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With the passage of the Patient Protection and Affordable Care Act (ObamaCare), we are facing a complete overhaul of our health care system in order to meet the needs of the additional 32 million Americans the system will serve. Achieving equitable access to health care for this culturally and linguistically diverse group calls for sweeping changes to our beleaguered health care system. The Institute of Medicine (IOM) in its 2010 report on the future of nursing challenges nurses to take their places as “full partners” with other health professionals in reconceiving the American health system. Advanced practice nurses (APNs) are urgently needed not only to fill in the gaps left by the primary care physician shortage, but also to take a leading role in caring for acutely ill patients as they transition through a variety of settings (IOM, 2010).

In addition our reworked health care system will require new expertise in delivering culturally competent, integrated care for acutely ill adults over the age of 65, who already constitute more than one-third of hospital admissions, and whose numbers will rise from 13% to 20% of the total population by 2050 (Administration on Aging, 2009; Agency for Healthcare Research and Quality, 2007). This demographic shift will necessitate the increased competency of bedside nurses to care for acutely ill older adults. Currently, less than one percent of RNs is certified in gerontology (Mauk, 2006). Clinical nurse specialists, with their focus on three “spheres of influence” (patient/family, nurse, and health system), are uniquely positioned to lead the necessary process of “gerontologizing” both acute care nurses and settings, through their multiple roles as expert clinician, nurse educator, multidi...

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...., Whelan, A.K., & Roberto-Forero. (2008). What do non-English speaking patients value in acute care? Cultural competency from the patient’s perspective: A qualitative study. Ethnicity & Health, 1(13), 479-96.

Institute of Medicine (IOM). (2010). The future of nursing: Leading change, advancing health. Retrieved on October 27, 2010 from: http://www.nap.edu/openbook.php?record_id=12956&page=1

Langer, N. (1999). Gerontologizing health care: A train-the-trainer program for nurses. Gerontology and Geriatrics Education, 19(4), 47-56.

Mauk, K. L. (2006). Gerontological nursing: Competencies for care. Sudbury, MA: Jones and Bartlett Publishers, Inc.

National Association of Clinical Nurse Specialists (NACNS). (2010). CNS core competencies. Retrieved on October 23, 2010 from: http://www.nacns.org/LinkClick.aspx?fileticket=22R8AaNmrUI%3d&tabid=94
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