United in a Common Cause: The National Workforce Alliance to Care for an Aging America

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• Nursing and NWACAA
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• Dr. Barbara Resnick

In April 2008, the Institute of Medicine (IOM) released a study titled “Retooling for an Aging America: Building the Health Care Workforce.”¹ This report documents the critical shortage of both professionals and direct care workers necessary to meet the health care requirements of the rapidly growing and increasingly diverse older population in the United States. Steps were proposed to address the recognized shortage by enhancing geriatric competence of all those who care for the elderly, increasing recruitment and retention of those dedicated specifically to geriatrics, and redesigning models of care to increase access and quality of care. A task force was subsequently developed to implement solutions to the challenges identified in the IOM report and essentially to expand and improve the workforce responsible for ensuring that all older adults receive high-quality, patient-centered care. The Atlantic Philanthropies and the Hartford Foundation graciously decided to fund post-IOM workforce report activities with the hope that some of the recommendations would become a reality.

The National Workforce Alliance to Care for an Aging America (NWACAA) was thus developed on September 17. The NWACAA is a multi-stakeholder group composed of representatives of consumers, family caregivers, clinical and academic professionals and trainees, organizations of direct care workers, researchers, employers, labor, and health care advocates. Its mission is to ensure a sufficient and competent workforce to meet the current and burgeoning demand to care for older adults.

Initially 21 organizations confirmed their commitment to the mission, principles, and priorities of the NWACAA and pledged their financial support for future actions proposed. Organizational members of NWACAA reflect a balance among consumers, direct care workers, family care givers, clinical and academic professionals, health providing organizations, labor, employers, and health care advocates. Table 1 provides a current list of the NWACAA members to date. The members developed and agreed on several basic principles:

Table 1. Members of the National Workforce Alliance to Care for an Aging America and Interested Organizations

To complete the proposed work, the NWACAA formed 3 work groups at the September 17 meeting: the Direct Care Workforce Group, the Professional Workforce Group, and a third work group titled Models of Care. Over the next 3 years, these groups will work toward resolving the issues raised by the IOM report.

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Nursing and NWACAA 

So where does nursing stand in all of this? Well the wonderful news is that nursing is well represented within the NWACAA through the efforts of individual nursing organizations (e.g., the American Nurses Association) as well as through the combined voice of the Coalition of Gerontological Nursing Organizations (CGNO). If you haven't heard of the CGNO or don't remember what it is, I strongly encourage you to visit www.hartfordign.org/policy/cgno/ and become familiar with the work of this group. Briefly, the CGNO, which is supported by the John A. Hartford Institute for Geriatric Nursing, located at New York University College of Nursing, represents more than 20,000 geriatric nurses seeking to improve the health care of older adults across care settings. Gerontological Advanced Practice Nurses Association (GAPNA), National Gerontological Nursing Association (NGNA), and American Assisted Living Nurses Association (AALNA) are all members of the CGNO, along with groups such as National Association of Directors of Nursing Administration in Long Term Care (NADONA/LTC), and the American Academy of Nursing Expert Panel in Aging (AAN).

Two representatives from CGNO will attend the NWACAA meetings and report the action/activities occurring within the NWACAA. This will then be disseminated to all CGNO members (i.e., the CGNO representatives from the individual nursing organizations that are part of the CGNO). Nursing therefore has a major voice among this interdisciplinary group and the opportunity to share our successes and challenges with regard to recruitment and retention of nurses in the area of geriatrics.

I am particularly excited about how the NWACAA will address the “direct care” workforce issues—the issues among the “nonprofessional” workforce such as nursing assistants and family caregivers. I hope, and anticipate, that there will be much cross-group work and cross-discipline interaction among the NWACAA members. Maybe, in 3 years, team practice will come to fruition in the truest sense? We will begin to match skills with care services such that the most appropriate and cost-efficient provider will provide the service and allow access o care for a greater number of older individuals. Our best diagnosticians will diagnose, our best managers of chronic disease will do that level of medical management, those best at knowing about and accessing health care resources will provide that service, and those best at providing direct nursing care at its most basic level will do so with the input, support, and appreciation of a team behind him or her.

So be aware of the work of your organizations in the NWACAA and provide the support and input that your NWACAA representation may call on you to provide. And of course, continue to support the gerontological nursing organizations of which you are currently a member and maybe—just maybe—reach out this year and join yet another one, get involved and increase your own individual voice in the field of gerontological nursing.

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Reference 

1. Institute of Medicine of the National Academies. Retooling for an aging America: building the health care workforce. Available at www.iom.edu/?id=53452. Cited November 15, 2008.
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