Describe how you see genetics playing a role as you see patients in your first clinical rotation, which will be primary care settings for all students. I’m a family Nurse Practitioner student
•Pose one question to your discussion group related to your readings or the webinar.
Outstanding/distinguished. Accurately addresses questions. Thoughtful and astutely analytic or original; connect to previous or current content or real life situations; fully develop ideas, connections, or applications; and virtually free of grammatical errors or typos. The post will facilitate learning for your fellow students. This corresponds to an A.
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• I see genetics playing a significant role in the patients I will see in my first clinical rotation. As evidenced by the webinars presented by the American Academy of Pediatrics, genetics and genomics are continuing to have a more prominent role in health care today. Of particular interest is the role of genetics in primary care. I found it interesting that 100% of pediatric primary care providers felt that taking a family health history is important but only 32% obtained the recommended three-generation family history (American Academy of Pediatrics [AAP], 2016a). To me, this demonstrates a need for education on what a health history should include and what sort of DNA testing should accompany certain findings. Obtaining an accurate and thorough family health history is a crucial component of genetic medicine. The family health history helps providers identify hereditary disorders, determine inheritance patterns, determine recurrence risks, identify at-risk individuals and identify individuals who are not at risk (AAP, 2016b). As a nurse practitioner student, I will have the opportunity to accompany my preceptor in obtaining an accurate health history. It will be important for me to understand the critical components of the health history and when to relay this information to my preceptor. A thorough family health history can improve, prevent or delay many adverse outcomes for patients (AAP, 2016b). For example, according to a 2007 census birth defects alone accounted for 21% of all infant deaths in the United States (Newborn screening and the era of medical genomics, 2015). This shows how important obtaining a newborn screen is and the importance of genetic testing. I also found it interesting that in one hospital in Cleveland 71% of the 4224 kids admitted to the hospital had a disorder of genetic causality or susceptibly (Newborn screening and the era of medical genomics, 2015). These statistics demonstrates the importance of genetic testing and the role it can play in preventing many adverse outcomes.
While most clinicians recognize the importance of obtaining an accurate family health history, there is a reason why it is often difficult to obtain. Some of the barriers to obtaining a complete family health history include a lack of time, incomplete records, inaccessible family members, incorrect or vague diagnosis, fear of discrimination/stigmatization and multiple caretakers for children (AAP, 2016b). These are just a few of the barriers and there are many more out there. As a nurse practitioner student, not only will I be responsible for obtaining a complete history, but I will also be responsible for educating my patients. The educational component is very important. There are many myths out there about genetic testing, and as a practitioner I will need to be educated about these myths and be able to answer many general questions about genetic testing. Some myths that are out there about genetic testing are that it only screens for rare diseases, insurance does not pay for it, that genetic testing leads to discriminations and that genetic disorders are not treatable (AAP, 2016a). A significant number of individuals believe these myths, and it is the practitioner’s job to educate these patients about the facts and dispel any myths.