May 15, 2007
Tuesday AM

In 2006 the first year of the baby boom generation turned 60. In the very near future, this, the largest U.S. generation in history - 77 million people - will come into their retirement years. In doing so, they will transform every aspect of American society.

This generation will not go silently into the good night. They will not meekly submit to retirement but will bend and shape the concept to suit their needs.

The evidence is clear that this will remain an activist generation until the end of its days. To meet their health needs, baby boomers will shape home- and community-support programs rather than look to institutions. While they will be far healthier and live longer than their parents, boomers -- the richest generation in history -- will have the resources to structure the support programs needed to deal with disabilities and remain independent in their own homes.

The sheer numbers of this generation suggest that there will be a tremendous increase in the need for nurses, especially those who work in home care. With this group already in short supply, the question is: Where will America find the home care nurses it will so desperately need? Here are some thoughts:

-- The face of the new worker is over 65. One of the most fruitful avenues will be to attract back nurses who retired. This will involve taking a hard look at the reasons why they removed themselves from the workforce (excessive paperwork, for example), and it will involve giving flexible hours and reasonable pay.

-- We should look to create a career ladder and promote those who have worked as home-care aides. These individuals who provide the hands-on personal care have the right ethic. Most of them would love it if, through some combination of education and experience, they could be elevated to the status of nurse.

-- We must make home care a preferred profession. Nurses who work in institutional settings will very quickly see the advantages of working in home care. The question should be: Are you good enough to be a home-care nurse?

-- We should give preference to nurses through our immigration laws. Our immigration laws create preference to certain categories of employees deemed critically important and in short supply. We should give preference to those who are trained, who have the right work ethic, caring and professionalism to work in home care.

-- We should increase the supply of home-care nurses. The shortage of good teachers is what limits the number of nurses that can be trained and graduated by our schools of nursing. Top-flight home-care nurses should be recruited to teach what they know in schools of nursing.

-- The Internet should be used by home-care agencies to help train and keep the skills of home-care nurses sharp. There is no reason why much of the training of future home-care nurses cannot be done virtually.

-- We should increase the reach of home care nurses by giving them access to the latest telehealth technology. I envision one nurse monitoring the data for a dozen monitors and dispatching a team to serve a patient the second that this is indicated by the telemetry. Telehealth will increase efficiencies and allow us to stretch this vital resource in order to serve more people.

Telehealth will also save money and lives and cost less than the traditional modes of home-care delivery.

In the final analysis, what is most important is to stress the mission and the values that explain why home-care nurses have selected a career in serving the infirm and dying. There is no more noble profession and none that provides the psychological rewards. Good pay and benefits will also help nurses choose to stay in home care but more important is the opportunity to help others who are ill and in need. Home-care nurses understand what Mother Teresa meant when she said, "Caring for others is love in action."

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