Fellowship allows already elite nurses to specialize in cancer care

As a child in Long Island, New York, Kathryn Mazzarella was fascinated by her mother’s tales of life as an oncology nurse. 

“Hearing about how she connected with patients and their families inspired me,” says Mazzarella, who years later chose the same path. First, she earned a bachelor’s degree, then landed a job in the Leukemia and Lymphoma unit at a prominent New York City hospital while completing a master’s degree in nursing. 

“I was fortunate to begin my career in a high-risk specialty that required clinical precision and human compassion,” she says. “It challenged me to expand my knowledge about various forms of cancer.” 

Last year, while attending the Oncology Nursing Society’s annual conference, Mazzarella learned about MD Anderson’s Post Graduate Fellowship in Oncology Nursing. The program provides advanced practice nurses – those with master’s or doctorate degrees and three years of clinical experience – with exposure to all major areas of oncology nursing, from prevention to palliative care, and everything in-between. Mazzarella applied and was accepted. 

“The fellowship is for those who want to achieve oncology nursing excellence through a channel other than the traditional on-the-job training apprenticeship model,” says Joyce Dains, Dr.PH, professor and chair ad interim of Nursing. 

Dains helped launch the program 12 years ago. At the time, it was the first of its kind in the country. Today, 10 such programs exist. Most are modeled after MD Anderson’s pioneering fellowship. 

Not just a disease 

Like Mazzarella, Ana Adriazola began her career in a hospital oncology unit. Unlike Mazzarella, she’s the first nurse in her family. 

“I was working as a hospital secretary in an oncology unit when I saw what nurses do and how they contribute to the team,” she says. “I loved the fast-paced nature of the job and knew it was for me.” 

Adriazola continued working while attending nursing school. After earning a bachelor’s degree, she signed on as a staff nurse in the same unit where she’d been a secretary. 

“One of the first patients I met was only three months older than me,” she recalls. “He had acute lymphocytic leukemia and was in and out of the hospital for treatment. This guy went through a lot – pain, infections, three bone marrow transplants and two relapses. All the while, he kept smiling and remained positive. 

“He and all cancer patients remind me each day that frankly, I have it easy,” she says. 

As Adriazola’s passion for nursing grew, she earned a doctorate degree in nursing practice, then entered MD Anderson’s Post Graduate Fellowship in Oncology Nursing to gain a greater insight into how the disease impacts patients. 

“Oncology encompasses the entire person, their family, and their environment,” she explains. “You can’t treat cancer without knowing who is in the patient’s life supporting them, what they eat, what their financial status is, where they live, what they have access to. This is what draws me to oncology – the realization that cancer is not just a disease, but a person’s life.” 

Highly competitive 

MD Anderson’s Post Graduate Fellowship in Oncology Nursing is highly competitive, says Angela Bazzell, DNP, the program’s director. Only three to four fellows are accepted each year from a pool of 50 to 80 applicants from all over the country. 

“Our fellows are top-tier,” says Bazzell, who graduated from the program in 2015. “Their academic and work references are impeccable. Their passion for nursing is palpable.” 

The one-year program combines classroom learning with hands-on experience. Fellows attend grand rounds, travel to a national oncology conference, care for patients with supervision from an advanced practice provider or a physician, author an academic manuscript for publication in a peer-reviewed journal, and prepare to take the national Advanced Oncology Certified Nurse Practitioner exam that will earn them the highly regarded AOCNP credential. 

At first, participants spend more time in the classroom than in the clinic. Before long, patient care takes a leading role. Last year’s fellows racked up 3,000 patient visits while rotating through about 20 departments. During the last half of the program, each fellow selects an area of specialization. 

Heidi Simmons decided to focus on cell therapy for treatment of blood cancers like leukemia, lymphoma and myeloma, where healthy cells are infused into patients to replenish those damaged by cancer. Before joining the program this year, she was a nurse in MD Anderson’s inpatient Lymphoma service and completed the cancer center’s New Graduate Nurse Residency Program which helps newly graduated nurses move into the registered nurse role. Later, she worked in a bone marrow transplant unit at an Austin hospital. 

“I’ve learned a great deal caring for patients with cancers of the blood,” says Simmons, who holds a master’s degree in nursing. “I’m looking forward to working with CAR-T cell patients, whose immune cells will be re-engineered to fight their tumors using this emerging kind of cell therapy.” 

Simmons moved from Austin when she learned of her acceptance to the fellowship, while her husband remained behind to continue his job as a financial portfolio manager. They see each other on weekends when they explore new coffee shops and take their two dogs on outings. 

In demand 

Program participants typically receive about five job offers when the fellowship concludes, yet 80% choose to remain on staff at MD Anderson. 

“They’re highly sought after, and demand is growing quickly,” says Dains. 

A study by the American Academy of Medical Colleges predicts a shortage of 4,000 medical oncologists by 2020. This translates to 10 million visits by cancer patients that can’t be handled due to physician shortage. 

“Our program is creating a pipeline of highly qualified oncology nurse practitioners who can help alleviate the shortage,” Dains says.