Nurses revisit assessments: Genomics allows the identification of red flags earlier

By Janice Petrella Lynch, RN, MSN
Nurse Editor/Nurse Executive
Jan Lynch, RN

Jan Lynch, RN

Over the past several decades, genomics has grown and changed exponentially, with words such as “revolutionary” and “new era” being used to describe the advances. Actress Angelina Jolie recently brought the science center stage with her decision to have a double mastectomy based on testing results. People are discussing the real possibility of having whole-genome sequencing, and experts are predicting that in the future every newborn may have it.

In genomics, scientists study all genes in the human genome together, their interactions with one another, and how environmental, psychosocial and cultural influences affect them. In cancer research, genomic breakthroughs are transforming the scope of care and treatment as scientists learn how genomes contribute to cancer risk assessment, prevention and diagnosis. Some experts say that in years to come, cancer will be considered a chronic, manageable condition with sequencing of tumors and individually tailored drugs. Nursing studies are underway on how certain associated risk factors can contribute to a broad range of other conditions, such as autism spectrum disorder, metabolic syndrome and cardiovascular disease, and the evidence being gathered is providing a greater understanding of patient health and well-being.

All of this is changing how we care for our patients. It’s becoming clear that regardless of specialty, education or experience, nurses must know about genomics and the implications for practice and patient outcomes. Each time a nurse takes a patient history, it’s a golden opportunity to be a case finder, looking for markers that can provide crucial information about that patient’s disease risk and susceptibility. Understanding the meaning of contributing factors, such as patient age at disease onset, ethnicity, and environmental and psychosocial issues, also is essential. Listening and really hearing what patients have to say can help avert late referrals, treatment delays and insufficient patient education.

Patients are realizing they have the right to access their genetic information, and that they can use it to modify their lifestyles and improve their health. With more information becoming available on genetic, behavioral, biomedical and other risk factors, patients are more savvy about the need for precautions such as health screenings, improved diets and increased exercise. They’re looking to their medical providers and to nurses — the ones they trust most — for guidance.

Nurse.com’s top news story this week explores innovative initiatives to help nurses build a knowledge base on the science.  A key goal is to give nurses confidence in raising genomic concerns with primary care providers and discussing their significance in patient care.

Let’s look at the burgeoning science of genomics and nursing’s role in it as opportunities to renew our belief in the value of nursing assessments and the importance of finding red flags in patient histories. Clear documentation is crucial, as is timely communication with the healthcare team and the patient. Let’s empower patients to take charge of their health and incorporate preventive strategies into their daily lives, and direct them to the most appropriate services.

Continuing Education Resources:

The Role of the Nurse in Genomics (Take this course for FREE till Jan. 10.)

Preventive Mastectomies: Smart Decision or Going Too Far? (Take this course for FREE till Oct. 24.)

Genetics: Part of Nursing Practice

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