the Average Pediatric Oncology Nurse's Salary?
Opportunities in peds oncology are expanding, and the financial benefits of pediatric oncology nursing make it an attractive specialty. So, just how much do pediatric nurses make? Pediatric nurses in the US earn an average income of $94,230, with some data indicating the average is $37 per hour. This average salary means peds nurses earn slightly higher incomes than other registered nurses, who earn an average of $89,010 annually.
Similar to pediatric nurses, pediatric oncology nurses can expect to earn an income that is slightly higher than average. Ultimately, nurse salaries are impacted by various factors such as their location, qualifications (including past work experience and certifications), and the type of facility they work in.
How Do You Become a Pediatric Oncology Nurse?
If you’re wondering how to become a peds onc nurse, the first step is to become a registered nurse. Individuals can join an accredited college or university system to complete a two-year Associate’s Degree in Nursing (ADN) or a four-year Bachelor of Science in Nursing (BSN) degree. After graduating, students must pass the National Council Licensure Examination (NCLEX-RN), which provides the credentials needed for licensing as registered nurses.
Once you are a registered nurse, if you are interested in becoming a pediatric oncology nurse, you can gain experience through an entry-level position in pediatric oncology, surgical oncology, or related specialties. Depending on the employer, oncology nurse certification may be required or preferred, which can be obtained through the Oncology Nursing Certification Corporation (ONCC). There is also a variety of pediatric nursing certifications available to peds nurses. Pediatric Advanced Life Support (PALS) is a requirement for most nurses working with a pediatric population.
What Certifications Can I Get as a Pediatric Oncology Nurse?
Depending on your workplace, additional certifications may be required to become a pediatric oncology nurse and obtain children's cancer hospital jobs. Registered nurses have a range of options for various certifications, which include the following:
- Certified Pediatric Oncology Nurse (CPON) certification is obtained after completing the CPON examination and 1,000 hours of practice as a pediatric oncology nurse.
- Certified Pediatric Hematology Oncology Nurse (CPHON) is offered by the Oncology Nursing Certification Corporation and is accredited by the National Commission for Certifying Agencies (NCCA).
- Oncology Certified Nurse (OCN) is a certification by the Oncology Nursing Certification Corporation and is a voluntary certification with an exam consisting of 175 multiple-choice questions.
- Advanced Oncology Certified Nurse Practitioner (AOCNP) is a certification by the ONCC to recognize nurses who have acquired knowledge, skills, and experience in cancer care.
- Advanced Oncology Certified Clinical Nurse Specialist (AOCNS) is a certification by ONCC intended for nurses specializing in cancer care and other life-threatening diseases.
- Oncology Nursing Society Certification in Chemotherapy and Biotherapy Administration (ONS-CBT) is a certification for nurses experienced in giving biotherapy and chemotherapy. To earn this certification, applicants sit for a three-hour exam consisting of 150 multiple-choice questions.
