advancement opportunities for
nurses aids could be part of
the solution to the nursing shortage

Initiatives to improve training and opportunities for career advancement have been undertaken by states as well as providers. States and providers are experimenting with specialized training for nurse aides in targeted patient care areas, such as treatment of persons with dementia, and are developing career ladders that offer aides a chance to improve their skills while also advancing their careers.

For example, according to Massachusetts officials, the Massachusetts Nursing Home Quality Initiative provides $5 million in fiscal year 2001 specifically to develop competitive nurse aide career ladder grants and to encourage the development of partnerships of concerned groups, including community colleges and workforce investment boards.

Initiatives that focus on workplace and social supports for nurse aides fall into two categories. The first type of support targets the structure of the aides work environment, focusing on issues such as nurse aide participation in care planning and the empowerment of nurse aides to act on their special knowledge of their clients.

For example, the Wellspring Program in Wisconsin is an alliance of 11 providers whose approach is based on the idea that management should foster quality of care with appropriate policies, but decisions on policy implementation should be left to the front-line workers who are most familiar with residents needs.

The second type of support focuses on general work skills and social supports for nurse aides. For example, the Iowa Caregivers Association, a nonprofit organization representing nurse aides, received state funding to develop a pilot project to determine the effect on nurse aide recruitment and retention of employee supports such as workshops on teamwork and communication and an aide-mentoring program.

Additionally, the California Caregivers Training Initiative is a state-funded effort to improve nurse aide recruitment and retention and includes providing supportive services such as childcare and transportation. Other state and provider initiatives have addressed general work skills through programs such as general educational development diploma preparation or courses in English as a Second Language.

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