CNAs are a vital part of an effective organization. On a daily basis they provide care to the elderly, chronically ill, and individuals who may require special care in nursing homes or long term care facilities. It has been shown that in the next twenty years there will be a need for an additional 700,000 CNAs in the United States. It is important then that CNA Training programs provide an individual with all of the tools they will need to thrive in their career as a CNA.

Each state has different requirements that must be met before one can take the CNA exam for certification. The training includes both an educational component and a clinical component.

The length of time it takes to complete training varies depending on who is teaching the courses, where the clinical training is taking place, and the state requirements for certification. Contacting the State Department that certifies Nursing Assistants will help one to find out what the requirements are for certification.

When a person makes the decision to become a Certified Nursing Assistant, they will find that there are many opportunities available in their local area to take the necessary classes and get the clinical training that is needed. Programs can be found through local hospitals, nursing homes, and community colleges. There are also Red Cross CNA training programs available in most states.

There are two phases in the CNA Training that must be completed before one can take the examination, the written test and the skills test.

There are many courses in the educational part of the CNA Training. These include medical terminology, Fundamental of Nursing, and other healthcare topics that will make sure that the individual can understand and work in the clinical environment. The state also requires that one receive a first aid certification which counts toward the educational requirements for the examination.

Clinical experience is gained through work at a facility. States differ on the number of clinical hours that an individual must work. The hours can range from a few weeks to a month to attain the required hours of clinical training. Some facilities pay a person who is working on their clinical hours and then hire them when they have passed the certification examination.

The examination can be scheduled after all of the requirements have been met. One submits proof of completion with their application and the test is scheduled. The test will cover both the educational and clinical work that has been done. It is important that if a long period of time has elapsed since taking the eduational courses for the CNA that they take a refresher course to prepare for the test.

After a person has completed the training and passed the examination they have become a Certified Nursing Assistant and can work anywhere in the state where they are certified. If they move to another state however they will need to complete a Request for Reciprocity.

Most people preparing for their test become nervous, since this is where all the training comes to its fruition. Even though you’ll be anxious, the reality is that most people find that written exam to be a breeze. Of course it helps to prepare prior to taking the exam by going over your notes and what ever other material you hopefully saved from your CNA classes.

Some general test taking tips might help you. On multiple choice questions, if you aren’t sure of the right answer, try subtracting the answers you know are not correct. That may leave you with an easier clearer choice. Also, trust your instincts. More often then not, your first answer will be the right answer.

The clinical portion will include many of the skills you learned and practiced in your training. You will probably be asked to demonstrate basic nurse assistant skills such as taking vital signs. Remember to take your time. Spending a few moments calming your self can help a great deal. When you’re trying to get an accurate measure of blood pressure and pulse wall being monitored by the test proctor.

You may also have to demonstrate other clinical skills such as the proper ways to move a patient, demonstrating proper hygiene such as hand washing, and possibly even changing and making a bed.

If you went through the ARC or Red Cross CNA training, you will be well prepared for testing. Another way, you can prepare and boost your chances for success on that test, is to spend some time looking through some of the free CNA classes online. Taking the exam online is also smart because you can work around the hours that you want to work around.

Being involved in an online study group can help you tremendously when you sit down to take the actual exam. Look for forums with others who are either practicing Certified Nursing Assistants, have recently taken the exam, or are studying for it like you are.

The CNA exam shouldn’t be intimidating or frightening. After all, the worst that can happen is you don’t pass. You can still sign up to take it again. And remember what it’s all for. All the classes and studying have given you the skills, knowledge, and confidence to become a professional Nurse Assistant, and open the doors to life-long job security, good wages, an exciting work environment, and the satisfaction of helping others and knowing that your chosen career makes a real, and significant difference to the patients you are charged with caring for!

The first written part of the CNA exam is relatively simple, and focuses on the overall basic medical concepts and procedures that would have been learned during the CNA training course. Enrollment into a good nursing assistant course, such as the Red Cross CNA class helps insure that you will pass the CNA exam. A nursing assistant course can last anywhere from a few weeks to 3 months including classroom training sessions, followed by a few practical training sessions, where the trainee learns clinical application and how to apply the skills thhe have been taught during the classroom session. The clinical training is carried out under the supervision of registered nursing staff and it usually involves working directly with real patients.

Most people who have passed the skills test will tell you that the written part of the exam is quite simple and easy to pass provided you have carefully studied the nursing manuals and books provided during the nursing assistant course.

Clinical Part Of The CNA Skills Test

The second clinical part of the exam is somewhat more challenging, and tests the clinical skill sets of the individual. Usually, the examinee is supposed to bring an escort with them, who will need to act as the model, for the practical examination. The examinee will need to demonstrate his clinical skill sets using the escort as the model. The examiner may ask the examinee to demonstrate any number of clinical skills that he may have learnt during the clinical training sessions of his nursing assistant course.

