Are you at that moment in your career when you are asking yourself what is next or which path to take? This comprehensive guide explores one possible career path as a nurse: Geriatrics.
Understanding the Role of a Nurse in Geriatrics
What does geriatric mean? The definition and meaning of "geriatric" are the branches of medicine that work with different diseases and the often complex needs of the elderly population. This includes medical treatments and nursing care for older adults.
According to the National Council on Aging, by 2030, the baby boomer generation will be 65 or over. By 2040, around 78.3 million people in the U.S. will fall into that age group.
Another interesting fact is that life expectancy is increasing with the advances in technology and medicine.
In 2022, people 65 years old were expected to live another 18.9 years. This data shows that work-wise, geriatrics nurses will be in demand in the foreseeable future.
What Is Geriatrics?
Children have particular needs as they grow up. Similarly, elderly people have needs that must be attended to by specialized professionals.
Therefore, it is important for elderly populations to receive care from specialized physicians and nurses. These professionals must be experienced with illnesses, diseases, and treatments that can affect older people; that is how geriatrics is defined.
According to Health in Aging, the following are the "five Ms" that all geriatrics providers have to focus on:
- Mind: In this area, the focus is on maintaining mental activity, managing dementia, preventing and treating delirium, and evaluating and treating depression.
- Mobility: The focus for mobility is on preventing falls and common injuries and maintaining the ability to walk and keep balance.
- Medications: This area focuses on raising awareness of medications' harmful effects, reducing unnecessary medications, and prescribing treatments for older adults.
- Multi-complexity: In this area, the focus is to asses older patients and help them manage different health and living conditions.
- [What] Matters most: In this area, geriatric patient care focuses on managing care goals, coordinating care planning, and ensuring the consideration of individual preferences in the treatment.
Nursing Geriatrics vs. Middle-Aged Patients
The main difference between middle-aged nursing and geriatric nursing is the age group of patients. Usually, people 40 to 60 years old are considered middle-aged, and geriatric people are 65 years and above. The following are some key differences between these two groups.
- Among geriatric populations, nearly 70 percent of older adults need long-term service support. This percentage is significantly higher than that of middle-aged adults. As people grow older, there are more chances of having multiple medical disorders.
- Care plans can get complicated because elderly people can start to have different symptoms simultaneously. Therefore, diagnosing senior adults can be more challenging than diagnosing younger people.
- A significant difference between treating an adult and an older adult is that, sometimes, people of geriatric age cannot make medical decisions for themselves.
- Elderly people, due to different health conditions, often need to use many medications (polypharmacy), which can generate adverse reactions.
Who Is Part of a Geriatric Team?
A team of healthcare professionals is necessary to conduct a comprehensive geriatric assessment and have different treatment options. Working as a team is essential in this specialization to achieve better outcomes. The following professionals are often part of a geriatric team:
- Geriatricians
- Nurses
- Nurse practitioners
- Nutritionists
- Physician assistants
- Social workers
- Occupational therapists
- Psychiatrists
- Psychologists
- Speech and hearing specialists
- Consultant pharmacists
- Physical therapists
- Geriatric nursing assistants or certified nursing assistants
An excellent geriatric care plan is achieved through the coordinated efforts of all the professionals involved in the team.
What Does a Geriatrics Nurse Assistant Do?
Geriatric nurse assistants (GNAs) work alongside geriatric nurses to care for older adults. They are trained to assist people over 65 with their non-medical needs, such as activities of daily living. It should be noted that not all states provide a nursing assistant path specific to geriatrics.
Some Responsibilities of Geriatric Nurse Assistants
Geriatric nurse assistants have some common responsibilities, such as the following:
- Take vital signs
- Help with activities such as bathing, eating, and dressing
- Provide emotional support
- Ensure patients wellbeing
- Reposition patients
- Ensure hydration
- Make patient beds
- Serve meals
How to Become a Geriatric Nurse Assistant
To become a GNA, you typically need to complete an approved certified nursing assistant training program. Furthermore, often, a criminal record background check, completion of a board-approved geriatrics course, and passing a state test are required to obtain the GNA certification.
What's the Average Salary for GNAs?
