The shift of oncology inpatient care to outpatient care: the challenge of retaining expert oncology nurses.

The prediction has come true. Patients with cancer are being treated as outpatients, and oncology admissions to hospitals have decreased significantly. Rather than dedicated oncology units, hospitals are combining medical-surgical units with oncology units; this trend seems particularly true in communitybased hospitals (Satryan, 2001). With these changes in unit demographics, how will dedicated oncology nurses working in hospitals continue to be experts in their specialty? What strategies can be used to help these nurses maintain their oncology skills and, just as importantly, maintain or increase their satisfaction on mixed units? Because many experienced oncology nurses are moving to the outpatient arena, who will be left to provide care best provided by an oncology nurse to patients with cancer? These questions present unique challenges for nurse leaders, bedside nursing staff, and others concerned about the delivery of quality cancer care.