Exploring the Role of the Adult-Gerontology Nurse Practitioner

, the number of Americans 65 and older grew five times faster than the total population between 1920 and 2020, reaching a 2020 peak of 55.8 million (or 16.8% of the population). If 1 in 20 people were 65 or older in 1920 and 1 in 6 are now of an advanced age, our healthcare system’s ability to address those individuals’ needs is crucial. In answer to these needs, it’s worthwhile to consider the value of Adult Gerontology Nurse Practitioners (AGNPs), advanced practice nurses trained specifically to care for adults and older adults.

The AGNP Paradigm

Ann Kriebel-Gasparro, DrNP, FNP, GNP, FAANP, is the president of the Gerontological Advanced Practice Nurses Association (GAPNA). Dually credentialed as both a family nurse practitioner and a gerontological nurse practitioner — while also having her Doctor of Nursing Practice — Dr. Kriebel-Gasparro is uniquely positioned to impart wisdom regarding the value of the AGNP role.

Dr. Kriebel-Gasparro shares, “Adult-gerontology primary care nurse practitioners (AGPCNPs) deliver primary care in outpatient settings from adolescence to older adulthood, and adult-gerontology acute care NPs (AGACNPs) provide care to critically ill adults and older adults, usually in hospital inpatient settings, and also urgent care or emergency departments.”

She continues, “Currently, more NPs are entering the FNP track than either of the Adult-Gerontology paths. There is a common myth that FNPs will have better job opportunities, but this is not exactly true. And despite a rapidly aging population, FNP programs vastly outnumber AGNP programs nationwide. Differences in competencies, certification examinations, and practice settings between the two are discussed in-depth in Adult-Gerontology Nurse Practitioners: A Discussion of Scope and Expertise by Peacock et al., who states:

“Adult NP (ANP) programs grew out of a need for more primary care providers in the 1970s…Gerontology NP (GNP) programs emerged in the 1970s and 1980s in response to an aging population and the need for more specialized care of older adults.

“In 2008, the ‘Consensus Model for Advanced Practice Registered Nurse (APRN) Regulation: Licensure, Accreditation, Certification & Education (LACE)’ was released. This document combined ANP and GNP into one population focus (AGNP) and differentiated primary care and acute care roles.”

The AGNP Career Path

When discussing the role that AGNPs have to play in healthcare and the careers that this role affords, Dr. Kriebel-Gasparro shares these reflections:

“There is a dire need for APRNs who will care for the aging population. Many academic faculty have noted that NP students who choose the FNP track may not be especially interested in pediatric rotations and don’t plan to practice with children upon graduation. However, many potential NP students have been led to believe that they will have better job opportunities upon graduation as an FNP.

In my role as the Director of two BSN-DNP programs in Pennsylvania, during many interviews with potential NP students, I asked students if they like to practice with children or had any prior pediatric experience. This raised some red flags if the potential student answered no to these questions.”

Kriebel-Gasparro continues, “An important component of the FNP program is the pediatric rotation. Many (not all) FNP students who did not care for pediatrics didn’t do well, and they admitted they chose the FNP because they were advised to or believed it would make them more marketable.

In terms of the AGACNP career path, Dr. Kriebel-Gasparro poses this thought: “Take a closer look at the role of an adult-gerontology acute care nurse practitioner (AGACNP). Do you have the desire to improve health outcomes for patients with acute and, often, chronic health conditions? If you answered yes, you should consider a career as an AGACNP. And the AGACNP role can also sometimes involve administrative, teaching, and research responsibilities.”

Looking to the Future

As mentioned previously, our current reality is a rapidly aging population. If we consider the Bureau of Labor Statistics (BLS) projections of 38% job growth for NPs, CRNAs, and nurse midwives through 2023 and couple that with Dr. Kriebel-Gasparro’s advice, there will likely be no shortage of career opportunities for nurses interested in advanced practice, including those who would choose to be employed by facilities or practices specifically targeting older adults.

Blindly applying to FNP programs based on erroneous advice or unrealistic expectations may be misguided, and those interested in gerontology would do well to consider the AGNP role.

To this end, when questioned about what makes a nurse’s application strongest when applying to AGNP programs, Kriebel-Gasparro advises, “As with any college/university application, the admissions team will look at grades, but grades are not the only thing that will be reviewed. Many schools are looking at applicants with a ‘holistic admission’ viewpoint, meaning academic excellence, intellectual vitality, and extracurricular activities are considered. Some schools will also consider hardship such as financial need.”

Kriebel-Gasparro adds, “Membership and activity in nursing organizations, volunteer activities in the community, publishing, advocacy, and other aspects will also be strong positive points for nurses applying to most any nurse practitioner program.”

With nurse practitioners holding the #1 job in 2024 with a median annual salary of $121,610, according to U.S. News & World Report, there are many career opportunities to consider, despite the knowledge that NPs are hard-working healthcare professionals with frequently long hours.

“As a nurse practitioner, I am always a nurse,” Dr. Kriebel-Gasparro proclaims. “I began my career as an LPN, then earned my RN, my BSN, became an NP, and finally completed my DrNP at Drexel in 2014.”

“I often hear nurses say they’re too old to continue their education, and this is untrue,” admonishes Dr. Kriebel-Gasparro.” Our profession needs nurses at the bedside but also as teachers in academia, as mentors, in the boardroom, and serving as legislators in local, state, or federal government. For instance, we proudly have family nurse practitioner Tarik Khan representing us in the PA House of Representatives.”

Dr. Kriebel-Gasparro concludes, “Without reservation, it’s never too late to continue your education. Nursing is one of the most diverse and most trusted professions. There is no expiration date for being a nurse, and I am so proud to continue to serve patients and communities in need for as long as I can, including caring for older adults who so clearly need our expert care.”

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