Practice Environment and Nurses’ Intent to Stay in Hematology/Oncology, Nursing

Results of a recent literature review identified practice environment factors that impact oncology and hematology nurses’ professional outcomes. The study results were published in the journal Cancer Nursing.

“In line with other areas of nursing, negative collegial relations, heavy workload, limited participation in practice affairs, and less favorable views of leadership were all linked with higher intention to leave,” they stated in their report regarding reasons oncology and hematology nurses may intend to leave their field or the nursing profession.

The study was a review of peer-reviewed, primary research or review articles found within databases that included MEDLINE, CINAHL, PsychINFO, Google Scholar, and Scopus. Articles were identified using a variety of key terms related to oncology and/or hematology nurses and the practice or work environment. Relationships involving these concepts were evaluated through descriptive analyses.

Thirty-two articles were found that met selection criteria for analysis. Six key elements of the practice environment were found across articles: workload, leadership, collegial relations, participation, foundations, and resources. Some of these elements showed relationships with each other; for example, workload was higher in the setting of inadequate staffing, among other factors.

Each of the 6 elements of the practice environment showed significant relationships with outcomes for nurses. Such outcomes included impacts on job satisfaction, psychological well-being, levels of burnout, and intention to leave. In the presence of negative elements of the practice environment, levels of job dissatisfaction were higher, as were levels of burnout.

With negative practice environment elements, psychological distress was also higher, as well as nurses’ intention to leave oncology/hematology nursing and the profession of nursing altogether. Job satisfaction, on the other hand, was linked to features such as involvement in important patient care decisions and participation in practice affairs.

One finding that the study investigators considered unique to the oncology/hematology field was that cancer-specific education appeared important in retaining staff. A sense of having inadequate education in cancer care was linked to a greater intention to leave or unwillingness to continue to work in the oncology field.

The study investigators noted that nurses in oncology and hematology face unique challenges in their field. “This review found that all 6 elements of the practice environment have a significant impact on nurses, their job satisfaction, well-being, and intention to stay within oncology and hematology or in the nursing profession,” the investigators wrote.

Reference

O’Dea A, Caulfield R, Roche M. Impact of the practice environment on oncology and hematology nurses: a scoping review. Cancer Nurs. Published online July 11, 2023. doi:10.1097/NCC.0000000000001264