AS NURSES, we need to think critically to effectively care for our patients. As students, we learn what nursing interventions are indicated for nursing diagnoses relative to specific diseases and how to advocate for our patients. In order to be a patient advocate, we must first understand our patients' diseases, and if chronic, how these diseases typically progress.
Many chronic diseases, such as cystic fibrosis, are inherited conditions.1-3 The importance of a comprehensive family health history and the implications of genetics are integral to our ability to appreciate how hereditary diseases affect patients and their families. Without at least a basic understanding of genetics and genomics, nurses can't educate patients when they turn to us for help.
Genetics or genomics?
Genomics refers to the study of the entire genome of an organism, or (in humans) the 23 paired chromosomes that comprise the genetic instructions found in each cell.4 In contrast, genetics refers to the study of a particular gene-its function, effects, and heredity.4 All nurses need to be adequately educated in both to understand disease processes, practice appropriate prevention techniques, reduce adverse drug reactions, and provide optimal patient care.5
Some diseases that were once considered pediatric, such as muscular dystrophy, are now seen more commonly in adult populations as advances in medical management help patients live longer. Thus, nurses are encountering more patients with genetic diseases in every practice area. If nurses don't understand how genetics could influence a particular disease or drug, we could miss an opportunity to advocate for the patient's treatment options or genetic testing.
Patients and their families often rely on nurses for health-related information. The general public doesn't always have a good understanding of basic genetics, so we can play a crucial role in helping patients and families understand their diseases.6 Knowing whether a patient's potential offspring or siblings are at increased risk for disease is important for health promotion and disease prevention. For example, adults (18 to 55 years old) are at a higher risk for a myocardial infarction or other heart disease if they have a family history of heart disease.7 The potential to avoid negative health outcomes not only helps the individual, it also benefits the family as a whole.
Why educate patients about genetics?
During clinical rotations in the community and hospital settings, we often hear patient explanations of their particular disease. One such explanation is "everyone in my family suffers from this so I couldn't prevent it." Statements like this provide not only the perfect opportunity to clarify for patients how genetics influence their health status, but also invite discussion about how environmental factors and lifestyle choices can affect their disease risk. Informing patients that they have a level of personal control in managing chronic disease can motivate them to make healthy changes and limit negative consequences. For example, while adults are at a greater risk for heart disease if they have a family history of heart disease, they can control modifiable cardiac risk factors such as smoking.7
Wanted: Consistent learning
Currently, there is a large gap in genetics and genomics education in nursing curricula, which are traditionally structured by a set of essential standards determined by the American Association of Colleges of Nursing and tailored to each school's unique mission.6 Consequently, the emphasis on genetics and genomics varies from program to program.8 However, we must consistently improve nurse knowledge by incorporating the essential components of genetics and genomics into existing curricula as mandated by the American Nurses Association.9 Our profession needs consistent and standardized genetics and genomics learning objectives.9 Ultimately, this knowledge will help nurses care for and educate patients more effectively.
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