Adult gerontology nurse practitioners (AGNPs) provide patient-centered, comprehensive healthcare to adults and geriatric populations in a variety of settings, applying evidence-based methods to assess, diagnose, and develop treatment plans for health conditions. The American Association of Colleges in Nursing (AACN) provides a breakdown of the scope of practice for the two subfields of AGNP: acute care (AG-ACNP) and primary care (AG-PCNP).
For AG-ACNP professionals, competencies include:
For AG-PCNP professionals, competencies include:
Both AGNP subgroups also provide referrals to other specialized healthcare experts when necessary.
The responsibilities and privileges of practice for AGNPs vary by region. The American Association of Nurse Practitioners (AANP 2015) notes that some states—particularly in the midwest—grant NPs generous privileges of practice and they may not need the supervision or permission of physicians to evaluate patients, prescribe medications, and perform procedures. Other states—mainly concentrated in the south—restrict the abilities of NPs to work independently in some circumstances and require the superintendence of other healthcare professionals. Additional information regarding the state-based differences in AGNPs’ scope of practice can be obtained from each state’s board of nursing, a list of which can be found on the National Council of State Boards of Nursing (NCSBN) website.
Read on to discover how to become an AGNP (acute or primary care), as well as information about specific schools, professional certification, and program accreditation.
Adult gerontology nurse practitioners (AGNPs) in both acute and primary care require at least a master’s degree to practice. According to CareerOneStop (2015)—a data group affiliated with the US Department of Labor—77.8 percent of all actively practicing NPs have master’s degrees, and another 12.7 percent hold doctoral or professional degrees. The estimates by the American Association of Nurse Practitioners (AANP 2015) are even higher, reporting that fully 95.1 percent of all NPs hold graduate degrees.
Here is a summary of how to become an AGNP with differences between the subfields noted below:
While in high school, aspiring AGNPs are advised to excel in science classes (e.g., chemistry, biology, anatomy, physiology, etc.) and volunteer in healthcare settings if possible. This experience can behoove an applicant to two- to-four year undergraduate nursing programs by providing hands-on instruction and valuable letters of recommendation.
At this stage, there are various program options available. Although some candidates choose to pursue associate degrees, it may be advisable to get a bachelor of science in nursing (BSN) degree instead. BSN programs fulfill a number of course prerequisites for graduate programs in nursing, including epidemiology, microbiology, chemistry (inorganic, organic, and biochemistry), human anatomy & physiology, statistics, and general education. Both associate (i.e., ADN) and BSN programs prepare students to take the National Council Licensure Examination for Registered Nurses (NCLEX-RN): the test to become a registered nurse (RN). Please note that to sit for the NCLEX-RN exam, a candidate’s undergraduate program must be accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing, Inc. (ACEN).
After BSN graduates pass the NCLEX-RN exam, they generally garner one- to three-years of experience prior to enrolling in a graduate program in nursing. Although many AGNPs choose to pursue a two-year master of science in nursing (MSN) in their preferred subspecialty (acute or primary care), some candidates may be advised to enroll in a three-year doctor of nursing practice (DNP) program. The American Association of Colleges of Nursing (AACN) has called the DNP “the future of specialty nursing education” and notes that nursing is one of the few healthcare fields which calls for master’s-prepared (as opposed to doctorate-prepared) professionals. At this point, the DNP is a terminal degree in nursing ideal for aspiring leaders, managers, and executives in healthcare.
For AGNP graduate programs—both acute and primary, MSN and DNP—applicants are typically required to submit:
Please note that some graduate nursing programs—often referred to as direct entry, alternate entry, bridge, or accelerated programs—accept applicants with associate degrees (and nursing experience) or non-nursing bachelor’s degrees. For example, the American Association of Community Colleges (AACC) provides a list of RN-to-MSN programs for candidates for associate degrees. Additionally, schools such as Kent State reviews non-nursing, post-baccalaureate students based on clinical portfolios, and others such as Johns Hopkins University (JHU), Seattle University, and the University of Rochester provide additional coursework in “accelerated” AGNP programs for non-nursing MSN applicants.
Finally, students in AGNP programs may also choose to specialize beyond acute and primary care tracks. For instance, the University of California, San Francisco (UCSF) provides specialty tracks for AGNP candidates in HIV/AIDS or occupational/environmental health. Other specialties offered may include oncology, cardiology, and orthopedics.
