Fox Chase Study: Improving Retention for Early-Career Oncology Nurses

The landscape of oncology nursing is facing a critical juncture as early-career professionals navigate the aftermath of the COVID-19 pandemic. A recent study led by Susan Rux, PhD, DNP, RN, FACHE, Associate Vice President of Professional Nursing Practice and Research at Fox Chase Cancer Center, highlights a troubling trend: many new nurses are leaving the bedside due to inadequate institutional support and emotional strain.

The research, titled "Exploring RN Resignations" and published in Dimensions of Critical Care Nursing, utilized in-depth interviews to understand why the newest generation of healthcare providers is exiting the workforce. Findings suggest that pandemic-related disruptions to clinical education left many graduates feeling unprepared for high-acuity environments. However, beyond technical skills, Rux emphasized that the core of nursing remains the human connection.

“If we keep our focus on the most important thing — which is the patient in that bed, yes we want to deliver safe [and] competent care but before we even touch a patient we need to be able to talk to the patient and communicate and and meet them ‘where they are,’ because patients come from all different socioeconomic backgrounds,” Rux stated.

This ability to communicate is increasingly complicated by the rise of "Dr. Google." Rux noted that today's patients are "extremely health literate because of the internet," which often requires nurses to perform "a little bit of service recovery that we need to say, ‘Oh, you know, Dr. Google really was not accurate there, instead let's look over here."

The study revealed that many new nurses felt "emotionally unequipped" for the realities of the profession. In the oncology setting, the burden on new staff is significant. Rux argued that "a new grad is not equipped, a new nurse within that first year is not equipped — whether it's a maturity level or they may even have a loved one, a family member, a community member that they have seen not have a great experience." This personal history can lead to "subconscious bias that they are either pushing down or that they're you know carrying outward," she said.

To combat these challenges, Fox Chase researchers point toward structured mentoring and a shift in hiring practices that prioritize engagement over simple experience. Rux stresses that the complexity of modern healthcare — particularly during critical patient events — cannot be managed in isolation. Drawing on her experience teaching Basic Life Support (BLS) and Advanced Cardiovascular Life Support (ACLS), she remarked, “Anybody that tries to manage a code alone is a fool, because you have a team of people that can take all different roles, and if we want a a good outcome from this patient, then you have to have more than just one person there helping that along.”