Marcia Van Riper, has a joint appointment in the School of Nursing and the Carolina Center for Genome Sciences at the University of North Carolina at Chapel Hill. During her stay at the Universidad de Navarra of School of Nursing, she taught a workshop on family-centered genomic health care for undergraduate students and a variety of other seminars and sessions for graduate students and faculty. She also spent time consulting with faculty and students. In this interview she talks about the main challenges of nursing today.

Your program of research has focused on the family experience of being tested for and living with a genetic condition. You are a strong advocate of using a family approach in the care of patients with genetic conditions. Why is it so important for nurses to use a family approach?
I truly believe that we need to use a family approach in the care of all our patients. However, using a family approach is especially important in the care of people being tested for and living with genetic conditions. There is growing evidence that families influence and are influenced by how individual family members make sense of, respond to and use the information they receive during the genetic testing experience. Although the DNA sample used to conduct a genetic test is obtained from an individual, the individual's decision to undergo testing, as well as the individual's test results, can have profound and enduring implications for other family members and the family as a system. Moreover, much of the care provided to individuals living with genetic conditions is provided by family members within the family setting. I am very interested in understanding more about how we, as nurses, can help individuals and families make choices about testing for, and treatment of, genetic conditions that fit with the beliefs, desires and values of our patients and their families.

How would this impact the treatment?
Nurses who take the time to hear a family's story are likely to provide care that is higher quality and more efficient than nurses who do not. Knowing what is most important to our patients and their families makes it possible for us to tailor the care we provide to meet any unique needs and concerns. It also leads to improved family-nurse collaboration which may result in enhanced family communication and increased support for family members. Nurses who know a family's story can share this information with other professionals caring for the patient and this is likely to improve the care quality and efficiency. It is also likely to lead to greater patient and family satisfaction with care, as well as greater job satisfaction for nurses and other health care providers.

Does this focus on the family represent a challenge?
Yes, a gap still exist between family theory, research, education, and practice. In many clinical settings, family nursing is visibly absent or developing very slowing. Many nurses and other health care providers do not "think family." Instead, they continue to think in an individualistic manner rather than thinking in an interactional manner. Many health care providers continue to believe it takes to much time to use a family approach to care. I and many other family nurses in the world (including Professor Cristina García-Vivar and others in the School of Nursing) have argued that if you take the time to understand the family perspective, you actually save time because you are able to tailor the care you provide.

Finally, how was your experience at the School of Nursing of the Universidad de Navarra?
I have been very impressed with the faculty, students and staff I have met, as well as the activities I participated in or observed. I had the pleasure of interacting with a wide range of faculty and students. As a whole, I found them to be engaging, thoughtful, passionate, hardworking and eager to learn more. I have been impressed by the nature and quality of the educational programs offered here, as well as the research being conducted. Being a family nurse who is passionate about transforming health for families worldwide, I think it is wonderful that you offer an elective course in family nursing. I also think is great that you have such a strong international program. I am looking forward to future collaborations.