The Essentials of Genomics and Genetics for Nurses - Assignment Example

? The Essentials of Genomics and Genetics for Nurses Katy Mooney NURS 505 Advanced Health/Physical Assessment May 6, The Essentials of Genomics and Genetics for Nurses The applicability of genomics and genetics to the professional nursing practice has considerably been increased ever since the completion of the Human Genome Project (HGP) in 2003. This paved the way for the genomic era in health care and advancements in genetics and molecular biology has contributed towards this development. Although many regard both genetics and genomics as equal, one can find considerable differences between the two. While genetics refers to the “study of individual genes and their impact on relatively rare single gene disorders” genomics includes the “study of all the genes in the human genome together, including their interactions with each other, the environment, and the influence of other psychosocial and cultural factors” (Consensus panel, 2008, p. 8). Genomics takes into account the environmental factors and clearly demonstrates how these contribute to human health and illness. While genetics focuses on single gene disorders, genomics “takes a holistic view of genetics” (Ward, 2011, p. 2). Genomics and genetics knowledge, as well as competencies have been proved to be essential prerequisites in the prevention, diagnosis and treatment of various chronic diseases. Similarly, with the advancements made in genetic and genomic research genetic testing is now being widely employed for the diagnosis and prognosis of many common diseases like cancer. As such, genetic and genomic competencies have become integral to the professional nursing practice today. This paper seeks to explore the essentials of genomics and genetics for nurses, and in doing so, it will look at genetic and genomic knowledge, competencies, professional responsibility, assessment and application of genomics and genetics to healthcare. Significance and Application of Genomic Literacy and Genomic Knowledge for Nurses Ward (2011, p. IV) has pointed out that certain levels of genomic literacy is a necessary prerequisite for the nurses ‘to achieve genomic competency.’ The author also suggests that the reductionist view of medical genetics has now been replaced with a broader genomic view. For him, the genomic era of health care is a paradigm shift for the nurses and they need to “consider the collective influence of multiple gene variations and the cumulative effects of all manner of environmental factors on an individual‘s health, risk for disease, response to therapies, even behaviors” (Ward, 2011, p. 4). Usually, nurses need to interact with the patients much more than other health care professionals and therefore it is imperative that they possess ample genomic literacy so as to prepare, administer and explain various genomic applications to the patients. Studies and researches in the realms of genomics have opened new horizons of clinical care to the patients. The applications of genomic discoveries are visible in many areas of the health care industry. As Jenkins, Grady and Collins (2005, p. 98) have observed, “the applications of genomic discoveries in clinical care are expanding diagnosis, treatment, and prevention at an accelerating pace, and that knowledge will continue to improve the health of people throughout the world.” This growing importance of genomics and genetics services has increased the professional responsibility for nurses as well. Genomics has also prompted nurses and other health care professionals to think in terms of the health of the individual rather than his/her disease. Another significant impact of genetics and genomic research is that it has given way for more comprehensive personalized healthcare. Genetic and genomic services facilitate more individualized approaches to treat one’s illness or disease. Lea & Calzone (2010, p. 15) have rightly pointed out that “the influence of genetic and genomic factors in health and disease is creating opportunities for earlier diagnosis, more effective and individualized prevention and treatment of disease, better response to treatments, and improved health outcomes.” Genome wide association study (GWAS) has been proved to be highly effective in identifying various genomic factors associated with chronic diseases. Similarly, genetic testing has also been proved to be beneficial in the diagnosis and management of diseases. The clinical applications of all these genetic and genomic discoveries necessitate sound genetic and genomic knowledge from the part of the entire nursing professionals. The Essential Competencies of Genetic and Genomic Nursing The essential competencies of genetic and genomic nursing can be categorized into two: professional responsibilities and the professional practice domain. The registered nurses need to display certain professional responsibilities as directed by the American NURSES Association and in order to fulfill these responsibilities satisfactorily they need to incorporate genetic and genomic knowledge and skills in their day to day health care practices. As part of their professional responsibilities the nurses are required to recognize their own values and attitudes related to genetic and genomic science, promote client’s access to genetic and genomic services, examine their competency for genetic and genomic practice on a regular basis, make use of genetic and genomic technologies, and advocate the rights of the patients for ‘genetic- and genomic-related decision-making and voluntary action’ (Consensus panel, 2008, p. 11). Similarly, it is essential that the nurses show certain genetic and genomic competencies with regard to their professional practices domain. These include eliciting family history information , collecting personal health histories that take into account genetic, environmental, and genomic risk factors, conducting competent health and physical assessments, evaluating the patients’ responses to genetic and genomic knowledge, developing a plan of action, and understanding the actual relationship of genetics and genomics to healthcare (Consensus panel, 2008, p. 11-12). These involve a systematic and step by step effort from the part of the health care nurses. First of all, they need to collect the patient’s personal and his/her three generation family health history. Then, based on these records