The current shortage of nurses and nursing faculty has reached crisis proportions. According to the U.S. Bureau of Labor Statistics, this country will be short 1.1 million nurses by 2012. The aging of the current nursing workforce, alternative job opportunities available for registered nurses, and a relatively flat earning curve over the past 20 years exacerbate the problem. Interestingly, many individuals looking toward second or third careers are turning to nursing. But the lack of nursing faculty to educate an increased workforce is evidenced by the 32,000 qualified applicants turned away from baccalaureate and graduate nursing programs in 2004 - resulting in the loss of an estimated 3,000 Ph.D.-prepared nurses. When community colleges are included in the statistics, the number turned away skyrockets to 125,000 applicants. The aging of the population, the correlation between age and cancer risk, and an increased per capita demand for health care create a "perfect storm" in the cancer care community.

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As president of the 32,000-member Oncology Nursing Society (ONS), I applaud the efforts of the nursing and cancer care communities to resolve this problem. We don't have exact numbers for the oncology nursing shortage, but we cannot ignore the consequences of a shortage for oncology patients across the continuum of care - beginning with prevention and early detection and extending through treatment and on to survivorship. The multidisciplinary approach that provides high-quality cancer care would be almost impossible without nursing clinicians, educators, administrators, and scientists.

In a recent meeting, Dr. Andrew von Eschenbach and I discussed the goal of eliminating suffering and death due to cancer by 2015 and how ONS and NCI might partner to realize that goal. This goal cannot be achieved without the efforts of oncology nurses. Our knowledge, skills, and commitment are integral to the clinical and research arenas of oncology. Our historical knowledge of cancer biology has been integrated into our understanding of cancer at the molecular level, and that knowledge drives patient and family education, administration of therapy, and management of sequelae to those therapies. Oncology nurses have translated a significant body of nursing research in symptom and side effect management, psychosocial and behavioral issues, and health promotion into practice settings. Our goals are to improve the outcomes, quality, effectiveness, and overall costs of care.

Oncology nursing's contribution to the existential issues of care must not be lost in the discussion of clinical and research issues. Oncology nurses are existential activists: They establish emotional connections with patients and families, affirm and value the person amid the realities of illness, listen quietly as patients describe their fears and vulnerabilities, give permission to speak the unspeakable, and remain in the moment - no matter how difficult. Nursing presence can provide meaning and comfort, diminish anxiety and loneliness, and offer reassurance. While the paradigm of oncology therapy will change over the next decade, the value of and the need for highly qualified, well-educated, and compassionate oncology nurses will not.

Karen J. Stanley
President, Oncology Nursing Society