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Oncology nurse Barry Farquhar, RN, is part of the near-retirement, baby boomer generation that threatens a double whammy for cancer care: more sick people and fewer RNs to meet the needs of patients such as Jean Buchanan.

Oncology nurse Barry Farquhar, RN, enjoys providing skilled, compassionate care. But as he approaches retirement, the 52-year-old nurse also worries about who will tend to his patients in the future.

Farquhar is part of the near-retirement, baby boomer generation that threatens a double whammy for cancer care: more sick people and fewer RNs to meet their needs.

His clinic at the Seattle Cancer Care Alliance has sufficient staff, yet area employment boards beg for oncology RNs at local hospitals.

"I keep wondering, who's going to take care of me?" Farquhar said. "Maybe we need to form a nursing co-op."

Farquhar may need to take his idea seriously. A national survey revealed that 88 percent of oncology RNs, 90 percent of nurse executives and 86 percent of oncologists believe a shortage of oncology nurses is under way, and a similar majority believe it will be a severe problem in 10 years.

Stretched staff

"The majority of oncology RNs say they have too much paperwork, that demands on them are accelerating and they're concerned about deterioration in the quality of care," said Peter Buerhaus, Ph.D., RN, FAAN, senior associate dean for research at Vanderbilt University School of Nursing in Nashville, Tenn. Buerhaus was the lead author on the survey-to which 494 oncology RNs, 663 oncologists and 342 nurse executives responded-published in the September/October issue of Nursing Economic$ Journal.

The survey, "State of the Oncology Nursing Workforce: Problems and Implications for Strengthening the Future," commissioned by the Oncology Nursing Society and co-authored by its research director, Gail Mallory, Ph.D., RN, also found that 58 percent of oncology RNs said staffing was less than adequate where they worked; 56 percent of oncologists agreed.

"We hear from our members all the time about staff shortages where they work," said Bridget Culhane, MS, MN, RN, executive director of the Oncology Nursing Society in Pittsburgh.

The oncology shortfall mirrors the larger nursing shortage and is amplified because cancer, already the second leading cause of death in America, is primarily a disease of aging.

In addition, it can be difficult to find oncology nurses because the specialty requires extra training, education and experience to safely care for patients who need toxic, high-tech therapies, careful monitoring, substantial education about treatment and symptom management and significant psychosocial support.

"It takes a certain type of nurse," said Deb Devine, MS, RN, AOCN, director of oncology at University of Colorado Hospital in Denver.

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