Genomic-based health care in nursing: a bidirectional approach to bringing genetics into nursing's body of knowledge.

Nurses can expect to become partners with patients and their families as genomic-based health care brings decisions involving gene-based diagnostics and therapeutics into commonplace practice. All health professionals need genetic literacy to continue competence in clinical practice in the future. This article explores the efforts nursing has undertaken during the past decade to integrate human and clinical genetics into practice and scholarship. Genetics nursing education literature in the second half of the 20th century was analyzed. A focused survey of 15 genetics nurses and nursing leaders regarding key national initiatives, genetics research training programs, and genetics education models was conducted. Nursing has taken a bidirectional approach (through grass roots and top-down initiatives) to implementing change and advancing genetics in nursing practice, research, and education. For optimal leadership in genetics education for nursing and other disciplines, bidirectional efforts must continue and concentrate on bringing genetics into clinical practice and scholarship as genomic-based health care spreads worldwide. Evidence of nursing's interdisciplinary leadership is recognized. Recommendations and strategies for continued nursing leadership and programs that build on previous work are presented.