title: Shaping advanced nursing practice in the new millennium.
abstract: OBJECTIVE
  To provide a review of converging themes and trends that are shaping advanced practice nursing roles in oncology nursing.
  
  
  METHODS
  Review and research articles, text-books, and organization documents.
  
  
  CONCLUSIONS
  The current managed care environment provides many opportunities and challenges for oncology advanced practice nurses. Advanced practice nurses have both clinical and organization competencies that enable them to mediate the clinical needs of patients and organization goals within the health care system.
  
  
  CONCLUSIONS
  Advanced practice nurses can help shape their roles and practice by active participation in the development of systems to support access to clinical and financial information for effective decision making, collaboration among disciplines, and incorporating evidence-based care in their clinical practices.
authors.affiliation: Mayday PainLink Project, Education Development Center, Inc., Newton, MA02458-2688, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Spross
authors.forename: C A
authors.initials: CA
authors.lastname: Heaney
mesh_terms: D019317:Evidence-Based Medicine; D006801:Humans; D008329:Managed Care Programs; D009720:Nurse Clinicians / Q000639:trends*; D009723:Nurse-Patient Relations; D009859:Oncology Nursing / Q000193:education / Q000458:organization & administration / Q000639:trends*; D020399:Practice Management; D014481:United States