The relationship between genetics and nursing practice

Nursing and Genetics

As noted by Lea (et al.) "Obtaining a family history is an established and familiar screening activity used by nurses and other healthcare providers across many healthcare settings" (Lea 2010:4). However, the increased commonality of doing a genetic profile on patients has made gathering such a family history far more revelatory than ever before. Nurses must gain a better understanding of how genetics affects patient health in a very specific fashion to be effective healthcare providers in the future. Nurses are "ideally situated" to inform patients about what genetic information means, given the patient-centered focus of the profession (Lea 2011: 3). Nurses must understand the implications of genetic testing to comprehend the extent to which a disease is likely to manifest itself in a patient. Patients must be able to realistically evaluate the threats they face.

At present, "genetic tests are offered to those suspected of having a genetic condition or identified as being in a high-risk group within a population, such as individuals known to be at risk for carrying or being affected by a specific condition because of family history or as a result of screening" (Lea 2011: 6). However, as the testing grows less expensive and less invasive, it may become more commonplace in the future and may include information about more minor conditions. Also, throughout the individual's lifespan, new knowledge of genetic tendencies may be required given that certain gene expressions can affect the efficacy of certain medications and treatments (Lea 2011: 7). As well as core competencies in terms of knowledge, nurses must also have an awareness of the emotional issues which genetic testing can provoke in the patients and close family members to ensure a sensitive as well as informative response that is psychologically astute.

Given the multifaceted knowledge-based and emotional components required in dealing with genetic information, nurses are increasingly seeking to specialize in this area. "Genetics nurses in advanced practice integrate genetics concepts and services into nursing practices that span many healthcare settings and specialty areas" (Lea 2006: 217). The field is growing and although some genetics nurses are primarily research-based in their practice, many others deploy their expertise in clinical situations. Of such specialists, the majority of these nurses have master's degrees: "thirty-one percent were certified as nurse practitioners; 57% provided direct patient care…Over one-third were educators and 19% conducted genome-related research" (Lea 2006: 213).

Five dominant themes have emerged in genetic-based research specific to the field of nursing. These include changing lifestyle behaviors to improve health in a manner that is informed by the genetic diagnosis (such as someone with a predisposition to heart disease modifying his diet); managing chronic illnesses that are genetic in nature (such as cystic fibrosis); reducing health disparities based in a lack of access to genetic information due to race, class, gender, and general access to healthcare; using technology to improve human life; and end-of-life care (Conley & Tinkle 2006: 18). The broadness of these themes indicates the pervasiveness with which genetics affects human health and the need for nurses to be able to apply that knowledge in a comprehensive fashion throughout the patient lifecycle.