course this semester and finds herself going home quite upset after the first week of classes when attitudes toward aging were discussed. While sharing with the course instructor her feelings and surprising emotional discomfort, Rose is helped to identify that she is afraid of getting older and being unable to care for her ailing mother and herself. As a single woman, she is unsure that she can handle what lies ahead for her as she is beginning to feel the effects of aging herself. Questions: 1. What can Rose do to become more comfortable with facing her own advancing age? 2. What factors may have influenced her discomfort with the course material? 3. Is there anything the instructor of the course might do to help Rose cope with the feelings she is having as she completes the required coursework? 4. There may be some activities that Rose can do in order to understand her feelings about aging better. Can you think of some such activities? 5. What is Rose’s role as the caregiver in this situation? How may the role change over time? 6. How much does Rose’s present home and living situation contribute to her fears and perceptions of aging? 55805_CH01_0001_0025.qxd 2/19/09 1:01 PM Page 10 Certification 11 tion or providing research ideas inspired by clinical problems, their basic preparation is aimed primarily at using research in practice. All nurses should read professional journals specific to their specialty and continue their education by attending seminars and workshops, participating in professional organizations, pursuing additional formal education or degrees, and obtaining certification. In being a research consumer, gerontological nurses can improve the quality of patient care in all settings. Expanded roles of the gerontological nurse may also include counselor, case manager, coordinator of services, collaborator, geriatric care manager, and others. Several of these roles are discussed in Chapters 20, 23, and 25. CERTIFICATION To provide competent, current care to elders, nurses need to have gerontological nursing content in their basic undergraduate nursing curricula and are encouraged to become certified in gerontological nursing. Less than 1% of nurses in the United States are certified in gerontological nursing; however, more than 50% of the patients cared for are elders. Adults age 65 or older utilize 48–50% of the nation’s total health care resources and represent approximately 38% of all admissions to hospitals (Stierle et al., 2006). Patients and their families are knowledgeable about quality health care and patient safety and want the most expert clinicians at the bedside. Certification provides reassurance to patients and their families that the nurses caring for them are highly skilled and possess expert knowledge in providing excellence in gerontological nursing care (Hartford Institute for Geriatric Nursing, 2008). Nurse certification is a formal process by which a certifying agency validates a nurse’s knowledge, skills, and competencies through a written examination in a specialty area of practice. There are two levels of certification: generalist and advanced practice level. Each has different eligibility standards. The American Nurses Credentialing Center (ANCC) is the certifying body for both levels of gerontological nursing practice. Generalist Certification The generalist in gerontological nursing has completed a basic entry-level program in nursing, which can be a diploma in nursing, or an associate or bachelor of science degree in nursing. Before meeting additional eligibility requirements to become certified in gerontological nursing, the applicant must be a licensed registered nurse for at least 2 years. ANCC offers the generalist computerized exam in gerontological nursing at over 300 computer-based testing sites across the country. This exam was the first one to become computerized, increasing the convenience of sitting for gerontological nursing certification. Certified gerontological nurses utilize principles of gerontological nursing and gerontological competencies as they implement the nursing process with patients. Gerontological certified nurses: • Assess, manage, and deliver health care that meets the needs of older adults • Evaluate the effectiveness of their care • Identify the strengths and