Geriatric NP- your opinion?

[SC ANP]

I have been wanting to do a Geriatric NP since I started NS. I like seniors, feel like I work well with them and have more patience with them than some others. However, I have had a lot of ppl tell me that a Geriatric NP is a waste of time, and all I'd be doing is working in a nursing home.

I have no interest in working with young adults, so I don't want to pursue a FNP. But I also don't want to be confined to a nursing home! Faculty from one of the schools in my area said that most of their grads are being asked to round in hospitals, at nursing homes, and work in an office (all about equally) - does this sound plausible? Is a GNP in demand? or even marketable?

I'd like to hear any & all opinions!

Thanks!

[Corey Narry, MSN, RN, NP]

I think the bulk of employment opportunities for GNP's are in nursing homes of all kinds. Many seniors live in these places for the rest of their lives and naturally, this is the setting where they receive their primary care. I have seen many job opportunities posted for NP's who round in nursing home facilities with physicians. I also don't know the logistics off the top of my head, but I believe Medicare (which insures people over the age of 65) have specific provisions for NP's who provide care to residents of nursing homes. As far as opportunities in hospitals go, most seniors admitted to a hospitalized level of care have acute care issues typically addressed by providers trained in acute care specialties. I've rarely seen a consult for Geriatric Medicine for a hospitalized patient.

However, the faculty member you spoke to is probably right by saying that some GNP's see patients in hospitals, clinics, and nursing homes. You have to realize that physicians trained in Geriatric Medicine either completed a residency in Internal Medicine or Family Practice and then added another year of Geriatric Medicine Fellowship. Many of these physicians maintain dual certification in both their primary specialty (IM, FP) and their secondary specialty (Geriatrics). If GNP's are working side by side with physicians of these types, then I am assuming that patients seen by the practice cover the spectrum of FP/IM to Geriatrics and not just purely primary care of the older adult.

I've also noticed (although others can correct me if I'm wrong) that Gerontological Nurse Practitioner programs tend to be an extension of the Adult NP program in the same institution. For instance, I've seen one specific institution where ANP and GNP students take the same didactic and clinical courses with the exception of GNP students having to take extra credits in training to care for older adults. I personally would find out if you can be eligible to sit for both the ANP and GNP certification exams in the program you are interested to attend. That way, you may be able to keep some flexibility in your future clinical practice as a nurse practitioner. Finally, I personally don't think you need to do the FNP route if you absolutely have no interest in caring for non-adult patients.

[core0]

To reinforce what NP Gilly stated, not all states recognize GNPs. Get an ANP and get exposure to geriatrics there. It will enhance your employability, especially if you want to work outside geriatrics.

David Carpenter, PA-C