Adult-Gerontology Nurse Practitioner Specialization Guide - 2022

Last Reviewed: September 30th, 2022

What does an Adult-Gerontology Nurse Practitioner do?

According to the US Census, for the first time in US history, older adults are projected to outnumber children under age 18 by 2034. With this growing population, the need for medical professionals that are properly trained to take care of the elderly is critical.

Nurse practitioners that are interested in furthering their careers and caring for elders may consider choosing a career as a Nurse Practitioner that specializes in geriatrics. Geriatrics is a branch of medicine that provides medical treatment for patients above the age of 65 years old.

Adult-Gerontology Nurse Practitioners (AGNPs) may act as primary caregivers to the elderly, can diagnose illnesses, and prescribe medications in some states. Individuals that choose a career path as an AGNP will outline a primary care path for patients through clinical and non-clinical skills.

These skills may include:

  • Clinical skills such as emergency medical procedures, administering blood transfusions, and performing procedures such as catheterization.
  • Communication skills to articulate health status and treatment plans to patients and their families. Communication skills include providing information in a clear manner that is also compassionate towards their patients.
  • Analysis skills to regularly examine patients’ medical history, home environment, and social factors to create or revise treatment plans. Analysis skills are especially important if the AGNP must get a patient’s history from a caregiver or family member, which would require that the AGNP make conclusions about the accuracy of the information given.
  • Critical thinking skills as patients’ care and needs may change over time as their health issues improve or worsen. AGNPs must be able to adapt to these changes in order to provide the proper level of care that their patients need.
  • Patience in working with elderly patients as many older patients struggle with memory loss and may have a difficult time remembering instructions. It is important that AGNPs are calm, patient, caring, and can adapt to their patients’ needs.
  • Care coordination skills to assist patients with complex treatment needs to ensure they receive the proper care from their medical team.
  • Understanding the aging process and geriatric health issues, including the effects of aging and chronic illness on the physical, mental, psychological, and emotional aspects of their patients.
  • Providing support and education about aging. Learning this skill allows AGNPs to provide information to patients and their families on how to properly receive care and what to expect from the aging process.
  • Developing treatment plans for chronic illnesses. Learning how to properly manage chronic illnesses for elderly patients is essential in ensuring patients receive proper long-term care.

Geriatric Nurse vs Adult-Gerontology Nurse Practitioner

Similarly, a Geriatric Nurse will also work with the elderly population and know how to take care of elderly patients with chronic illnesses.

The main difference between Adult-Gerontology Nurse Practitioners versus Geriatric Registered Nurses is that a Geriatric RN is an entry-level position and is responsible for carrying out the treatment plan, whereas an AGNP will work to diagnose illnesses, can prescribe medications based on state legislature, and can develop the treatment plan with physicians and other members of a multi-disciplinary team.

Geriatric Registered Nurses are not allowed to prescribe medications, diagnose patients, or create treatment plans. The benefits of becoming an AGNP is that there is more autonomy, a greater scope of practice, and increased earning potential. It is however important to mention that specific roles and responsibilities for both Geriatric RNs and AGNPs will vary according to specific state regulations and licensures.

Most nurse practitioners work full-time jobs and can work in a hospital setting or outpatient setting. Those working in acute care may be required to be on call for certain hours.

There are two types of Adult-Gerontology Nurse Practitioners: acute care and primary care. Acute care nurse practitioners help adult and geriatric patients with health issues that can be fixed quickly, such as acute illnesses or injuries. Acute care nurse practitioners will also typically work in a hospital setting or emergency room setting. In contrast, primary care AGNPs can form long-lasting relationships with patients as they take care of elderly patients with chronic illnesses and help them through the aging process.

A Day in the Life of an AGNP

A typical day as an Adult Geriatric Nurse Practitioner will include:

  • Collecting and recording medical history
  • Assisting with activities of daily living such as eating, dressing, ambulating, using the bathroom, bathing
  • Ordering tests as needed
  • Interpreting test results
  • Explaining conditions or results the patient, family, and other members of the care unit
  • Creating a care plan and educating the patient and family on the plan
  • Administering medications to patients
  • Treating critical or chronic conditions such as cancer, obesity, heart disease, stroke, and diabetes
  • Treating injuries that are caused by falls such as fractures of an arm, wrist, hip, or ankle
  • Monitoring vital signs and comparing to previous data

These daily activities as an Adult Geriatric Nurse Practitioner will vary depending on if they are in acute or primary care, in a hospital setting, or in an outpatient clinic. Daily activities will also vary upon state legislature and laws based on their scope of practice.

Career Stability and Projections

According to the US Bureau of Labor and Statistics, Nurse Practitioners is the fourth fastest growing occupation projected from 2020 to 2030. Nurse Practitioner jobs are projected to grow 28.2% from 2018 to 2028.

This projected increase can be attributed to the fact that the adult population is likely to increase dramatically as the Baby Boomer generation increases in age. Baby Boomers are the second largest generation in the United States, at an estimated 73 million.

Other attributions to this increase in the need for healthcare workers include longer lifespans due to improvements in medical care, and also record-low birth rates.

Another factor causing Nurse Practitioner jobs to increase is because there is a shortage of primary care professionals in the United States. This shortage allows for a growth of Nurse Practitioner positions as Nurse Practitioners can have the ability to diagnose, treatment plan, prescribe medications (dependent upon their practicing state), and provide other important functions that can supplement the shortage of primary care providers.

