Objectives: To provide a review of converging themes and trends that are shaping advanced practice nursing roles in oncology nursing.

Data sources: 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.

Implications for nursing practice: 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.