potential genetic risk factors are to be identified and appropriate referrals to genetic specialists are to be made in relevant cases. Professional Responsibility of Nurses Regarding Genomics and Genetics The professional nurses have pivotal responsibility in managing health, screening/prevention and identification of risk factors, diagnostics/interventions and outcomes. With regard to genetics and genomics they are also supposed to identify patients who need specific genetic and genomic information and offer them credible and accurate genetic and genomic services. Similarly, they should also be equipped to identify various “ethical, ethnic/ancestral, cultural, religious, legal, fiscal, and societal issues related to genetic and genomic information and technologies” (Consensus panel, 2008, p. 12). They should be able to identify the potential impact of genetic and genomic information on the patients as well as their family members. Very often, it is the health care nurses who are in immediate touch with the patients and therefore nurses with genetic and genomic competencies are better equipped to facilitate referrals for specialized genetic and genomic services. This genetic and genomic knowledge also proves to be extremely beneficial while they collaborate with other genetic and genomic health care providers. However, the health care nurses are bound to ensure both privacy and confidentiality while offering or recording genetic and genomic information. In certain cases, the nurses need to impart genetic counseling to the needy patients. There is no doubt that specific knowledge in genetic and genomic services will enhance the clinical performance of the health care nurses. Integration of Genomics and Genetics to Healthcare Hanson, Novilla, Barnes, Cruz & Meacham (2007), in this respect, point out that genetics and genomic knowledge has got potential implications for the identification and prevention of chronic diseases. The authors hold that nurses should be well-versed in genomics and the use of family health history for effective health care services. The researchers purport that “family health history captures the familial nature and incidence of chronic diseases and provides valuable insights on the risk for chronic diseases within the context of shared genes, environments, and behavior” (Hanson, Novilla, Barnes, Cruz & Meacham, 2007, p. 219). Thus, genetic and genomics knowledge has been proved to be an effective preventive tool for assessing chronic disease risk factors. It has been identified that chronic diseases often result from genetic factors, behavior and environment. Individuals whose family members suffer from chronic diseases are more vulnerable towards chronic risks compared to the general population. Genomics based on family health history can help individuals to adopt healthier life styles by moderating such risk factors that would trigger chronic conditions and diseases. Similarly, the concept of personalized genomics whereby the individual can gain awareness regarding one’s own individual risk for diseases has also assumed significance in the modern era. In the same way, the number of patients carrying out genetic tests has also increased considerably. Recent researches have revealed that “advances in the field of human genomics have helped to better explain the non-modifiable and modifiable risk factors that contribute to chronic disease within the context of shared genes, behaviors, and environment” (Hanson et al., 2007, p. 226). All these emphasize the need to train health care nurses with the essential genetics and genomics competencies that are essential in modern health care. Conclusion It can thus be concluded that it is imperative to develop genomic competencies among health care nurses in an emerging public health genomics era. Chen and Goodson (2007, p. 157) believe that the completion of the Human Genome Project (HGP) by the National Institutes of Health (NIH) in 2003 is a “milestone in human history, as advanced genomic technologies/information can offer insight into specific diseases and may help develop highly efficient, personalized treatment and prevention programs.” Advancements in the field of genomics are sure to change the public health practices of the future generations. However, the Human Genome Project also brought about many challenges that need to be addressed at the earliest. These challenges include questions related to genetic literacy, genetic testing, and genetic discrimination, access to genetic services, genomic profiling, genomic information and technologies (Chen & Goodson, 2007, p. 157). Similarly, implementation of genetic and genomic health care services necessitates commitment and the development of a long-term plan from the part of the nursing leaders as well as the academic faculty. Practicing health care nurses should be offered in-service trainings, continuing education or academic courses to update their knowledge regarding genetic and genomic health care services. Similarly, there should be ample provisions in the nursing curricula to integrate genetic and genomic knowledge into the nursing courses and instructional resources. References Chen, L & Goodson, P. (2007). Entering the public health genomics era: why must health educators develop genomic competencies? American Journal of Health Education, 38(3), 157-165. Consensus panel. (2008). Essentials of genetic and genomic nursing: competencies, curricula guidelines, and outcome indicators, 2nd edition. Retrieved May 4, 2012 from: http://www.genome.gov/Pages/Careers/HealthProfessionalEducation/geneticscompetency.pdf Hanson, C., Novilla, L., Barnes, M., Cruz, N.D.L & Meacham, A. (2007). Using family health history for chronic disease prevention in the Age of genomics: translation to health education practice. American Journal of Health Education, 38(4), 219-229. Jenkins, J., Grady, P.A & Collins, F.S. (2005). Nurses and the genomic revolution. Journal of Nursing Scholarship, 37(2), 98-101. Lea, D.H & Calzone, K.A. (2010). Integrating genetics and genomics into oncology nursing. Oncology Nurse Edition, 24(2), 13-45. Ward, L.D. (2011). Development of the genomic Nursing Concept Inventory. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy. Washington State University College of Nursing. Retrieved May 4, 2012 from: http://research.wsulibs.wsu.edu/xmlui/bitstream/handle/2376/2880/Ward_wsu_0251E_10114.pdf?sequence=1 Read More