Another reason there is a projected job increase in Nurse Practitioner jobs is because Nurse Practitioners are starting to become recognized as key members in healthcare, in comparison to the typical career route of becoming a physician.

Some individuals may choose the Nurse Practitioner path over a traditional physician path as it is more cost and time effective in obtaining a career that is fulfilling and is compensated well, in comparison to the years and loans needed to complete a physician’s career path. For example, becoming a Nurse Practitioner may take on average six to eight years, compared to at least ten to twelve years to become a physician.

A recent survey conducted by Clinical Advisor stated that over a quarter of all nurse practitioners currently work in offices. Nearly 20% worked in independent clinics and another 15% worked in a hospital clinic. Only approximately 14% actually worked in hospitals. This contributes to the projected increase in Nurse Practitioner jobs as there is an increased demand for outpatient centers.

The projected growth in demand for outpatient care nurses is significant and believed to be around 20%. Nurse Practitioners are also in demand as there is a projected need in rural and underserved areas. With the ability for Nurse Practitioners to diagnose, treatment plan, and potentially prescribe medications, choosing a career path as a Nurse Practitioner could greatly improve access to care for underserved areas.

Career Satisfaction

A study conducted in June 2016 assessed how satisfied Nurse Practitioners (NP) felt in their careers based on several factors. In this study, the respondents were 93% female, 87% white, 5% held doctorate degrees, and 49% worked in a primary care setting.

In this study that assessed the responses of over 9,000 nurse practitioners, the strongest predictor in career satisfaction was whether or not nurse practitioners felt like their skills were being fully utilized. NPs that felt like their skills were being fully utilized scored an entire point higher than those NPs that “strongly disagreed” that their skills were being fully utilized.

NP career satisfaction was also related to their working relationships with physicians, although this point affected their career satisfaction to a smaller magnitude. Their research suggests that NPs who work independent of physicians had a slightly higher satisfaction score by 0.2 points. This result could be due to NPs having more autonomy and more involvement in leadership and organizational roles when working independently of physicians.

In general and on average, NPs were “satisfied” in overall job satisfaction, “satisfied” with respect from other colleagues, and “satisfied” with the sense of value with what they do. NPs were “slightly less satisfied” with the respect they receive from physician colleagues and were “least satisfied” with their input into organizational practices and policies.

A study published in the Plastic Surgical Nursing Journal found that 100% of participants agreed that mentorship for nurse practitioners that are just beginning their careers lead to increased levels of job satisfaction. This mentorship allowed NPs to feel a sense of community and direct access to availability should they have any questions regarding their treatment or care of patients. This increase in job satisfaction led to happier work environments and is correlated to decreased job turnover and in turn improved patient care and outcomes.

Biggest Complaints as a Nurse Practitioner

Although having a career as a Nurse Practitioner can be very rewarding, individuals pursuing this career path should take into consideration some of the most common complaints of being a NP. These complaints include long shifts, emotional and mental fatigue, education and qualification requirements, legal risks, and health risks.

Individuals expecting to work as a Nurse Practitioner should expect to work shifts anywhere from 10 to 12 hours a day and can also expect to work during weekends and holidays depending on their work environment. Although this job can be very rewarding, emotional and mental fatigue can play a large role in dissatisfaction as taking care of others can be very taxing on individuals.

Another disadvantage of becoming a NP is the extensive amount of education, exams, and qualifications needed. Out of all of the nursing jobs, NPs require the most education. Legal risks are also a point of concern for NPs in comparison to nurses, as NPs are legally liable for diagnosing, treatment planning, and the care of their patients.

Health risks related to working in a hospital setting, exposures to bodily fluids that have the potential to be contaminated, and working near ill patients is also a cause of concern for becoming a Nurse Practitioner.

Requirements to Become an AGNP

There are several steps required to become an Adult Geriatric Nurse Practitioner.

First, an individual must earn a Bachelor of Science in Nursing Degree from an accredited program. This can take three to four years to complete. Individuals who wish to pursue a faster route can get an associate’s degree in nursing, and then enroll in a RN-to-BSN bridge program that can be completed in as little as 20 months. Accelerated nursing programs are available to individuals currently holding an associate’s degree in vocational nursing, and can take a LVN-to-BSN bridging program which would allow them to skip the first three semesters of the BSN program.

The next step would be to pass the NCLEX-RN Certification program to become a registered nurse.

Then, a Master of Science Degree in Nursing is required. Finishing a Master of Science Degree in Nursing can take two years with a full-time course load, or up to five years if working and taking classes part-time. Some MSN degrees specialize in Gerontology, but AGNPs do not need this specialization to enter into the field.

Next, a minimum of 500 faculty-supervised clinical hours as a gerontology nurse are required to sit for The American Nurses Credentials Center for the Gerontological Nurse Practitioner Certification Exam. If working full-time, nurses can complete this requirement as quickly as thirteen weeks.

There are two different certifications dependent upon whether you are pursuing Acute Care or Primary Care. Acute AGNPs will focus on critical care, oncology, the emergency department or cardiopulmonary and work in inpatient hospitals, specialty labs and intensive care units. Primary Care AGNPs will work in private practices and VA facilities or college campuses.

This exam is 200 questions, four hours long, and has 175 scored questions plus 25 pretest questions that are not scored. The passing score for this exam is 350 out of a maximum of 500 points. This certification is valid for five years and can be renewed by application up to 1 year before expiration.