The U.S. Bureau of Labor Statistics does not provide separate salary data for GNAs. However, it does provide wage data for nursing assistants in different industries. The following are two industries where GNAs are likely to work with the elderly population:
- The average wage for nursing assistants working in skilled nursing facilities is $38,730 per year and $18.62 per hour.
- The average wage for nursing assistants working in continuing care retirement communities and assisted living facilities for the elderly is $37,660 per year and $18.10 per hour.
However, if you want a higher hourly rate, you can choose to work per diem shifts. Find geriatric nurse assistant PRN jobs by signing up here.
What Does a Geriatrics Nurse Do?
Nurses in this specialty have the training and knowledge to manage the needs, chronic conditions, and diseases specific to the older population. These conditions include diabetes, dementia, congestive heart failure, hypertension, liver failure, and more. Geriatric nurses also work with patients who suffer from heart attacks or strokes and need specialized care amongst a plethora of other health conditions that people of an older population are prone to.
Some Responsibilities of Geriatric Nurses
Geriatric nurses have some common duties, such as the following:
- Provide wound care, palliative care, and end-of-life care.
- Monitor the patient's physical, cognitive, and emotional status to address any needs.
- Monitor vital signs and administer medication.
- Educate patients and families about lifestyle modification, medication management, and healthcare conditions.
- Coordinate with other healthcare professionals, families, and all involved parties so that the patient receives the proper care.
- Monitor the patients' environments to prevent falls and accidents.
- Support with daily activities such as eating, dressing, and bathing.
- Develop healthcare plans according to their patients' needs.
How to Become a Geriatric Nurse
If you desire to work in geriatric nursing, you must first complete an approved program to become a registered nurse.
- Associate Degree in Nursing (ADN): This program usually lasts two years if you study full-time. It can take a little longer if you study part-time.
- Bachelor of Science in Nursing (BSN): This program typically lasts four years. It provides a more comprehensive curriculum than an ADN.
After you complete a nursing program, whether an Associate Degree in Nursing or a Bachelor of Science in Nursing, you need to take the National Council Licensure Examination (NCLEX-RN). After passing your exam, you can acquire your license and become a registered nurse. You may also need to meet other state-specific requirements.
Obtaining experience in different settings, such as hospitals, long-term care, nursing homes, and other facilities, will allow you to have direct contact with the older population. These experiences will help you understand their needs and develop the skills to attend to people of geriatric age.
Continuing your education is also important. Look for certifications from seminars, workshops, or training programs specific to geriatric nursing. These certifications will keep you updated with the latest advances in the specialty.
Geriatric Nursing Certifications
Different certifications can help you advance in your career and demonstrate your knowledge of geriatrics.
- Certified Hospice and Palliative Nurse (CHPN): The Hospice and Palliative Credentialing Center (HPCC) offers this certification. It requires an active RN license, 500 hours in hospice and palliative nursing practice within the past 12 months, or 1,000 hours within the previous 24 months.
- Gerontological Nursing Certification (GERO-BC™): The American Nurses Credentialing Center (ANCC) offers this certification. To be eligible, you need to have a valid RN license. In addition, you must have two years of full-time experience as an RN, a minimum of 2,000 hours in clinical practice in gerontological nursing, and 30 continuing education hours in gerontological nursing within the last three years.
- Certified Dementia Practitioner (CDP): The National Council of Certified Dementia Practitioners (NCCDP) awards this certification. Eligible professions for this certification include healthcare professionals and clergy. Candidates must have at least one year of paid experience in the geriatric healthcare industry and a current license in the field.
- Advanced Certified Hospice and Palliative Nurse (ACHPN): The HPCC awards this certification, which requires an Advanced Practice Registered Nurse (APRN) license. The official site lists additional requirements.
These are just a few certifications that you can pursue in geriatrics. Certifications can help your resume stand out when facilities are looking for a geriatrics nurse.
What's the Average Salary for a Geriatric Nurse?
The salary of a geriatric nurse can vary depending on the facility they work in and the city where they live, among other factors. According to the U.S. Bureau of Labor Statistics, the average wage for RNs is $94,480 per year and $45.42 per hour.
