Genomics field explodes: Nurses respond

Nursing Progress Notes - Fall-Winter 2008

"We need to teach nurses about advancements in genomics research and technology so they can translate that science to patients and families in a practical way." – Joyce Dains, Dr.P.H.

“Explaining to patients their risk for developing cancer or developing a secondary cancer can be complicated,” says Joyce Dains, Dr. P.H., advanced practice nurse in the Cancer Prevention Center, and director of advanced practice nursing programs. “The clinical application is about the role of genomics in disease prevention, early diagnosis, treatment, drug selection and therapy.”

Dains, a cancer genetics educator, says when she sees a “red flag,” such as a family history that suggests an inherited risk, she refers the patient to a genetics counselor. “They do a multigenerational evaluation of the family history and can advise about genetic testing. Other than inherited risk, there are issues such as gene variation, changes in gene expression and the interaction of your environment with your genes - environmental exposure, diet and/or exercise issues and smoking. All cancer is genetic, but not all cancer is hereditary.”

A whole new world

Information and discoveries stemming from data collected during the course of the U.S. Human Genome Project (1990-2003) have been the catalyst for changes in medicine and nursing practice at all levels. And with these changes, the need for nurses to become more educated about genomics has increased. Dains notes that many of today’s nurses had no genomics instruction when they were in school.

A whole new curriculum

Dains would like to see genomics education programs for all nurses in the future. “Right now, it’s informal, on-the-job education. We need to teach nurses about advancements in genomics research and technology so they can translate that science to patients and families in a practical way.”

"At no time in the history of cancer nursing have the discoveries moved so rapidly or held such promise."

Calzone, K. and Masny, A. "Genetics and oncology nursing." Seminars in Oncology Nursing (2004) Volume 20, Issue 3:178-185.

“Genomics programs for nurses nationally have tended to be more bench-oriented and at the fellowship level,” notes Dains. “But there are a few master’s-level opportunities out there.”

Graduate-level genetics programs are available through nursing schools at:

• Columbia University
• University of Iowa
• University of California, San Francisco
• University of Pittsburgh
• University of Washington

    – International Society of Nurses in Genetics

The Oncology Nursing Society recognizes three levels of oncology nursing practice in cancer genomics:

General oncology nurses

• Baccalaureate-level preparation
• Certification: Oncology Certified Nurse

Advanced practice oncology nurses

• Master’s-level preparation
• May have post-graduate preparation as clinical nurse specialists or nurse practitioners
• Certification: Advanced Oncology Certified Nurse

Advanced practice oncology nurses with subspecialties in genetics

• Master’s-level preparation
• May have post-graduate preparation as clinical nurse specialists or nurse practitioners
• Completed additional training in genetics, through continuing education and/or academic preparation
• Certification: Advanced Practice Nurse in Genetics

Genetics: The branch of biology that deals with heredity and variation in similar or related animals and plants. The genetic features or constitution of an individual, group or kind.

Genomics: The science that deals with genomes and their functions.

Genome: The total genetic information present in a somatic cell and unique to any specific organism.

– Webster’s Dictionary