Perspectives on Nursing Care of the Advanced-Age Population and on Nursing Certification

Sarah P. Macklin-Brown, RN-BC, MS Ed, CASE, CPHQ


July 08, 2009

Nursing Care of the Advanced-Age Population

Sarah P. Macklin-Brown, RN-BC, MS Ed, CASE, CPHQ, a bedside nurse for over 44 years shares observations about changes in care for older patients during her career and the importance of nursing certification.

Over the last decade, nursing care of the advanced-age population has changed. In addition to care being provided by older bedside nurses, nursing care is research oriented, evidence based, and theoretically proven.

At the bedside since 1964, I have watched nursing care evolve while embracing all that medical and technological advancement have to offer. “Ball point pens are out, touch screens are in.” In 1964 taking a patient’s temperature took 3 minutes using a mercury thermometer. Now, temperatures are practically instantaneous with a core/digital thermometer.

Inventions of this sort continually re-define a nurse’s role in patient care. Wireless communication devices and computers allow for improved care at the bedside, less misinterpretation of care orders, and improved communication among caregivers. Patients are entering the hospital well educated about their care and the options available to them. That same patient is recuperating faster and is being discharged sooner.

Technology has not only developed faster and more efficient patient care methods, but patients now want to play an active role in their care. Caring for these patients requires nurses to be well-read and well-informed on the latest advances in medical and nursing care. Many older patients enter the hospital with detailed medical knowledge, questions, and opinions. A dedicated and informed nurse is ready for that.

Advanced age patients are also more active today than 20 years ago. They are not “taking it easy” in their golden years. They are running, walking, cycling, traveling, and generally, are doing things they were unable to do when they were raising families. Unfortunately, reflexes have slowed, eyesight may be failing, bones are weaker, and there is less muscle mass. This can lead to traumatic injuries as a result of recreational pursuits. Additionally, with notable changes in the current economy, older adults are remaining in the workforce longer, thus causing more stress-related illnesses such as headaches, back pain, chest pain, and exacerbation of other chronic conditions such as hypertension and diabetes.

Certification and a Nurse's Career

To stay up-to-date with nursing care today, nurses need to look beyond their place of employment to further education and learning opportunities. An RN behind a nurses’ name is just the beginning. New nurses, and older nurses as well, should attend programs offered by their facility and aim for certification in their specialty. Certification sets you apart from other nurses. It displays your commitment and dedication to the profession of nursing. Nurses should join their professional organizations and understand that nursing is not limited to one area. Every nurse has a niche. Working in different areas will help nurses find that niche.

I chose medical-surgical nursing early in my career. A medical-surgical nurse cares for patients across the continuum of the adult population. This is accomplished by providing care for conditions that affect multiple body systems and disease entities. My experience in caring for patients has focused specifically on patients with medical conditions, those facing surgical procedures, and those with acute and chronic conditions.

A lifelong learner, I spotted the “C” (designation for certification) on another nurse’s nametag in 1986. After obtaining certification myself in 1987, I made a commitment to maintain my certification. To do so, I regularly attend educational seminars, maintain professional journal subscriptions, attend professional meetings, and maintain membership in professional organizations. I pride myself on knowing what is happening in the world of nursing.

My recent appointment to American Nurses Credentialing Center’s Commissioner on Certification (COC) is a highlight in my 44 years as a bedside medical-surgical nurse. Volunteering as a Commissioner allows me to take the knowledge that I have gained to another level. Working with other members of the COC gives me the opportunity to make sure that nurses who desire to become certified will be successful in their pursuit. Serving on this commission, I am also able to participate, as a stakeholder, with specified accountability, ownership, awareness, and ability in furthering nursing certification.

This content is provided by American Nurses Credentialing Center (ANCC) for publication on the website.

The American Nurses Credentialing Center's (ANCC) internationally renowned credentialing programs certify nurses in specialty practice areas, recognize healthcare organizations for nursing excellence through the Magnet Recognition® and Pathway to Excellence Programs, and accredit providers of continuing nursing education. In addition, ANCC offers an array of informational and educational services and products to support its core credentialing programs.

ANCC is passionate about helping nurses on their journey to nursing excellence. Visit ANCC's web site at

The American Nurses Credentialing Center (ANCC) is a subsidiary of the American Nurses Association (ANA).


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