Our clinic, an outpatient-based clinic that services a large rural area, has changed dramatically since the 2021 AONN+ Annual Conference. We have added 2 outreach clinics 3 days a month to outlying small towns. While we have added outreach services to our area, we have also seen an increase in referrals both for hematology and oncology as well as for specialty infusions. We have trained new nurses and medical assistants, and a few other staff have moved on. This required us to rearrange many duties to cover the increasing changes of the department. With all the growth and staffing changes, I have been unable to relinquish some of the ancillary roles that I currently perform which would allow me to focus more directly on navigation services.