There are currently no published standards for nurse-patient ratios in oncology settings. In fact, ONS has decided not to recommend staffing standards because of significant variations among institutions, patient populations, care settings, and individual patient needs.
In 2000, ONS conducted a survey that addressed the perceptions of oncology RNs, oncologists, and nurse executives in both inpatient and outpatient settings about the oncology work environment and staffing. Lamkin, Rosiak, Buerhaus, Mallory, and Williams summarized the survey results in two ONS reports (2001 and 2002) in which they addressed the issue of staffing ratios and why ONS decided not to make specific recommendations for staffing oncology nursing areas.
"The imposition of regulations mandating minimum nurse staffing levels or ratios are not supported for a number of reasons. . . . Oncology nurses take great pride in providing individualized patient care. The plan of care created by oncology RNs takes into account patients' and their families' physical, psychological, spiritual, and social needs. Oncology RNs expend great effort keeping up with treatment innovations, technology, patient and family education, and individualized patient care. Nurse staffing must be based on patient acuity, setting, skill and experience of the RNs, available ancillary staff, technology, and each individual patient and family" (Lamkin et al., 2002, p. 98).
In 2005, Lamkin published “Reasons for Not Establishing Oncology Nursing Staffing Standards” in Oncology Issues. The article validated the findings from the 2000 survey and discussed variations in practice related to patient ratios, staff skill and experience, technology, and practice settings. The author stated that “it is easy to conclude that individualized cancer care may not lend itself to nursing standards. Instead care should be based on patient acuity, the care setting, the skill of the oncology nurse, the presence of other team members, and the availability of technology” (p. 37).
ONS is currently developing additional resources that can help guide staffing decisions in oncology settings.
Lamkin, L. (2005). Reasons for not establishing oncology nursing staffing standards. Oncology Issues, 20(5), 37.
Lamkin, L., Rosiak, J., Buerhaus, P., Mallory, G., & Williams, M. (2001). Oncology Nursing Society Workforce survey part I: Perceptions of the nursing workforce environment and adequacy of nurse staffing in outpatient and inpatient oncology settings. Oncology Nursing Forum, 28, 1545–1552.
Lamkin, L., Rosiak, J., Buerhaus, P., Mallory, G., & Williams, M. (2002). Oncology Nursing Society Workforce survey part II: perceptions of the nursing workforce environment and adequacy of nurse staffing in outpatient and inpatient oncology settings. Oncology Nursing Forum, 29, 93–100. doi: 10.1188/ONF.93-100