Genetic testing is now the standard of care for common diseases such as cancer and heart disease, predicting risk and enabling earlier and more effective patient care. It’s an exciting revolution in patient care that has far-reaching potential and continues to grow and expand. But in Canada, we are not using all of our health human resources to take advantage of this important transformation in healthcare.
What’s missing are nurses.
Nurses are consistently rated the most trusted health profession and are the largest health care workforce in Canada, providing care to the most vulnerable and remote patients.
At the beginning of the revolution in genetics, nurses were educated to offer genetic care to patients. But the educational opportunities have not kept pace. Genomics services have become siloed, and Canadians are now unnecessarily waiting for care and answers to their common genetics questions.
Nurses are ideally positioned to ensure that patients have access to accurate genetic information about their disease conditions and care options – but they no longer receive adequate training. Our governments, professional societies and post-secondary institutions need to work together and find resources to address this significant gap.
According to the Canadian Nursing and Genomics Initiative (CNGI), Canadian nurses lack crucial supports in their basic and continuing education about genomics when compared to nurses in other countries, such as the U.S. and the UK, where nurses are expected to provide information on condition, inheritance and treatment options for patients using relevant genetic counselling skills.
A recent survey of more than 1000 Canadian nurses revealed that while many patients seek nurses’ knowledge about genomics, nurses report wanting to learn more to better help their patients. Canadian nurses and their patients are missing out.
Basic nursing education should ensure new nurses are prepared to help patients understand their genomic test results and offer strategies for talking about results with family members. Basic nursing education should also prepare nurses to identify people who might benefit from genomic services, answer questions on genetic testing, and help people make lifestyle changes to lower risks.
To deliver this education, nurse educators need programs, supports and incentives to develop their own competency in genomics.
A health care system that expects nurses to provide genomics-informed care must provide proper training. Canadian health systems are ripe for re-design to better utilize nurses to meet the needs of patients, families and communities affected by genetic conditions and risks.
Nurses in the workforce need to be equipped with genomic knowledge about their patients through continuing education courses, toolkits and clinical decision support aids. These resources are available to nurses in other countries, and they are making a difference to the quality, accuracy and safety of
patient care.
Canada is falling behind
Armed with genomics knowledge, nurses could work more effectively with genetic counsellors, physicians and pharmacists to provide care to thousands of people requiring genomics services.
Imagine the impact of Canada’s nearly half a million nurses, once armed with genetics knowledge. Genetic testing can only improve health when health care professionals can employ the results.
Knowledge about genetic testing, risks, and therapies needs to be better integrated into nurses’ basic and continuing education programs, to get into the “DNA” of the nursing profession.
Nurses are poised to deliver the world-class health care Canadians expect – employing their knowledge of genetics to provide the best patient care.
By Nicole Letourneau and Jacqueline Limoges
Nicole Letourneau PhD RN FRSC is a Professor and University of Calgary Research Excellence Chair in Parent and Child Health.
Jacqueline Limoges PhD RN is an Associate Professor at Athabasca University and co-lead of the Canadian Nursing and Genomics Initiative.