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As of the US Census Bureau’s most recent report published in 2011, there were approximately 40.5 million Americans meeting the criteria for geriatric care. These Americans, age 65 and older, comprised 13% of the total US population. The Bureau projects that by 2030, that number will be closer to 72 million. Baby boomers consist of approximately 77.6 million Americans who consume 77% of all medication prescribed in the US today. As this segment of the population ages, they will further drive the demand for advanced practice gerontological nursing services.
According to the American Academy of Nurse Practitioners’ March 2012 report, Gerontological nurse practitioners (GNPs) make up 3.2% of all NPs in practice. The unique level of expertise they bring to geriatric care is reflected in the fact that GNPs in the US have an average of 11.6 years of nursing experience.
Among the considerations unique to gerontological care are age-related impairments include everything from blindness and hearing loss to dementia. Geriatric nurse practitioners (GNPs) must be mindful of environmental, circumstantial, and behavioral factors related to falls, malnutrition, elder neglect and abuse, and end-of-life directives. Gerontological nurse practitioners often serve as primary care providers, offering whole patient care, or as team leaders, coordinating the services provided by nursing staff, dieticians, social workers, psychologists, and physical therapists to ensure that patient needs are met.
Working under collaborative agreement with generalists, gerontologists, or other specialist physicians, GNPs assess and evaluate patients to determine social history and identify environmental and behavioral risk factors; order diagnostic tests and interpret results; diagnose ailments and illnesses; design, coordinate and manage patient care; prescribe medication; and council patients and their families.
Working in a long-term care facility provides a unique experience as compared to a conventional clinical setting. In a long-term care facility, GNPs have the ability to see patients on a daily basis. This creates a situation conducive to compiling clinical observations, while earning trust and building rapport, resulting in solid relationships with patients and their families.
Education and Degree Options
Gerontological Nurse Practitioners hold master’s degrees, post master’s certificates or doctorate degrees specific to the geriatric patient population focus. While the overall credit and clinical requirements of programs vary, most graduate-level programs are designed to meet the certification requirements of the American Nurses Credentialing Center and the American Academy of Nurse Practitioners through a combination of classroom learning and clinical preceptorships focused on the distinct needs of an aging population.
Expect graduate level programs to include core APRN courses in advanced pathophysiology, advanced pharmacology, and advanced physical assessment specific to the patient population, as well as gerontological nursing theory, statistics, and research methods. Standard course content also includes health promotion and disease prevention, as well as differential diagnosis and disease management.
Doctor of Nursing Practice programs in gerontological nursing include didactic and clinical study in evidence-based practice, informatics, and epidemiology. Doctorate level programs include an internship that will allow students the opportunity to focus on subspecialties like palliative care, oncology, or cardiology.
Post-Master’s certificate programs provide patient population focused advanced education to RNs who hold an existing MSN. Highly specialized post-master’s certificates include:
- Gerontological Social Policy
- Gerontology with Focus on Management of Aging Services
- Occupational and Environmental Health
- Geriatric Exercise Science Track
- Geriatric Oncology
- Geriatrics and Mental Health
Certification
Completion of a graduate, post-graduate certificate, or doctorate level program accredited by the Nursing Accrediting Commission (NLNAC) or the Commission of Collegiate Nursing Education (CCNE) will prepare students to take the national gerontological certification exams offered by both the American Nurses Credentialing Center and the American Academy of Nurse Practitioners. Eligibility to sit for the exams offered by these two certifying bodies is also contingent upon holding an active RN license. Recognition or licensure as a gerontological nurse practitioner granted by state Boards of Nursing requires first becoming certified by one of these two certifying bodies.
The American Nurses Credentialing Center awards the GNP-BC credential to qualified applicants who pass their national certification exam.
The American Academy of Nurse Practitioners awards a combined Adult-Gerontology Primary Care NP Certification.
Associations
The Gerontological Advanced Practice Nurses Association (GAPNA) is an organization geared specifically for NP’s in the field of geriatrics. This organization advocates for continuing education, offers education material on issues specific to the geriatric population, and advocates for the needs of geriatric citizens. The GAPNA works with other known associations to continually improve the care offered to geriatric patients.
The National Gerontological Nursing Association (NGNA) is geared to all nurses providing gerontological care, advanced practice or otherwise.
Salary
The average among respondents to the 2011 National Salary Survey published by Advance for NPs & PAs showed that NPs working in geriatrics earned an average salary of $94,485. Non-salaried geriatric nurse practitioners working part time earned $49.41 per hour on average.