Role Exploration



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Role Exploration Mary A. Beyer NORFOLK, VIRGINIA Fall, 2011 Role Exploration Role Chosen The role I chose to examine is that of Geriatric Nurse Practitioner, or Gerontological Nurse Practitioner. I specifically chose this role because of my life-long affection for, and interest in, older adults. I especially enjoyed caring for older adults in my role as a registered nurse in the hospital. Educational Preparation

For entry into a nurse practitioner program, candidates must be graduates of a certified program in nursing that leads to a diploma, an Associate Degree in Nursing, or a Bachelor of Science in Nursing; must hold a current, active RN license and meet the undergraduate requirements and GPA of the desired institution. Some institutions require clinical experience in nursing, especially in the area of desired specialty as a nurse practitioner.

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For certification as a Gerontological Nurse Practitioner, the requirements, as set by the American Nurses Credentialing Center, begin with having a current, active RN license in a state or territory of the United States; a Master of Science in Nursing degree from a gerontological nurse practitioner program accredited by the Commission on Collegiate of Nursing Education (CCNE) or the National League for Nursing Accrediting Commission (NLNAC), which included a minimum of 500 faculty supervised clinical hours; course work in advanced health assessment, advanced pharmacology, and advanced pathophysiology; content in health promotion and disease control, and differential diagnosis and disease management. Then one is eligible to take the certification exam administered by the American Nurses Credentialing Center (ANCC) to become a Geriatric Nurse Practitioner, Board Certified (GNP-BC). The American Association of Nurse Practitioners (AANP) also offers certification as a Gerontological Nurse Practitioner (GNP-C). One can also e certified with a post-Master’s, PhD, or Doctorate in Nursing Practice (DNP), after having completed a gerontological program. A nurse practitioner specializing in the field of Adult care would also qualify to care for older adults. Responsibilities and Functions The Gerontological Nurse Practitioner (GNP) provides direct care to older adults by diagnosing, treating and managing acute and chronic conditions and those associated with aging, as well as palliative care. The GNP works independently, and in some states, under the supervision of a physician, in collaboration with other health care workers to render care to older adults, all done with input from their families.

The responsibilities of the GNP include: taking a comprehensive health history, including a mental health assessment, functional and psycho emotional assessments; a complete physical examination, use of pertinent screening tools to determine health status; ordering and/or performing pertinent diagnostic tests; analyses of test results and/or data collected –along with health care team, if necessary– to determine health status, and need for treatment; consult with, or referral to, other health agencies or resources; prescribing needed medications; developing and implementing with client, and caregivers/family members– along with the health care team– a plan to promote, maintain and rehabilitate health; evaluation of client’s response to care; collaboration with other health care professionals and health care agencies involved in client’s care. Practice Environments There are a variety of practice environments for the Gerontological Nurse Practitioner in urban and rural settings, including acute care in hospitals and rehabilitation facilities; long term care in nursing homes and assisted living facilities; ambulatory care in geriatric, medical and family practice clinics; home care through home health and hospice agencies, as well as working along side a doctor in his private practice, or in one’s own practice, if allowed by the particular state.

The job potential for GNP’s is particularly promising, as the elderly is the fastest growing segment of the population of the United States. This will continue to increase the demand for medical care for the elderly, especially in locations that are medically underserved, leading to increasing job availability for GNP’s. Salary The average salary for Gerontological Nurse Practitioners ranges from $75,000 to $90,000 and above. This variation is mainly dependent upon geographic location and employer. GNP’s in California, Hawaii, and New Jersey, for example, have the highest salaries compared to those in mid-western and southern states. Individual salaries are further influenced by, and increase with, additional education and experience. Being a GNP brings additional rewards.

There is the satisfaction of rendering quality care to a large and growing population that is in dire need of specialized care at this particular time in their lives. For me, it is the feeling of gratification that comes with knowing, that after a person has lived many years, I can be of help in making their final years as healthy and comfortable as possible, even when the need for palliative care arises. Most important, is the relationship that develops with the client, and the opportunity to learn from the experience with each individual. Positive and Negative Aspects Two major positive aspects of being a GNP– for me– are the feeling of gratification and satisfaction as stated above.

The ability to administer care independently, from assessment, ordering tests, prescribing medications, to evaluating patient response, is a totality of care that is unknown in the “normal” realm of nursing. The choice of location and the considerable income ––because of the demand for GNP’s nationwide– are pluses for me, because my husband will retire within/ at the end of the next three years: our retirement location is still uncertain and our income will be markedly reduced. A major negative aspect would be the emotional toll of caring for those whose in frail condition, knowing there is not much more that can be done for them, and more so, for their families and loved ones.

Likewise, the emotional attachment to the clients and their families, since in many cases, the care may be long-term. Summary While this is something I would like to pursue, I must think realistically about the time involved to be qualified for this role, given my present age of 55 years. When fully qualified, I will be approximately 61 years old. I am not sure that I want to be a student that long, nor am I certain I will be able to then physically carry out the responsibilities and functions involved. I now have a lot to consider, as I make decisions about my future as a nurse. For now, I am happy to continue on my present path to obtain my BSN, and make each decision as the occasion arises.

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