Genetics and genomics have become one of the most important areas in healthcare. COVID-19 has most recently shown that when rapid changes are needed, genetics is strongly involved in elucidating the etiology of diseases such as describing the pathophysiological mechanisms or developing therapies and vaccinations (Pairo-Castineira et al., 2021). Genomic-based information is important in healthcare, for example, in more accurate diagnostics of diseases, tests of molecular mechanisms of diseases for personalized drug treatments, pharmacogenetic tests for the anticipation of adverse drug treatment effects, and targeting of disease screenings (Ministry of Social Affairs and Health, 2015). Previously, genetic testing had been focusing on single-gene diseases. Now, there has also been a shift from this reactive testing to proactive testing with genome-based studies adding the prevention of multifactorial diseases to the competence list for professionals (Mills and Haga, 2014). It is obvious that this shift requires a new kind of expertise from healthcare staff. Not only the development of science but also the public awareness of genomic knowledge creates an additional need for education. Citizens have easy access to new genomic information through direct-to-consumer services, and this has created an entirely new need for knowledge for workers in healthcare. Therefore, it is evident that applying genomic information into practice is no longer only specialists’ work (Saleh et al., 2019).

To accomplish these demands, building comprehensive competencies for genomics in nursing is essential. In studies measuring genomic competence of nurses or midwives, the knowledge level has been described to be low to average (Skirton et al., 2012; Calzone et al., 2014; Wright et al., 2019). Nurses have indicated that it is important to become more educated about the genetics of common diseases (Calzone et al., 2014). According to Camak’s (2016) review, nurses are underprepared for incorporating the applications of genetics and genomics to patient care, and they have shown low confidence in delivering genetics (Williams and Dale, 2016), but nurses who had taken genetics courses since licensure reported higher confidence than those who had not attended any genetics education (Calzone et al., 2014). Newcomb et al. (2019) noticed that nurses performed genomic activities rarely in their clinical work. Therefore, it is clear that confidence in skills does not yet exist, and competence must be strengthened within all the nurses at all levels and across all specialties.

Public health nurses (PHNs), working in primary or occupational healthcare are at the forefront of receiving citizens with the genome test results they have purchased. They also discuss with patients about the genomic data effects on patient families, possibilities of receiving secondary test results, and other ethical issues in the process of acquiring informed consent. In addition to this, PHNs are vital in observation of adverse drug reactions in homecare. However, Goda et al. (2019) reported that public health nurses encountered difficulties in recognizing the genetic issues and were not conscious of them while providing their professional services. In a study of Kawasaki et al. (2021), PHNs benefited from education and achieved deeper understanding of genomics and their own role in patient education with genomic issues.

The long-term goal of genomics is said to be a reduction of health inequalities (Ministry of Social Affairs and Health, 2015). Public health nurses have a significant role in achieving this. Their competencies include implementing strategies to reduce health inequalities in population and at the individual intervention level (Mabhala, 2015). Although activities at the community level are not performed as often as at the individual level in PHNs’ daily work, both are core responsibilities (Haron et al., 2019). At the individual level, mitigation of the impact of genetic risk and lifestyle counseling are a part of the preventive services delivered by public health nurses.

It is recognized in the Finnish National Genome Strategy (Ministry of Social Affairs and Health, 2015) that the capacity of healthcare professionals to use and implement genome-based information should be strengthened. Nurses are vital professionals in implementing information and achieving the goals of genomic information in their day-to-day work with patients (Whitley et al., 2020). Nursing is the largest healthcare profession. There are about 60,194 nurses, 9,301 public health nurses, and 2 417 midwives in Finland working as employees and entrepreneurs (OSF, 2019). The number of nursing students graduating and entering working life each year is about 4, 000 in Finland. In 2020, this consisted of 3, 076 nurses, 669 public health nurses, and 36 midwives (OSF, 2021). Such a large workforce should not be overlooked. Thus, attitude, perception, confidence, and knowledge of genomics of all nurses are essential factors when integrating genomic applications into practice.

