DNP–ONS Chapter Collaboration Helps Address Oncology Nurse Retention and Burnout

At a time when oncology nursing turnover continues to challenge cancer care delivery, Leigh Flegge-Schlie, DNP, APRN, FNP-BC sought to create a program that could help nurses feel more supported, engaged and fulfilled in their work.

The result was RESET, an evidence-based educational initiative developed through a collaboration between Flegge-Schlie and the Central Indiana Oncology Nursing Society (CIONS) Chapter. What began as a doctoral project has since grown into an ongoing effort focused on improving oncology nurses’ intent to stay in the profession while addressing common contributors to burnout and compassion fatigue. As the program continues to evolve, organizers are exploring opportunities to expand its reach and impact.

Flegge-Schlie, who was pursuing her DNP degree at Saint Mary’s College of Notre Dame at the time, said the idea for RESET emerged from challenges she witnessed firsthand while working on an oncology unit experiencing significant staff turnover.

“If I was going to be spending so much time researching something, I wanted it to be something that could actually have a positive outcome by the time I was done with school,” Flegge-Schlie said. “I just started really honing in on retention, oncology nurse retention, trying to figure out how to get people not only to feel appreciated but stay.”

Identifying Key Drivers of Burnout

According to Flegge-Schlie, repeated themes emerged in both the literature and participant surveys regarding why oncology nurses leave the field.

“The research showed us that it was personal resilience, lack of organizational commitment and then chronic exposure to grief and loss,” she explained. “Those things repeatedly in the literature and in surveys through our participants kept popping up as reasons why they weren’t staying in the field.”

RESET was designed to directly address those challenges through targeted educational programming and community-building activities.

The program included sessions focused on personal resilience, organizational commitment and chronic exposure to grief and loss, with clinical experts providing practical guidance and strategies nurses could apply in their daily work.

“It’s important to me not just to talk about it, but to do something about it,” Flegge-Schlie said.

To foster connection among participants, organizers also incorporated interactive and social elements into the program, including an improv session designed to encourage laughter and strengthen peer relationships.

“Literature shows that if you get healthcare workers laughing together, they’re much more likely to build that community,” Flegge-Schlie said. “We ended with improv and just this huge spread of food. People spread out, laughed — it was fun.”

Collaboration Expanded the Program’s Reach

What began as a local DNP project has continued to expand into a multistate collaboration involving ONS chapters across the region, with leaders working to build on the program’s momentum and broaden participation.

Flegge-Schlie said partnering with CIONS was critical to the initiative’s success and highlighted the value of collaboration between nursing students and professional organizations.

“When you’re a student, you don’t have the funding or the connections to make a big thing happen,” she said. “A lot of times chapters can help connect you to vendor partnerships or places willing to host. That type of partnership not only let me give ONS a really good program, it also helped me do really good research at the same time.”

According to CIONS leaders, the initiative became the chapter’s highest-attended event to date and attracted participants from four states.

The chapter later developed a formal framework for future DNP–chapter collaborations, including guidance for project oversight, administrative support and resource allocation.

Why Retaining Experienced Oncology Nurses Matters

Flegge-Schlie emphasized that retaining experienced oncology nurses is essential not only for workforce stability but also for maintaining high-quality patient care.

“I see so many nurses who have this time of experience — they get burned out, they get frustrated, they’re not paid well enough — they just say, ‘Okay, I’m done,’” she said. “That could be 10 or 15 years of experience that now is replaced by someone fresh out of school.”

Although she stressed that new graduates are valuable members of the workforce, she noted that losing seasoned oncology nurses means losing critical clinical insight and mentorship.

“You’re losing that richness and that depth and that perception that someone has after all those years of experience,” Flegge-Schlie explained. “We need to keep those people in order to well train the up-and-comers.”

The financial impact of turnover is also substantial. According to Flegge-Schlie, replacing a single nurse costs approximately $53,000, with hospitals spending an estimated $10.5 million annually on turnover-related expenses.

“If we can reduce these expenses, we could potentially allocate more funding toward retention and nursing care,” she said.

Looking Ahead

Flegge-Schlie said she continues to analyze data from the RESET initiative while working with collaborators to further develop the program. She believes the findings could help inform retention strategies beyond oncology nursing and support future iterations of RESET.

“This was never intended to be a one-time event,” Flegge-Schlie said. “The goal is to continue growing RESET, learning from the data and creating opportunities that help oncology nurses feel supported throughout their careers.”

She added that collaboration remains central to creating meaningful and sustainable nursing workforce initiatives.

“Through collaboration, both parties achieved success,” Flegge-Schlie said. “I was able to complete my DNP project, and together we created something that continues to benefit oncology nurses and advance nursing education. We’re excited to see where RESET goes next.”

References

1. Flegge-Schlie L, Ambruso S, Gerbracht M. RESET initiative and DNP–ONS chapter collaboration. ONS Voice. Accessed May 16, 2026