For a more detailed discussion on becoming an AGNP—including breakdowns of the various subfields and certifications—please visit the how to become a nurse practitioner page.
In addition to the vast array of online adult NP programs available, here are four hybrid or on-campus AGNP programs, two in each subspecialty (acute and primary care):
Case Western Reserve University in Cleveland provides a comprehensive, 39-credit AG-ACNP MSN program with courses such as theoretical foundations of acute nursing care, assessment for advanced practice, and collaboration & consultation. This program boasts entry options for ADN- and BSN-prepared students and involves 600 hours of supervised clinical practicums as well as two subspecialties: cardiovascular nursing and flight nursing. This school also has an AG-PCNP program.
The University of Pittsburgh’s top-ranked AG-ACNP program helps students with leadership aspirations push their training to new heights with the terminal DNP degree. Tying for #5 on U.S. News & World Report’s (2016) list of top AG-ACNP programs, this three-year curricula combines 1,020 hours of hands-on clinical training in local preceptors and courses such as applied statistics for evidence-based practice, ethics in healthcare, and management of adult episodic/chronic health problems. This practice-focused doctoral program admits both BSN- and MSN-prepared candidates, and master’s-prepared students may be able to complete their coursework predominantly online. Finally, this school also offers an AG-PCNP DNP program.
The University of Michigan, Ann Arbor’s (UM) prestigious AG-PCNP program—ranked #3 among U.S. News & World Report’s (2016) top AG-PCNP programs—provides “the Michigan difference” in Master’s-level advanced practice preparation. Boasting a variety of clinical practice settings to expose its students to a range of conditions and a rigorous curriculum with classes such as primary care (PC) of older adults, behavioral & lifestyle management in PC, and pharmacotherapeutics I/II, UM’s 48-credit MS – AG-PCNP program prepares its graduates to become community-based NPs. Please note that UM also offers an AG-ACNP program.
Rutgers University hosts an AG-PCNP DNP program at its Biomedical Health Sciences Campus in Newark, NJ. Designed for BSN-prepared nurses, this school offers instruction in epidemiology & population health, information technology for evidence-based practice, and the social determinants of health. Providing a “holistic approach to primary care for patients across the lifespan,” Rutgers combines 68 hours of coursework, 540 clinical hours at preceptor site(s), and 500 additional mentored hours to fully flesh out the student’s capstone project. Additionally, this school has a DNP program in the AG-ACNP specialty.
Following graduation from an AGNP program, these prospective healthcare professionals generally seek national certification and local licensure.
For AGNP specialists in acute and primary care, they must seek licensure through their state-based board of nursing. The procedures differ by region, and as mentioned in the introduction, the National Council of State Boards of Nursing (NCSBN) provides a useful list of these boards’ contact information.
For AG-ACNPs, there are currently four main professional certifications. The American Nurses Credentialing Center (ANCC) offers the acute care NP (for which last application will be accepted December 2015) and the AGACNP-BC (“board certified”) certifications. Each of these must be renewed every five years following the completion of professional development (i.e., continued education [CE] hours). Also, the American Association of Critical Care Nurses (AACN) provides two acute care NP certifications: adult and adult-gerontological.
For AG-PCNPs, there are four common national certifications. The American Academy of Nurse Practitioners (AANP) provides the adult nurse practitioner and AG-PCNP certifications, and the American Nurses Credentialing Center (ANCC) provides the adult NP (for which last application will be accepted December 2015) and the AGPC-BC certifications.
Prerequisites for these certifications include earning an MSN or DNP from a program accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing, Inc. (ACEN); completing relevant coursework; being an active RN; showing proof of at least 500 faculty-supervised clinical hours; and passing an exam.
Students enrolled in any AGNP program should verify their school’s accreditation status. The Accreditation Commission for Education in Nursing, Inc. (ACEN) and the Commission on Collegiate Nursing Education (CCNE) are two accrediting agencies recognized by the US Department of Education. These accrediting organizations evaluate the facilities, faculty, student outcomes, and curricula of nursing programs, effectively providing a level of assurance to enrolling students about the quality of education they will receive. The ACEN accredits diplomas, certificates and degree-level programs while the CCNE accredits bachelor’s, graduate, and residency programs.
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Online MSN - AC-AGNP
Online MS - AC-AGNP