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Geriatric Clinical Nurse Specialist_old


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									There is a critical shortage of geriatrics-prepared health care professionals. There are currently about 750
geriatric nurse specialists in the United States compared with a projected need for 25,000 geriatric nurse
specialists in the year 2020. Geriatrics needs to join pediatrics as a required element of training for the
next generation of health care professionals. A Geriatric Nurse Practitioner Certificate and Clinical Nurse
Specialist Certificate in Geriatrics prepares graduates to assume a role as a healthcare provider dedicated
to providing appropriate care to the elderly.

According to the U.S. Census Bureau, currently one in eight Americans is sixty-five years old. By the
year 2010, the ratio will be one in five, and by the year 2025, 20% of Americans will be over age sixty
five. The subset of elderly eighty-five years and older is the fastest growing segment of the aged
population. Older adults have many more health problems than younger adults; people age seventy-five
and older have an average of three chronic health problems and use more than 4.5 prescription drugs.
Older adults visit physician offices more than their younger counterparts. Those between the ages of
sixty-five and eighty-five receive the majority of home-care services. Almost 90 percent of residents in
nursing homes are over age sixty-five with an average age of eighty-five. Those elderly requiring nursing
home placement represent a vulnerable and frail subpopulation of older adults. These older adults suffer
from multiple chronic illnesses and are often unable to feed, bathe, dress, transfer, and use the toilet
(referred to as activities of daily living or ADL’s) without at least some assistance. Many residents are
cognitively impaired and half are thought to have dementia. This latter population requires specially
trained staff who understand how to care for patients with dementia who frequently also have
concomitant behavioral problems. The registered nurse is the primary professional provider in the
nursing home setting responsible not only for patient care but for overseeing the work of other licensed
and non-licensed nursing staff.

Primary care of the elderly is a nursing role mainly because most problems encountered by the elderly are
areas in which nurses have expertise, e.g. functional mobility, alterations in nutrition, bowel and bladder
dysfunction, hazards of immobility, maintenance of ADL’s. Two of the most significant obstacles to
quality health care in long-term care facilities are the lack of physician services and poorly trained staff.
The advanced practice nurse (the GNP and Clinical Nurse Specialist in Geriatrics) can provide the
expertise and continuity of care necessary to establish a safe, stable environment for nursing home
residents and staff. In addition, this nurse specialist can impact the care of the elderly in the community
(those living at home/retirement communities), supportive and assisted living centers and adult day care
and outpatient centers with the goal of proactive healthcare.

 The elderly often manifest illness with an atypical presentation. The balance of routine daily lives can be
tipped by the slightest insult. It takes a trained eye to detect the subtle signs and symptoms of impending
illness/insult before a crisis emerges. For example, the ultimate blow of being told they can no longer
drive can throw some elderly into the depths of depression. Hence, early detection and identification of
problems before they cascade into an emergency situation is the main goal of geriatric nursing. Hospitals
are dangerous places for older adults and a significant number of elderly develop hospital-acquired
complications related to both overtreatment and undertreatment. Many elderly patients also experience
functional declines during hospital stays. Prevention is the best treatment.

Studies have shown that the functional outcome measures for nursing home residents were significantly
greater for services from teams that included a geriatric nurse practitioner than for those residents
receiving only physicians’ services. Older patients cared for by nurses trained in geriatrics are less likely
to be physically restrained, have fewer readmissions to the hospital, and are less likely to be transferred
inappropriately from nursing facilities to the hospital. The advanced practice nurse can function as a
primary care practitioner and as an educator to impact the quality of care delivered to the older client. The
benefits of the geriatric nurse specialist, along with the projections for increased demands for healthcare
professionals trained in geriatrics points to the need to increase programs for advanced practice nurses
whose specialty addresses the unique needs of the aging population.

                                  Geriatric Clinical Nurse Specialist *

    Course #                                     Course Title                                     SH

                                      Core and Core Support Courses
NUSC 525            Intermediate Statistics                                                        3
NUSC 526            Nursing Inquiry I                                                              2
NUSC 527            Nursing Inquiry II                                                             2
NUSC 528            Health, Environment and Systems                                                2
NUSC 529            Issues of Advanced Practice in Nursing                                         2
NUSC 530            Physiologic Basis of Nursing Practice Across the Lifespan                      4
NUSC 531            Pharmacotherapeutics in Advanced Practice in Nursing                           3
NUSC 532            Comprehensive Health Assessment for Advanced Practice                          3
NUSC 533            Applied Pharmacotherapeutics in Advanced Practice in Nursing                   1
NUSC 597            Master’s Project            or                                                 3
NUSC 598            Thesis Research: Master’s                                                      5
                                            Concentration Core
NUMS 540            Pathophysiological Basis of Disease                                            3
NUMS 550            Common Geriatric Health Problems                                               3
NUMS 552            Management of Complex Geriatric Health Problems                                3
NUMS 553            GCNS Practicum I: Common Geriatric Health Problems                             3
NUMS 555            GCNS Practicum II: Complex Geriatric Health Problems                           4
NUMS 557            GCNS Practicum III: Integrative Practice                                       4

                    Total Degree Hours                                                           43-45

* Optional Advanced Practice Palliative Care Nurse Certificate Program

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