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In 1990, Tena graduated from Asheville-Buncombe Technical Community College as a registered nurse. Prior to graduation, she had been employed as a nursing assistant on the urology/oncology unit of St. Joseph’s Hospital. She continued on this unit as a registered nurse and decided to specialize in oncology. When the hospital developed an independent oncology unit, Tena accepted the charge nurse position for the 3 to 11 shift. During this time, she completed certification in chemotherapy administration and began increasing her participation in patient education programs. She became an active member of the Oncology Nursing Society, and began working part-time in a medical oncology clinic. Tena managed physician schedules, administered chemotherapy, educated patients and new staff members, and developed documentation standards. During this time, she trained staff and began in-house mixing and preparation of chemotherapy agents using ONS guidelines. In 1993, Tena was promoted to clinical coordinator and managed fifteen clinical staff members. Tena resigned this position in December of 2000, but remained an employee with the clinic, assisting one of the physicians with physical exams and pre-chemotherapy assessments. In December 2001, Tena received a MSN and ANP certificate from Duke University. At present, she is employed by Cancer Care as an ANP, providing quality care to outpatient and inpatient oncology patients.