In the last decades, nursing education contained little of genetics (Calzone et al., 2014; Calzone et al., 2016; Wright et al., 2019), and most of the current nursing workforce graduated before this genomic era. Effective education is, therefore, needed both at the undergraduate level and from the perspective of continuing education (Whitley et al., 2020).

The lack of published core genomic competencies of nursing at the national level in Finland led to the development of education. Tampere University of Applied Sciences has been profiled for the extensive use of gene and genome information in healthcare. The PROFITU strategic project (years 2019–2021), funded by the Ministry of Education and Culture, has developed curricula in the fields of healthcare, both bachelor and master levels, by adding studies related to genetics and genomics into the curricula. In addition, continuing education has been planned for different target groups, which has increased due to the need of working life.

This article describes the process of development and lays emphasis on the importance of genomic education of public health nurses.

Health promotion is changing rapidly due to genomic information. Nonetheless, there is a debate about whether genomics can bring anything new to health promotion. What is new about genomics to promote community health and whether diseases are overemphasized at the expense of health? In addition, the technology associated with the genome has also been questioned. (McBride, 2008; Terry, 2020). Thus, genomic science is developing and making the implementation challenging. (Whitley et al., 2020). It must be noted that the change is taking place and that it must also be prepared from an educational point of view. We agree that genomics will come to play a vital role in precision public health and health promotion, but it also requires concurrent knowledge on the basic variables of health promotion such as determinants of health, environmental factors, and health education methods. (Terry, 2020). This means new responsibilities to the public health nurses. The education of PHNs covers the basic elements of health promotion in different age groups. As a result, they play a key role when implementing genomic information into preventive precision public health.

As science takes steps forward in work life, education should be at the forefront of this development and to prepare nurses to face future demands. Nurses often experience considerable strain at work with demands from new competencies (Hasson & Arnetz, 2008). Education can transform requirements into a resource to experience new aspects, such as genomics, that stimulates professional growth and development to achieve work goals more effectively, and to provide high-quality nursing care as Broetje and Jenny (2020) describe. We agree with the consensus panel when they emphasized that in genomics, it is essential to define what a nurse (all academic levels, roles, and clinical specialties) is required to know about genomics to achieve competency (Consensus Panel, 2009). However, the challenge is that there is a gap in knowledge among the healthcare professionals and many competing priorities in nursing (Whitley et al., 2020). To fulfill these challenges, there is a need for close cooperation with the various stakeholders. Educational organizations are responsible for this development work together with working life. It is important to create a new type of training that increases the skills of those already employed. In an area as renewed as the genome is, it is vital to work closely with the scientific community as well. In this way, educational organizations are always able to be at the forefront of new knowledge and develop confidence in knowledge of and communication skills about genomics. This might allow nurses personal investment to drive learning new skills. (Whitley et al., 2020).

In this educational development, TAMK was a pioneer, both nationally and internationally. National development can often be slow, and therefore it is important that TAMK is able to develop new types of expertise in healthcare. Large-scale integration requires commitment from the education organization and its management. Adding something new, such as comprehensive content, takes time, investment, and administrative/management support. Funding was also crucial in enabling us to train teachers on new knowledge. Finnish Ministry of Education and Culture partially funded the TAMK PROFITU–project to profile new competencies to general and public health nursing as a pioneer education organization. However, the following years really show how successfully genomics was integrated when the new curricula are in place and evaluated. In addition, the courses should be constantly evolving in-line with the developments in genomic research and genomic nursing practical needs. Development work with international partners will continue, for example, as a virtual student exchange at the master level. In addition, new Erasmus + funding will create new possibilities internationally.

Genomic nursing is still looking for its direction and its operating environments in Finland. The nurses are experts in their fields, so their expertise in genomic knowledge should be visible in nursing activities too. The utilization of genomic knowledge requires multidisciplinary collaboration (Syurina et al., 2011), and nurses have their part and role to play in that collaboration. No one is going to give that role to nurses from the outside. In addition, the development of genomics in nursing does not mean passively waiting for something to just happen or waiting for someone else to say or determine what genomic nursing expertise is. Nursing managers, educators, and researchers should take an active role so that genomic competencies can be increased in nursing care.