[NPInfo] genetics

Mon Sep 10 08:22:35 PDT 2007

Winifred, I agree that there are many sides to the genetics debate that should be considered when teaching this topic. While it may be important for a patient to know if she carries the breat cancer gene (for example), if her insurance company pays for this test, the information may be used to rate her risk and insurability. 

How confidential is this information if the patient is getting tested and receiving treatment paid for by their insurance? Also, how statistically accurate is genetic testing, especially for some of the newer tests? Your point that information not specifically requested could be included is very insightful.

Sue D in MI

 --- On Sun 09/09, nursinglaw at aol.com < nursinglaw at aol.com > wrote:
From: nursinglaw at aol.com [mailto: nursinglaw at aol.com]
To: npinfo at nurse.net
Date: Sun, 09 Sep 2007 23:39:06 -0400
Subject: Re: [NPInfo] Re: [NRSED] need some help with teaching genetics

As you incorporate genetics into your clinical curriculum, please keep in mind the ethical and policy considerations associated with genetics and include those within your respective coursework. Nurses should be aware of the ethical and privacy concerns that arise with the growing field of genetics and genome research.? First and foremost, who owns the gene sequence -- the person who donates the DNA, or all the members of the family with the same sequence, i.e. twins.? Is the genetic counselor (or nurse) responsible for making all parties with the same gene pool aware of the illnesses, ailments which manifest in the test of other kin?? And, what happens when one shares information when the individual who gave the DNA refuses to consent to disclosure of health information to kin? What happens when genetic information provides unintended information, i.e. paternity, and the granter of the DNA is a minor?? Should the hospital, counselor or nurse disclose the 
information? What if the DNA provides significant positive health information and the genetic information is used to develop drugs or vaccines -- again, who owns this information? Many of these questions have been answered, but some have not.? Discussions should occur about the ethical dilemmas which arise from having genetic information. On the regulatory side, is a nurse a genetics counselor?? It depends on the state and the regulation.? The person who teaches genetics should check state law to determine whether a nurse may be licensed or has been grandfathered in to serve as a genetics counselor.? And, if not, does the failure to be considered a genetics counselor limits actions or activities nurses may conduct related to genetic counseling and access to genetic information. I would make sure my students reviewed the ANA and ISONG standards as well. In short, just teaching the clinical aspects of genetics does not provide adequate support 
for nurses -- we need to review the ethical and regulatory consideratons as well. Winifred Carson-Smith, Esq. nursinglaw at aol.com 202/232-5193 202/232-5194 (fax) -----Original Message----- From: Margaret Allen <pegallen67 at yahoo.com> To: nrsinged at lists.uvic.ca; NAHRS at LISTSERV. KENT. EDU <NAHRS at LISTSERV.KENT.EDU> Cc: Npinfo at Nurse. Net <npinfo at nurse.net> Sent: Sat, 8 Sep 2007 4:44 pm Subject: [NPInfo] Re: [NRSED] need some help with teaching genetics Nursing & allied health librarians have been discussing how to integrate searching instruction into the curriculum to help promote evidence based practice. Including instruction on how to use database subheadings would be perfect for a genetics case study, especially when the basic content is introduced in basic courses. This could be in conjunction with content on prenatal testing, as well as oncology nursing. Your librarian should be 
available to teach how to do these searches using CINAHL and MEDLINE subheadings, and could even help grade the assignments (review bibliographies, search strategies, and APA or other formats). Note that one of the requirements of an integrative review is to note the search strategies and databases used - an example of another place for collaboration. If you are teaching online (partial or all), librarians should be part of your course faculty and grade some assignments so they can see if the students are understanding the content they present. Also, they can participate in entire course to suggest better references when online discussion is not based on current evidence. Their content can be online tutorials, not necessarily taking class time if you teach with combination of online and in-class methods (online enhanced instruction). Many offer Chat as well as email reference assistance - this can be embedded in the 
courses. Several colleagues are also educated in a health profession; many are RNs. I've copied to NAHRS list and will forward any ideas librarians share from other schools to NRSED - will also pass your comments to NAHRS. We wish that there was a CCNE requirement to work with librarians to teach accessing and using the peer-reviewed literature, as well as teaching assesment of quality in website information (things not published in peer-reviewed sources). It's not that easy anymore to tell what's what, with so many journals available via web-based databases. The same can be said for NLNAC and for Magnet hospital criteria. We are working with ANCC to suggest ways that the Magnet program could work with librarians serving hospitals. This effort is via the Nursing and Allied Health Resources Section (NAHRS) of the Medical Library association. Another librarian collaboration plug: clinical agreements should support 
 clinical agencies - especially hospitals - working with academic librarians and libraries to support the equivalent access to library resources in the academic and clinical setting. If students do not see staff using evidence based resources, they will not value this type of activity. I'm also copying this to the NP Info list, where they are discussing RN lack of knowledge re. EBP. Note that we librarians understand that evidence needs to be used along with assessment of patient preferences (NP Info talking about how some patients don't want extra "care" - they want to be as independent as possible - while others need more comfort/presence type care.) I'm sending this while staying with elderly aunt in assisted living apartment; she is independent Ph.D. who wants to do as much for herself as possible, yet needs more help with activities of daily living and also TLC/reassurance. Hope this helps - Peg 
 Margaret (Peg) Allen, MLS-AHIP P.O. Box 2, Stratford, WI, 54484 715-687-4976 Mobile 715-212-3635 Peg Allen, Library Consultant www.pegallen.net pegallen67 @ yahoo.com Coordinator, Hmong Health Education Network www.hmonghealth.org Health Information for the Global Village (MLA theme 1995) ----- Original Message ---- From: Nursing Educators Discussion List <nrsinged at lists.uvic.ca> To: NRSINGED at lists.uvic.ca Sent: Friday, September 7, 2007 3:49:15 PM Subject: [NRSED] need some help with teaching genetics Fellow Faculty, I need some assistance from those of you that are further ahead of us on this issue. One of the newer requirements of CCNE is teaching genetics to baccalureate nurses. Could you give me an idea of how you meet this requirement? Is it integrated in various classes or is it taught in one class and what is the depth and breath of what you cover? Thanks so much Sue Chubinski, 
 USF Ft. Wayne, IN ________________________________________________________________________ Email and AIM finally together. You've gotta check out free AOL Mail! - http://mail.aol.com _______________________________________________ NRSINGED mailing list NRSINGED at lists.uvic.ca https://lists.uvic.ca/mailman/listinfo/nrsinged _______________________________________________ NPInfo mailing list NPInfo at nurse.net http://lists.nurse.net/mailman/listinfo/npinfo ***************************** ________________________________________________________________________ Email and AIM finally together. You've gotta check out free AOL Mail! - http://mail.aol.com _______________________________________________ NPInfo mailing list NPInfo at nurse.net http://lists.nurse.net/mailman/listinfo/npinfo *****************************

_______________________________________________