Genomics and Personalized Medicine: What Nurses Need to Know

By Jennifer Larson, contributor

June 27, 2013 – Jean Jenkins, PhD, RN, is extremely enthusiastic about the potential of genomic research and genomic medicine.

“It ultimately will be the foundation for all care that’s provided,” said Jenkins, a clinical advisor for the Genomic Healthcare Branch for the National Human Genome Research Institute (NHGRI).

One way that nurses and others can learn more about the development and evolution of genomic science is to explore a new Smithsonian Institution exhibition titled Genome: Unlocking Life’s Code at the Smithsonian National Museum of Natural History in Washington, D.C. It is the result of a collaborative effort between the Smithsonian and the National Institutes of Health (NIH).

The opening on June 14, 2013, was timed to coincide with the anniversary of two major scientific breakthroughs. This year marks the 60th anniversary of the discovery of the DNA double helix, and just 10 years ago the entire scientific community celebrated a major landmark: the completion of the Human Genome Project. Researchers had successfully mapped the exact order of three billion genetic letters of the human genome.

The age of personalized medicine

The exhibition has opened at a watershed time for personalized medicine. The cost of DNA sequencing has dropped dramatically in recent years, opening up the possibility for testing to more and more people. The field of oncology has begun to incorporate genomic information into new and powerful cancer treatments. The NHGRI has launched research initiatives to delve into the applications of genomic approaches for the treatments of a variety of disorders. Additionally, the U.S. Supreme Court recently ruled that human genes can’t be patented.

As a result, genomics is becoming more and more interesting and relevant to the general population, as people start to wonder how genomics might affect them and their family members’ health, noted Meg Rivers, an exhibition developer with the Smithsonian.

“That really informs the topics that we cover,” she said of the exhibition, which includes three main content areas: (1) The Genome Within Us, which gives an explanation of the genome; (2) Your Genome, Your Health, which explores the relationship between genomic research and medicine; and (3) Connections: Natural World and Genomic Journeys, which shows the connection between humans and all life on the earth.

The Genome: Unlocking Life’s Code exhibit will remain open through the fall of 2014, when it will pack up for a four-year tour around North America.

The nursing connection

Many health care professionals are excited by the potential of genomic medicine because they know it can lead to personalized treatment plans for patients–plans that take into account not just a person’s traditional risk factors, but also their very specific genetic information. Given the more targeted approach, the belief is that these treatments should be more effective.

Laurie Badzek, JD, RN, a researcher with the West Virginia University School of Nursing, believes that nurses should take a closer look into genomics and genetics. After all, genomics research is paving the way for new treatments that will be able to provide more targeted care for their patients.

“It’s the future,” said Badzek, who is directing a study on making connections between genomics and nursing care.

A 2009 primer for nurses by Dale Halsey Lea, MPH, RN, that was published for the Online Journal in Nursing sums it up this way: “A basic knowledge of genetic terms and concepts and an understanding of genomics can provide nurses with a foundation that will enable them to provide competent, personalized healthcare.”

Along with Jenkins and Kathleen Calzone, PhD, Badzek is working with teams of educators and administrators from 20 hospitals with Magnet status from the American Nurses Credentialing Center (ANCC). The teams are designing interventions to help nurses better understand the connection between genomics and the bedside care that they deliver to their patients.

“This is the direction that medicine is going, and we will be [compelled] to follow its path,” she explained.

Because of their particular role in the caregiving process, nurses will be very important in helping people grapple with many of the issues that are raised when they are considering the results of genetic screening and trying to plot a course for their future.

“If they’re well informed, nurses are well positioned to help patients think things through,” Jenkins said.

Nursing education catching up

Jenkins hopes to see genetics and genomics integrated into the curricula at nursing schools. While stand-alone courses are a good start, eventual integration is essential.

Right now, many faculty members are learning about genomics at the same time that their students are learning about it. But that hopefully will change, Jenkins said, noting that the American Association of Colleges of Nursing (AACN) has been working to help faculty get up to speed on education strategies for the application of genomics to nursing practice.

Resources that are helpful for educators include Essentials for Genetic and Genomic Nursing: Competencies, Curricula Guidelines, and Outcome Indicators, 2nd edition, for which Jenkins was co-chair, and Essential Genetic and Genomic Competencies for Nurses with Graduate Degrees.

Learn more: Genomics resources for nurses

Nurses who are interested in learning more about genetics and genomics, including how they will impact nursing practice in the future, can check out the following resources: