Abstract
Nurses have been responsible for providing primary health care in the modern health care system as well as all through history. Advance practice registered nurses can be certified in different roles. One of the important roles is that of a Geronotological Nursing Practitioner (GNP). Geriatric nurses have become a significant part of modern medicine as they are the primary care givers to elderly patients and it is recognized as a very critical advance practice nursing specialty. GNP’s are entrusted to manage a very critical part of patient care, and they have to be vigilant at all times to be good at their job. However, despite this role of nursing being evolved through the ages, their number has been significantly low as compared to their demand. It can give rise to a crises in future as the need for Geriatric Nurses will increase more and more with each passing year, thanks to modern medicine and higher life expectancy. The state should get involved to make sure that enough GNPs are being effectively trained to meet the need of the future. Personal development of GNP’s is also a necessity to make sure this vision of their role is achieved.
Introduction
Profession of nursing has been as old as the institution of health care. Advance practice Nursing have evolved over the years to become one of the most important pillar of modern health care all over the world. The role of an advance practice nursing could be defined as a progressive and sophisticated level of clinical nursing practice that utilize graduate level educational expertise, comprehensive knowledge base of nursing and experiential expertise of catering health needs of patients. It involves education as well as experiential knowledge base; application of research and theory of nursing practice; and ensuring continuous progress in the field of nursing with respect to research and practice.
An advanced practice registered nurse (APRN) is a nurse, who has post-graduation level education in the field of nursing. APRNs have to have higher education and medical knowledge, expertise and skills. They are responsible to provide new and innovative ways to ensure best quality and economical patient care. In many areas, they are responsible to provide patient care to the underserved people of the society. They have to be able to self-sufficiently diagnose and treat patients with a high level of professionalism and provide medications accordingly. It is of utmost importance that the nurse has to be intelligent, agile and perceptive as well as kindhearted and sympathetic. There are several types of registered advance practice nurses:
Nurse Practitioners
Clinical Nurse Specialists
Certified Registered Nurse Anesthetists
Certified Nurse Midwives
Gerontological Nursing Practice
The APRN role of Gerontological Nursing Practice (GNP) has always been my goal for the future. This role is responsible for extremely critical patient care of elderly and requires higher expertise than any other role. Despite being the most critical role, it has been greatly underappreciated when it comes to developmental steps for the well fare of this role. Nurses have been providing patient care to elderly since the dawn of times but with modern medicine as the life expectancy increased so did the need of specialized nurses for this demographic, however, in spite of this role being evolved over the years, there is still a long way to go.
Gerontological Nursing Practice GNP
An advanced practice nurse who is referred as a GNP are trained to work with elderly patients and help them cope with the distinctive challenges that they have to face in their daily lives. A GNP in order to be good at their job has to be kind, expertly trained, and compassionate as they are the most valuable member of the healthcare professionals. They have to work in all types of medical settings, like critical care hospitals, assisted living facilities and nursing homes. Their scope of work varies depending on the condition of the patient, they might be responsible for day to day care of a patient or might be responsible for ensuring correct medicine adjustments. Irrespective of the clinical environment, GNPS have to devote their entire days referring with patients and their family members, coordinate with other nursing staff in the hospital and at the nursing home, and consult with social workers, physical therapists, and pharmacists. Unlike a general practice nurse, a GNP would more likely end up dealing and managing long term patient care, managing medication, and ensuring physical therapy and comparatively less time spending on primary diagnosis.
History of GNPs in the US is noteworthy because its response has to cater to the growing need of elder patients and their families. This particular specialty has been recognized pretty recently. First research group of GNPs were assembled by The American Nurses Association (ANA) in 1962; the first practice group of GNPs was organized in 1966. The first Geriatric nursing standard was published by the Geriatric Division of ANA quite later in 1968, and the initial geratric nurses were shortly certified by. Since then, there has been an ever increasing number of elder patientsmodern health care system in America, and paradigm shifts in State modern medical health policies and financial funding have aided GNPs in conducting research, and performing in practice. As per the rules of ANA the name gerontological nursing for this area of special experiential and knowledge base has been defined. There is no need to get confused by the term geriatric nursing and it is the same as GNP and is equivalent and will be used interchangeably
In spite of strenuous effort of 30 years, by both the institutions of academia and training of nursing organizations, and considerable state and federal funding for training, still the number of advanced practitioner nurses GNPs remains very insignificantly small. There are 63 programs in US that can train and graduate a GNP and they pass out an average of three GNPs annually. In the meantime from 1991 till now, only about 4200 GNPs have been certified nationally by the American Nurses Credentialing Center (ANCC). As the number of GNPs is significantly very low and as most of them predominantly prefer to work in urban assisted living facilities, GNPs end up exerting a very nonexistent influence on the patient care needs of the most of the elder patients.
As much as the modern medicine is making strides in research and development, the life expectancy of an average person has increased by at least a decade. This means that there is more chance of an average person to require assisted living in their olden days as compared to half a century ago. With increase in the number of people in the elder demographic, we require an equal increase in the number of expert GNPs. As GNPs are responsible for a number of patient care aspects, their specialization in their field is of utmost importance. (Eileen T., 2008)
In my opinion every person that requires assisted living should have an excess to highly trained and experienced GNP. In order to achieve this vision GNP’s has to be motivated by the state to be trained in this specialty in a way that they can provide best possible care. Elder patients vary in their criticality and so their GNPs should be well practiced to be able to handle any level of criticality. They have to be motivated enough to provide the required quality of care. I aim to complete my training with this thought in mind that I am not just responsible for dealing with one type of scenario but I should be prepared to handle any type of medical emergency faced by an elder patient.
Federal and State governments should make this their priority to invest in increasing the number of specialized GNPs as with passing day their need will increase due to increase in the number of people in elder demographics. Government should offer scholarships, grants, incentives on the job and other similar steps to ensure that the demand and supply of GNPs meet in the future. As much as the demand is increasing for specialized GNPs, their number is not increasing with same frequency and this could result in a serious crises in future.
I plan to make elder patient care my focus in advance studies in order to be the part of solution rather than problem for the future. I also have making myself equipped with all type of specialty care training as my top priority because a GNP has to be think on the foot and should be able to face and handle any type of medical emergency on their own. Thirdly, I would conduct focus groups with my peers who will be following other specialties to make them at least as much familiar with this critical specialty that if need arise they can effectively substitute for GNPs.
References
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