The examinee may be asked to demonstrate from three to five clinical skills such as – washing hands, respecting the patient’s privacy, repositioning the patient, grooming the patient, taking the patient’s temperature measurement, holding the bedpan, or changing the linen of the patient’s bedding.

Each and every step of the CNA skills test is carefully observed and evaluated by the examiner. Even a small lapse such as not washing hands or not knocking on the door before entering a patient’s room may land you in trouble. Therefore, the examinee has to take extra care performing the various exercises. Most importantly, the examinee should be calm and composed because this is what the examiners would like to know – whether or not you are able to perform perfectly well even under stressful real life conditions. So, if you remain calm and composed, and carry out the clinical part of the exam perfectly well, you can be assured of your success.

The CNA exam is supervised by a state examiner. He observes and carefully evaluates every examinee’s performance. He may also give mock cases to the examinee and ask him to assume that the model is a victim of cardiac arrest, who also has his left side of the body paralysis. He might then ask you to get the model out of his bed, on to a wheel chair. So, at that time, the examiner would be watching carefully to note from which side the examinee lifts the model and how he transfers him on to the wheelchair. You need to follow the correct procedures learned during your training and pay small attention to details like locking the wheels of the wheel chair before transferring the model on it.

You may have a great career ahead as a certified nursing assistant, but for that, you would need to pass the CNA skills test and obtain state certification. Remember to stay calm, and pay attention to minute details and you are sure to pass the exam with flying colors!

Written by Melanie Ullman

The Red Cross CNA training course meets both Federal and State CNA (certified nursing assistant) training requirements, as well as GNA (geriatric nursing assistant) training requirements for certification. Classes are conducted in state-of-the-art classrooms, which are equipped with four hospital beds, a Hoyer lift, mannequins, wheelchairs, and all other necessary materials and equipment that students will need to know how to use and operate once on the job. Students learn to how to perform the following procedures:

• First Aid for Choking
• Hand washing
• Putting on and Taking Off Protective Clothing
• Handling a Plastic Trash Bag
• Using an Electronic Thermometer
• Counting and Recording a Person’s Pulse
• Counting and Recording a Person’s Respiration’s
• Taking and Recording a Person’s Blood Pressure
• Moving a Person Around in Bed
• Positioning a Person in Supine, Fowler’s, and Lateral Positions
• Transferring from Bed to Chair
• Repositioning a Person in a Chair
• Using a Mechanical Lift to Transfer a Person from Bed to Chair
• Brushing and Flossing Teeth
• Providing Denture Care
• Giving a Person a Complete Bed Bath and Shampoo
• Helping a Person with Showering and Shampooing
• Brushing and Combing a Person’s Hair
• Helping a Man Shave with an Electric and Safety Razor
• Cleaning a Person’s Fingernails and Toenails
• Helping a Person Dress/Undress
• Making an Occupied/Unoccupied Bed
• Helping a Person Eat
• Measuring a Person’s Height and Weight
• Helping a Person Use the Bathroom/Commode/ Bedpan/Urinal
• Providing Perineal Care for a Person with a Urinary Catheter
• Emptying a Urinary Drainage Bag
• Applying an External Urinary Catheter to a Male
• Collecting Urine/Stool/Sputum Specimens
• Testing Urine for Sugar and Acetone
• Giving a Person a Tap Water Enema
• Diapering a Child
• Collecting a Urine Specimen from an Infant
• Helping a Person with Passive Range of Motion Exercises
• Helping a Person Walk
• Applying Elastic Stockings
• Sterilizing Glass Baby Bottles
• Bathing a newborn
• Providing Post Mortem Care
• Applying Compresses and Assisting with Soaks
• Changing an Ostomy Appliance

According to American Red Cross instructor Martha Gross, “Our Nurse Assistant training course is very fast paced. Our students are out in the workforce after just four or five weeks.” Once the course is completed, students become eligible to take the state certification exam. Many graduates, after passing their exams, find jobs in home health care, long-term care facilities, developmental disabilities homes, and hospitals.

There are many free CNA training opportunities available, however the Red Cross does charge for their course. You can often get free training and certification through local hospitals and nursing homes, or local vocational training organizations, however they do not cover the cost for the state exam.

While it might be beneficial for a student to have previous CNA training, The American Red Cross does not offer credit for previous training, experience, or coursework taken at any other medical facility, school, college, or university. Some providers do take workplace experience or prior training into account.

