Oncology Nurse Practitioners in Genetics: Examining Scope of Practice and Competence

Genomic science is rapidly evolving, and ordering germline testing requires appropriate and comprehensive assessment of a patient's personal and family history, as well as the knowledge base to facilitate selection of the best test or panel of tests, provision of pretest counseling for informed consent, interpretation of test results, post-test recommendations, and coordination of care for other at-risk family members. Prior to ordering germline genetic testing, an advanced practice RN's scope of practice accountability includes consideration of competence in the provision of genomic care. This article provides a case study to illustrate the complexities of issues related to competence when ordering germline genetic testing.