in the facility where i work, there is an inpatient heme/onc unit, an outpatient clinic, and a bone marrow transplant unit. the clinic is basically a very hectic doctors office. they see kids who need routine follow ups, or have problems (febrile at home, n/v/ dhydration) or are getting outpatient chemo. they will also transfuse blood products. depending on the severity of the problem, they get they get admitted. most of the kids on the floor are there for chemo (1-5 days at a time, then if all is well, they go home after a couple of days). the others are usually there for fever/neutropenia. the bmtu is self explanatory. those kids are there for at least a month (many much longer) and face many many complications). the acuity is higher, the ratio is anywhere from 1:1 to 1:3. the inpatient nurses work on both the floor and bmt (we rotate in and out), but the clinic is staffed seperately. i prefer bmt, as that is where i started out. its a lot of iv meds, mouthcare, dressing changes, blood transfusions, chemotherapy, and psychosocial care. it's very challenging, but demanding and emotionally draining at times.
i hav enot taken the plunge for certification. i'm in grad school, so it's impossible for me to devote the time to studying. it's extremely difficult. you need a certain # of documented hours in the field before you can sit. maybe someday. the extra pay is about $750 at my place. any other q's, let me know.