You may have heard of the “graying of America.” The rapid increase in older populations is challenging healthcare today. This unprecedented growth will have Baby Boomers account for almost a quarter of the population.
As people age, they often have more than one medical issue or comorbidity. This requires more healthcare resources and more providers — doctors, nurse practitioners (NPs) or physician assistants (PAs). At 25 years old, patients may have one or two health visits a year, often for preventive care. Yet at 65 years of age, some need numerous visits with their primary care provider and specialists such as cardiologists and endocrinologists. There is a severe shortage of physicians in primary care and specialty care. By 2030, experts predict a shortfall of 120,000 providers, with the greatest need in rural areas.
Adult-gerontology nurse practitioners (AGNPs) work with patients ranging from adolescents to the elderly. With their training, AGNPs can focus on acute care or primary care.
Adult-gerontology acute care nurse practitioners (AGACNPs) focus mainly on treating illness. In contrast, adult-gerontology primary care nurse practitioners (AGPCNPs) focus more on preventing illness and on chronic disease management.
Employers often accept either an AGPCNP or AGACNP, along with work experience. The average annual salary ranges from around $74,000 – $110, 000 (PayScale; November 2020). Adult-gerontology NPs can choose from a number of healthcare facility and practice settings.
Many adult-gerontology nurse practitioner job opportunities focus on a disease specialty such as diabetes or cardiovascular disease. Others provide specific services such as hospice/palliative care or radiation oncology. In partnership with pulmonologists, for example, you may only care for patients with pulmonary conditions. If you prefer to specialize and hone specific skills, then a job with a particular patient population or with a specific treatment might be a good fit. However, if you like diversity and learning about different conditions, then you might consider a more generalized position.
Some positions provide all aspects of patient care, including diagnosis, treatment, and health promotion. This could mean practicing in both inpatient and outpatient settings. For example, a position with a cardiology service may include seeing patients in the clinic, rounding on hospitalized patients, and telehealth monitoring. In order to make healthcare more accessible, many providers practice at more than one location within a city or rotate to remote locations. Some nurses may thrive from the exposure to different settings, while others may find it stressful.
Perhaps you want a role in public service. Positions within the U.S. government (federal, state, local, or tribal) or with a not-for-profit organization are possibilities. For example, NPs may work in the veterans’ community living center to follow resident veterans in the main facility and respond to consults. Others may provide care to the uninsured, like an NP position with the San Francisco public health clinic. Or perhaps the position is at a nonprofit home care agency that mainly serves Medicare and Medicaid patients. Public health service positions can be higher-paying for NPs, and new NP graduates are often accepted. Holders of such jobs may also qualify for the Public Service Loan Forgiveness Program offered by the U.S. Department of Education.
There is significant overlap when looking at degree requirements on job postings, so it is critical to seek out details: patient population, setting and focus (prevention or illness), and practice. Community-based settings can include medical offices, ambulatory care centers, long-term care facilities, community living centers, clinics, home care agencies, house calls or concierge medicine. Some offer an advanced practice provider clinical fellowship with a hospitalist to provide more intense inpatient training.
The demand for AGNPs will continue to expand as the growing senior population requires providers to help them manage the physical, mental and social effects of aging. Nurses play a crucial role in understanding, identifying and responding to barriers that prevent people from being healthier. One aspect of health disparity is the lack of access to healthcare and long wait times for appointments due to a shortage of providers. AGNPs can help fill the gap and lead the way to healthier communities.