Oncology Nurse Self-Care: Essential for Recruitment, Retention, and Safe Patient Care

During basic nursing education, we are taught to monitor patient self-care, care of the caregiver, and sometimes our own self-care. However, as cancer treatments become more sophisticated due to precision medicine and cutting-edge technologies, oncology nurses must scramble to remain knowledgeable about new drugs and treatments and deliver nursing care reflecting best practices. In countries without universal health care or low-cost insurance, oncology nurses are routinely confronted by patients and families struggling to find the financial resources to continue cancer treatment. Abandonment or disrupted treatment significantly reduces the chance for cure and, for those for whom cure is not possible, diminishes the options for end-of-life nursing care, for example, pain control and nutritional, spiritual, and emotional nursing care. High nurse/patient ratios in settings where nurse/patient limits are not in place by law or union regulations result in additional stressful work environments. Facilities with limited ancillary professionals for supportive care, for example, nutritionists, psychologists, or social workers, translate to nurses assuming this care. The outcomes of all the above are too often oncology nurse compassion fatigue and burnout. How can oncology nurses protect themselves from compassion fatigue and burnout? How does a nurse with more than 5 patients with cancer in a shift find the time or space to practice self-care? What spaces are set aside for oncology nurses to decompress during their shifts? Are they an inviting place of quiet refuge? Or are they an afterthought of a small room, sometimes right off the nursing station, sparsely furnished with older kitchen equipment? What do these breakroom or lounge environments say about how the hospital administrators view oncology nurse self-care? Oncology nurses are not robots; they require time away from patients during the day to recharge, have nourishment, and time to practice self-care. Linton and Koonmen1 put forward “self-care as an ethical obligation for nurses” in general. A hospital ethos and environment of respect and responsibility for a robust oncology nursing workforce is required in order for oncology nurses to truly exercise self-care. Oncology units/wards with thoughtfully constructed and updated nursing breakrooms or lounges and monitoring of nurses taking their contracted breaks and lunch times are more likely to increase oncology nurse retention and maintain staff enthusiasm for their nursing practice. The American Nurses Association Code of Ethics states, “The nurse has moral duties to self as a person of inherent dignity and worth including an expectation of a safe place to work that fosters flourishing, authenticity of self at work, and self-respect through integrity and professional competence.”2 Oncology nursing literature has many innovative ideas to help oncology nurses practice self-care, most of which are low- or no-cost. Examples include Take-A-Break,3 “exercise for mind and body,”4 5 self-care strategies in less than 5 minutes from the Oncology Nursing Society,5 and mindfulness meditation.6 The World Health Organization Global Strategic Directions for Nursing and Midwifery (2021–2025) brought global attention to nursing shortages, migration, workplace safety and prevention of violence and harassment, and retention challenges in the midst of the COVID-19 pandemic.7 The updated State of the World’s Nursing report, released in 2025, included new statistics on the nursing workforce and highlighted attacks, violence, and involuntary displacement of nurses in areas of conflict.8 Unfortunately, neither document addressed nurse self-care. Limited information about the global-level oncology nursing workforce characteristics is available from ministries of health worldwide. A recent literature review (2021) of the “global distribution and density of the [oncology] health care workforce” revealed a single article (a total of 33 included) that addressed nursing.9 This 1996 study from the United Kingdom reported 2.4 oncology nurses per 100,000 population and 1 oncology nurse per 100 patients as one example.9 The increasing literature about oncology nursing shortages, compassion fatigue, burnout, and workplace violence worldwide, for example, the United States,10 serves as a warning that publications alone are not enough to address the issue, and the use of “violence in the workplace” assessment tools may be an initial step.11 Another recent literature review (2021) found adult oncology nurse burnout resulted from “workload demands and disease acuity…[and] workplace culture.”12 The authors note the shared responsibility for burnout prevention and wellness promotion between the oncology nurses and administrators to maintain the nursing workforce and build resilience. Hospital administrators, oncology nursing societies/associations, oncology nurse leaders, nursing unions, and oncology nurse advocates worldwide must stand up and highlight the importance of nurse self-care to recruit and retain a robust and effective oncology nursing workforce. Oncology nurse successful retention requires respect, a safe nurse/patient ratio, and a work environment with mandated self-care time and place to achieve job satisfaction, leading to improved patient outcomes and a healthy hospital environment for patient care.