Indeed, I also view the responsibilities of nurses in providing future healthcare services with trepidation. As noted by Porter-O’Grady (2001), nurses are at a crossroads. As a profession, we will either embrace the science of genetics, anticipate potential implications, and make a difference for client services; or we will be left behind. With the dawn of genomic medicine, the increase in patient numbers seeking genetic services alone will require new models for genetic health care delivery (Guttmacher, Jenkins, & Uhlmann, 2001). Nurses have an opportunity to become involved in designing these services.

Step A is to enumerate ways that we can begin to integrate genetics into practice now. Not every nurse needs to be an expert in genetics, but basic genetics content is essential for the provision of competent nursing practice of the 21^st century (International Society of Nurses in Genetics [ISONG] & ANA, 1998). Examples of nursing roles in the application of genetics to health care are delineated for the generalist nurse, advanced practice nurse, and advanced practice nurse in genetics (Lea et al., 2000).

Step B is to define competency in genetics for all nurses. Efforts are underway by professional nurse organizations such as the ISONG to assure competence in genetics nursing practice through the credentialing by portfolio process (see http://nursing.creighton.edu/isong).It is essential that student nurses recognize the importance of competency in genetics and like Roletta, become proactive about their learning needs. Collaborative models of genetics education have been proposed by a coalition focused on efforts to develop interdisciplinary national health professional education about application of human genetics information (Core Competency Working Group, 2001; see http://www.nchpeg.org). Recommendations for genetics nursing education have been proposed and could be utilized by faculty to design curriculum (Jenkins et al., 2001; Jenkins, Dimond, & Steinberg, 2001). Materials and courses to assist faculty in these efforts are available (http://www.gpnf.org, http://www.fbr.org and http://www.nih.gov/ninr).

Step C is for nurses to assume the leadership to bridge the knowledge gap regarding genetics in practice, education, research, and health policy. An excellent opportunity to be an active participant in guiding such efforts is available through the Secretary’s Advisory Committee on Genetic Testing http://www4.od.nih.gov/oba/sacgt.htm).

Translating genetics into health care will affect clinical outcomes. As Roletta recognizes, the education of nurses about DNA is even more than learning the ABC’s outlined above. Only with ongoing efforts of nurses can human benefits result from the application of genetic scientific discoveries.

Dr. Jenkins

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References:

Core Competency Working Group of the National Coalition for Health Professional Education in Genetics. (2001). Recommendations of core competencies in genetics essential for all health professionals. Genetics in Medicine 3, 155-158.

Guttmacher, A., Jenkins, J., & Uhlmann, W. (2001). Genomic medicine: who will practice it? A call to open arms. American Journal of Medical Genetics, 106, 216-222.

International Society of Nurses in Genetics, Inc. and American Nurses Association. (1998). Statement on the scope and standards of genetics clinical nursing practice. Washington, D.C.: American Nurses Publishing.

Jenkins, J., Dimond, E., & Steinberg, S. (2001). Preparing for the future through genetics nursing education. Journal of Nursing Scholarship, 33, 191-195.

Jenkins, J., Prows, C., Dimond, E., Monsen, R., & Williams, J. (2001). Recommendations for educating nurses in genetics. Journal of Professional Nursing, 17, 283-290.

Lea, D., Williams, J., Jenkins, J., Jones, S., & Calzone, K. (2000). Genetic health care: Creating interdisciplinary partnerships with nursing in clinical practice. National Academies of Practice Forum, 2, 177-186.

Porter-O’Grady, T. (2001). Profound change: 21^st century nursing. Nursing Outlook, 49, 182-186.

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Roletta Bryant-Harris

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