For a more specific idea of geriatric RN salaries, we can look at two industries that work closely with the elderly population and their prospective wages:
- Skilled nursing facilities: $82,930 per year and $39.87 per hour
- Continuing care retirement communities and assisted living facilities for the elderly: $77,180 per year and $37.11 per hour.
Nevertheless, geriatric nurses can find high hourly rates with Nursa’s PRN jobs.
Job Outlook for Geriatric Nurses
According to the U.S. Bureau of Labor Statistics, the projected job growth for RNs between 2023 and 2033 is 6 percent. This growth rate is faster than the national average for other professions.
According to the United States Census Bureau, between 2010 and 2020, the country saw the fastest growth in the group of adults aged 65 and over. This population group currently represents 16.8 percent of the U.S. population.
Since life expectancy is increasing, the older population is expected to grow, and so will their healthcare needs. Therefore, geriatric nursing is and will continue to be in high demand.
Where Do Geriatric Nurses Work?
A geriatric nurse works in different settings, such as the following:
- Hospitals: Geriatric nurses can work in long-term acute care hospitals or LTACHs with other members of the healthcare team, providing medical and emotional support.
- Long-term care: In long-term care facilities, nurses provide various services to help maintain the patient's independence and quality of life. In nursing homes, nurses assess mental and physical skills and develop care plans, among other things.
- Assisted living facilities: In assisted living facilities, nurses provide supportive quality healthcare.
- Home Care: In home health, geriatric nurses help with bathing, dressing, and eating in their patients’ homes. They also assess patients and administer medications.
- Skilled nursing facilities: In skilled nursing facilities, the nurse assesses patients, administers medication, and provides emotional support, among other things.
- Rehabilitation centers: Nurses work with an interdisciplinary team to help elderly people improve their mental and physical capabilities with the goal of returning home.
Which Types of Advanced Geriatric Nurses Are There?
There are different types of advanced practice registered nurses in geriatrics, such as the following:
Gerontological Nurse Practitioner (GNP)
A GNP is a nurse practitioner who works exclusively with older people. They administer medications and may prescribe medications in some states. They also create care plans for their patients. They usually work with patients who have physiological dysfunctions, have fallen, or suffer from incontinence.
The American Nurses Credentialing Center offers the Gerontological Nurse Practitioner Certification (GNP-BC). However, it is currently only available for renewal.
Adult-Gerontology Nurse Practitioner (AGNP)
An AGNP differs from a GNP-BC because they also work with adolescents and adults. You can become a primary care or acute care adult gerontology nurse practitioner.
- An acute AGNP works in critical care, emergency, and cardiopulmonary departments.
- A primary care AGNP may work in private practices and college campuses.
The ANCC offers Adult-Gerontology Nurse Practitioner certifications for either primary care or acute care. The Academy of Nurse Practitioners Certification Board (AANPCB) also offers an AGNP primary care certification.
Before pursuing one of these AGNP certifications, you need to earn a master's degree through an AGNP program and become licensed to practice in your state.
Adult-Gerontology Clinical Nurse Specialist (AGCNS)
An Adult-Gerontology Clinical Nurse Specialist cares for older adults with complex medical conditions, providing specialized advanced nursing care. To become an AGCNS, you need to have a master's, post-graduate certificate, or DNP from an accredited program.
Furthermore, you must complete 500 faculty-supervised clinical hours and pass the Adult-Gerontology Clinical Nurse Specialist Certification (AGCNS-BC™) exam conducted by the ANCC. Once you obtain this credential, renewal is required every five years.
Geriatric Associations
Various associations exist for geriatric nurses. Membership in these organizations can provide opportunities for nurses to network, further their education, and create community. Consider the following:
- The American Geriatrics Society is an association of healthcare professionals seeking to improve older people's health, independence, and quality of life. It provides research opportunities, advocacy for its members, and public education.
- The National Gerontological Nursing Association works with different professionals involved in geriatrics in various settings. This organization provides educational resources and networking opportunities.
- The Gerontological Advanced Practice Nurses Association works with geriatric nurses. The association provides educational resources, certifications, and networking opportunities.
- The National Association for Geriatric Education is for professionals in geriatric education. It provides educational resources and networking opportunities.
- The National Council of Certified Dementia Practitioners works with professionals who work with dementia. It provides educational resources and certifications.
