limitations of their patients • Maximize patient independence • Involve patients and family members (American Nurses Credentialing Center [ANCC], 2008) There are a number of compelling reasons for nurses to pursue gerontological nurse certification. Certified gerontological nurses: • Experience a high degree of professional accomplishment and satisfaction • Demonstrate a commitment to their profession • Provide higher quality of care to older adults • Act as resources for other nurses and interdisciplinary team members • Demonstrate evidence-based gerontological nursing care • Are recognized as national leaders in gerontological nursing care • Create the potential for higher salaries and benefits • Are actively recruited for employment at nursing faculty, in Magnet and NICHE designated hospitals, in long-term care facilities, in acute rehab, and in community health agencies (ANCC, 2008; Hartford Institute for Geriatric Nursing, 2008) See the ANCC Web site (http://www.nursecredential ing.org) for eligibility requirements and information about gerontological nurse certification and recertification. 55805_CH01_0001_0025.qxd 2/19/09 1:01 PM Page 11 12 Chapter 1: Introduction to Gerontological Nursing Advanced Certification The ANCC offers two separate advanced practice certification exams in gerontological nursing: the clinical specialist in gerontological nursing (GCNS-BC) and the gerontological nurse practitioner (GNP-BC). There are different eligibility requirements for each exam. The ANCC Web site (http://www.nursecredentialing. org) provides eligibility requirements and information on certification and recertification. As with most certifications, minimum educational and practice requirements must be met and maintained. Both certifications are considered to signify expert clinicians; those certified must hold a minimum of a master’s degree in nursing, which includes at least 500 hours of precepted clinical practice. Recertification mandates retaking the exam or submitting a portfolio that demonstrates that the candidate has met specific requirements. Many states require advanced practice registered nurses (APRNs) to hold a separate license as an APRN. The advanced practice role encompasses education, consultation, research, case management, administration, and advocacy in the care of older adults. In addition, APRNs develop advanced knowledge of nursing theory, research, and clinical practice. The APRN is an expert in providing care for older adults, families, and groups in a variety of settings. The gerontological clinical nurse specialist focuses on three spheres of influence: patient/ family care, developing nurses, and impacting organizations and systems. Gerontological clinical nurse specialists (CNSs) play important roles in acute care by developing and implementing gerontological nursing evidence-based practice. In addition, some roles involve a collaborative practice or consultative role with hospitals or long-term care facilities and interdisciplinary teams. In some states, gerontological CNSs may obtain prescriptive authority and broaden their scope of practice. Gerontological CNSs have developed and managed clinics for common conditions in the older population such as incontinence, falls, wounds, or cognitive impairments. The ANCC describes the role of the gerontological CNS as follows: The Clinical Nurse Specialist in Gerontological Nursing (GCNS) is a registered nurse prepared in a graduate level gerontological clinical nurse specialist program to provide advanced care for older adults, their families, and significant others. The GCNS has an expert understanding of the dynamics, pathophysiology, and psychosocial aspects of aging. The GCNS uses advanced diagnostic and assessment skills and nursing interventions to manage and improve patient care. Using theory and research, the GCNS’s practice considers all influences on a patient’s health status and the related psychosocial and behavioral problems arising from the patient’s altered physiological condition. The GCNS practices in diverse settings and is actively engaged in education (e.g., patient, staff, students, and colleagues), case