About the need for, the development and the evidence for the effectiveness of advanced nursing practice in the care of older people - delivered in Luzhou, Sichuan Province, China 2018

1. Gerontological Nurse
Practitioners (GNPs)
Roger Watson

2. Gerontological Nurse Practitioners (GNPs)
• Why do we need them?
• What do they do?
• Are they effective?
• What do they need to know?

5. Definition
Nurse Practitioners are Registered Nurses who serve as
primary and specialty health care providers under a physician.
Much like a geriatrician, Gerontological Nurse
Practitioners work with elderly patients, diagnosing illness,
conducting exams, and prescribing medication.
(Discover Nursing website)

6. Background
As our life expectancies increase and our population
ages, there will be an increasing need for specialized
healthcare professionals who are able to address the specific
needs of older adults. In the nursing field, this has long fallen
to Gerontological Nurse Practitioners (GNPs), also known as
Geriatric Nurse Practitioners. These nurses are trained to
work with older patients and deal with the special
challenges that they face. A GNP is a compassionate,
highly trained, and valuable member of the healthcare
professional.

8. Patient population
A geriatric nurse practitioner works with an older patient
population. Unlike pediatrics, which can deal with anyone
under the age of 18, there is no generally accepted age group to
which the term “geriatric” applies. Rather, geriatric nurse
practitioners work with adults who are facing the
challenges of aging, including problems that may not
necessarily occur in children or younger adults.

9. Clinical background
Geriatric nurse practitioners may work in a number
of different clinical environments. One of the most
common places to find this kind of specialized nurse is in an
assisted living facility or nursing home. Geriatric nurse
practitioners are also commonly sought as caregivers for those
aging adults who need part-time or full-time in-home
healthcare. Hospitals may also employ GNPs in their acute
care for the elderly, or ACE, units. Of course, many aging
adults do not need such extensive care, so a GNP may also find
work in an outpatient clinic, a palliative care clinic, or as a
primary care nurse practitioner. It is actually quite
common for geriatric nurse practitioners to work in a
combination of these roles, remaining on call for a
hospital while visiting long-term care facilities, for
instance.

10. Physical & Emotional Considerations
• Any nurse practitioner must be active and physically
fit, but perhaps even more so for a geriatric nurse
practitioner. Elderly patients become more likely to need
assistance in their daily self-care activities and while these
tasks may often fall to nursing assistants or other staff,
geriatric nurse practitioners should be willing and able to
help as well. This means a degree of physical strength is
required to help patients stand, walk, and bathe. For
GNPs that work at multiple locations, which is common, and
those who are on call at local hospitals, the physical toll of
travel and odd hours can be taxing, but such is the reality for
many in healthcare professions. GNPs who work at just one
home may find their schedules to be a bit more relaxed,
generally working regular hours and checking in on the same
patients on a regular basis.

11. Physical & Emotional Considerations
• The range of patients that GNP can treat is a wide one.
However, the fact of the matter is that GNPs will see
many of their patients reach the end of their lives.
This can take an emotional toll on both the practitioner and
the patient families that the GNP will counsel.
Gerontological Nurse Practitioners should be
comfortable speaking about end of life issues and
choices in a clear but compassionate way. GNPs
should also be prepared for tension to run high in some
cases as family members and patients may not always see
eye-to-eye on these delicate issues.

17. The review demonstrates
improved or non-inferiority
results of nurse practitioner
care in older people across
settings.

19. Both patients and
referring physicians
were very satisfied
with this model of
care…

21. Adding a GNP to an
outpatient diagnostic
multidisciplinary facility for
patients with cognitive
disorders may improve
GP concordance rate of
the advice from the DOC-
PG and reduce subjective
burned of the informal
caregiver.

23. How to become a GNP (USA)
• Step 1: Obtain an Undergraduate Degree in Nursing. ...
• Step 2: Obtain State RN Licensure. ...
• Step 3: Obtain Experience. ...
• Step 4: Obtain a Master's Degree. ...
• Step 5: Earn Certification. ...
• Step 6: Obtain an Advanced Practice Nursing License. ...
• Step 7: Consider a Doctorate in Nursing Practice.

40. Conclusion
• We need them due to demographic changes
• They provide advanced, integrated care for older people
• They are effective
• They need advanced skills

41. r.watson@hull.ac.uk
0000-0001-8040-7625
@rwatson1955