- The American Nurses Association is for registered nurses. It provides educational resources, certifications, and networking opportunities.
Important Soft Skills for Geriatric Nurses
Geriatric nurses need to have the knowledge to understand the health problems and needs that are specific to the elderly population group. Specific skills help to provide quality care to their patients, like the following.
- Patience and empathy: Often, elderly patients may have mobility, speech, and cognitive problems, which require patience and empathy from caregivers. Nurses must understand what their patients are going through to provide compassionate care.
- Awareness: Geriatric nurses need to recognize changes in their patients, like early signs of dementia, weight loss, and mobility problems. When nurses act promptly, they can work with the healthcare team to slow the progression of the condition.
- Flexibility: Adapting to changing needs is an important skill for a geriatric nurse. Elderly patients may have good and bad days, which can change the way nurses provide care.
- Communication skills: Since nurses in this specialization may have long-term patients, good communication skills are essential to building strong relationships with them. Some patients may have difficulties expressing themselves. Therefore, it is important that nurses have nonverbal communication skills as well.
- Teamwork: Elderly patients often need the services and skills of different healthcare professionals. These professionals must work together to achieve better patient outcomes.
- Patient management: Geriatric patients must face many changes and have specific needs. In many cases, nurses must deal with patients who are having difficulties accepting these changes, such as using wheelchairs. It is important to know how to help them in the transition. In other cases, it is important to help patients maintain their mobility.
Physical Requirements for Geriatric Nurses
Geriatric nurses work with people aged 65 and above. Therefore, nurses have to be able to meet certain physical demands in order to perform certain necessary functions, such as the following:
- Geriatric nurses need to be able to lift and move patients.
- Nurses must be able to stand for long periods of time.
- Nurses need to have good vision.
- Geriatric nurses have to be able to kneel or stoop.
- Nurses need to have fine motor skills.
Common Health Conditions in Older Adults
There are some common conditions that older people develop for different reasons. Here are some common health conditions in geriatrics according to the World Health Organization:
- Hearing loss: Hearing loss related to aging usually affects both ears equally. This condition occurs because of changes in the inner ear as people age.
- Cataracts: Cataracts are opacifications of the eye lens that affect the ability to see. They are the leading cause of blindness in older people.
- Refractive errors: Refractive errors are vision problems that affect how people see. The most common are myopia, hyperopia, astigmatism, and presbyopia.
- Back and neck pain: This can result from different causes, such as arthritis, spinal stenosis, and herniated discs.
- Osteoarthritis: This is the most common form of arthritis. It occurs when the protective cartilage that cushions the ends of the bones wears down, affecting the hands, knees, hips, and spine.
- Chronic obstructive pulmonary disease: This disease causes swelling and irritation in the airways, limiting airflow into and out of the lungs. It can cause breathing difficulties, cough, and a whistling sound in the lungs.
- Diabetes: Diabetes occurs when the body can't make enough insulin, causing too much glucose to stay in the blood.
- Depression: It is a mood disorder that can affect the way people think, act, and feel. It is a common problem among the elderly population.
- Dementia: It occurs when nerve cells in the brain stop working, lose connection with other cells, and die. As people grow old, they lose some neurons. However, people with dementia have greater losses, causing memory loss and confusion, among other things.
- Urinary incontinence: This affects older adults, and it happens when muscles around and in the bladder don't work as they should, causing urine leakage.
- Delirium: It is an acute disorder of attention and cognition that is common in older adults and can be life-threatening.
- Pressure ulcers: These are also called bedsores and can develop when a person spends a long time sitting or lying down. These ulcers are damaged areas of the skin caused by pressure.
What Is Palliative Care?
Palliative care focuses on comfort and the best possible quality of life for people with serious illnesses such as cancer, dementia, Parkinsons, and heart failure, among others. It can be provided at any stage of an illness. It should not be confused with end-of-life care.
There are three levels of palliative care, which are the following:
- Primary: The primary level focuses on relieving patients' suffering and improving the quality of care. Nurses are mainly responsible for this level.
- Secondary: A hospital specialist or hospice consultant provides care at this level.
- Tertiary: This level is provided by a research, academic, or educational medical center.
Geriatric nurses are trained to provide palliative care, and they become a great support for older adults and their families.
What a Day of a Geriatric Nurse Looks Like
On a daily basis, geriatric nurses attend to the complex health needs of their patients. These can be physical or mental issues like dementia, Alzheimer's, and cancer, among others.
When you start your shift, you will receive the report from the previous shift and start your duties. Then, you will typically prepare your patient to eat their breakfast or dinner.
You will assess their vitals, as well as their mental and physical skills, and administer their medications. At some point, you will talk with the healthcare team and discuss changes and courses of action for ongoing care.
Some shifts can be more demanding than others. Understanding the aging process is essential for identifying the early stages of significant changes in your patients.
Is It Difficult to Be a Geriatric Nurse?
Geriatric nurses have demanding jobs. Nevertheless, it is comforting to know that their work has a great impact on patients' lives.
Elderly people may have various health problems affecting their mobility and cognitive skills. It can be physically and mentally demanding for nurses to deal with these situations every day. Lifting and moving patients is typically part of a geriatric nurse's daily routine and can be physically draining.
Sometimes, there are heavy workloads, and nurses must care for many patients during their shifts. This situation can lead to emotional and physical draining.
Patients sometimes have very difficult conditions, and nurses must provide end-of-life care. This situation can be emotionally challenging since nurses have likely built strong relationships with their patients.
Having multiple healthcare professionals on the team, from geriatricians to nutritionists, may make it difficult to coordinate with everyone.
Being a geriatric nurse is challenging. It is important to learn how to deal with stress and find activities to relax and unwind in your free time. Helping someone live out their last years as well as possible has great personal rewards.
What Are the Advantages of Being a Geriatric Nurse?
All professions have advantages and disadvantages. Here are some of the rewarding aspects of choosing this career path:
- Patients: Usually, in geriatrics, nurses care for patients for long periods. This can lead to building solid relationships with them and their families.
- Settings: Geriatric nurses are in great demand due to a growing aging population. Therefore, they are needed in various healthcare settings.
- Coworkers: Geriatric nurses work in teams with various healthcare professionals. The senior population's needs range from geriatric psychiatry to nutrition. As such, nurses have connections with a broad pool of healthcare professionals.
Telemedicine and Gerontology
Advances in technology are revolutionizing health assessments. Wearable devices can gather live and continuous information about patients' conditions at all times.
With the help of this technology, healthcare professionals can monitor patients without needing face-to-face checkups. The following are examples of the data that technology can collect at all times for physicians and clinicians to analyze:
- Heart rate
- Electrocardiogram
- Body temperature
- Oxygen saturation
- Respiration rate
- Blood pressure
This live data can help monitor older adults at all times. Therefore, healthcare professionals can find symptoms of different conditions in the early stages.
For example, a higher body temperature can be a sign of an infection. An abnormal electrocardiogram could be a warning for cardiac arrest.
Furthermore, geriatric nurses can act faster when the devices trigger warnings about their patients' conditions. These early warnings improve the chances of better outcomes.
Older adults may have difficulty using these technologies. They usually prefer personal contact with healthcare professionals rather than using devices. Furthermore, seniors often need help with technology, and it may be difficult for them to use it independently.
Wearable devices and other types of technology in gerontology must be simple and user-friendly so that the older population can use them without problems.
Geriatric Nursing: A Demanding but Rewarding Specialization
Geriatric nursing is a specialization in great demand since the elderly have become a larger percentage of the country's population over the years. With advances in medicine, life expectancy is increasing. The population of 65 and above often has more health problems and needs that require specialized attention and treatment.
In this specialization, geriatric nurses often build strong relationships with their patients since they usually need long-term care. Conditions like dementia or Alzheimer's can affect people as they grow older. Sometimes, these conditions can be challenging for geriatric nurses to handle, making their jobs more taxing.
Being a geriatric nurse can be emotionally and physically draining. However, it is also a rewarding specialty because nurses can see the impact they make on the lives of their patients and their loved ones.
A great way to have a better work-life balance and make a higher hourly rate is to work PRN, which can let nurses choose where and when to work. Sign up with Nursa and request your first PRN shift as a geriatric nurse.
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