A typical day of a certified nursing assistant would go something like this: In the morning they would help the patients dress if needed, and assist them in any way to get ready for the day, including help in the bathroom if needed. They would also assist in feeding the patients breakfast if needed. Especially with the elderly or extremely ill patients, vitals usually need to be taken. Sometimes, depending on the patient, vitals can also mean listening to the heart and lungs and recording how the patient is breathing.

In the afternoon, nursing assistants would help with transferring patients to and from their different appointments if necessary, make their beds, and help feed them lunch if necessary. Vitals usually need to be taken yet again with the very old and/or sick patients. In the evening, nursing assistants would help put patients pajamas on if needed and help feed them dinner if needed as well. Vitals usually need to be taken again with the very old and/or sick patients. Nursing assistants also need to assist with baths too either during the afternoon or evening if the patients are unable to do so themselves. So, as one can see, nursing assistants are there for the patient for all their basic needs during the entire duration of the day.

Nursing assistants are also responsible for changing diapers on patients if used. If the diapers are non-disposable, nursing assistants are responsible to clean them out in places called Hopper Rooms, which is basically cleaning by water pressure, then the diaper is thrown in a container to be washed later. Other random duties that nursing assistants are expected to perform during the entire duration of the day is to empty catheters for patients that have them. Also, to empty bedpans as well if used.

If nursing assistants work during the night shift (or, the graveyard shift), they are expected to check on their patients often, and if needed, take their vitals, help them to the bathroom, or change their diapers. Nursing assistants are also expected to run errands for their patients such as getting them drinks and such.

Usually, to get trained as a certified nursing assistant, one must attend classes, usually offered in various locations close to one’s residency. At the end of those classes, if the tests are passed adequately, then the certification is issued. One must have a certification to work as a nursing assistant, just as one must be licensed to work as an LPN (licensed practical nurse). Just as one cannot work as a nurse without the proper training, neither can a nursing assistant, or shouldn’t anyway!

There are many jobs for certified nursing assistants. Part of that reason is because there are always people who get sick, there are always people who get into terrible accidents, and there is always the elderly who need extra care that they cannot do themselves.

In summary, nursing assistants are there to help the nurse with the basic care of their patients. They basically do everything to care for the patients except for the things beyond what they are trained to do. Therefore, the nurses patients also become the nursing assistants patients as well. Just as doctors report to nurses at the end of the day, nursing assistants report to the nurse they have been working for at the end of the day. Nursing assistants go through a complete summary of each patient. Not only that, but nursing assistants also have to update the newcomer taking over for them on their shift, meaning that they have to also give a complete summary of each patient to the nursing assistant replacing them.

Then, the final task for nursing assistants at the end of the day is to fill out everything that was done for the patient in a very specific and organized fashion. Each location will have a different way of having their employees fill out the necessary paperwork, whether it be on paper or on a computer.

A CNA must have the ability to understand and carry out routine non-technical, oral and written directions in relation patient and/or resident care. The willingness to cooperate and to carefully follow a prescribed routine is essential, as is discretion – patient privacy is something to be taken very seriously. You should have the ability to get along well with others and to secure cooperation of patients and/or residents. And even more so than many jobs, neatness and personal cleanliness are a must.

That said, the primary duties of a certified nursing assistant are always care of your patient. This can include daily care of a patient, and assistance as appropriate, such as help with eating, getting dressed, and movement.

As a CNA your duties may also include taking and logging patient information: vital signs (BP or blood pressure, pulse, respiration, and temperature), assessing your patients pain level, and their weight.

As a Nursing Assistant, it will also be your duty to report on your patient. Depending on where your job is, that may mean reporting to a head nurse or supervisor. A CNA is expected to be the “eyes and ears” for the attending nurse.

To function well and be the best possible Assistant, you are expected to be patient, caring, responsive, and above all responsible and professional. Your role may be varied, but the well-being of the patient or patients that you care for is always “Job Number 1″. A CNA can’t afford to be distracted or disinterested.

Here are some actual examples of duties a Certified Nursing Assistant is expected to perform, taken from recent “Help Wanted” classified ads:

• Assists in walking, feeding, bathing and related restorative and rehabilitative care activities for
  patients and/or residents and aids in caring for their personal needs and comfort;
• Assists nurses in lifting and turning patients and/or residents, in restraining disoriented patients
  and/or residents, in holding patients and/or residents for treatment, in care of involuntary patients
  and/or residents and may assist in preparing them for surgery;
• Helps regulate number of visitors and gives information to visitors in accordance with instructions from
  the nurse in charge;
• Assists professional nursing personnel in carrying out assigned range of motion, promotion of self-help
  and independence activities and reality orientation;
• Assembles information concerning the patient’s and/or resident’s condition and enters reports on the
  patient’s and/or residents record;
• Cleans and sterilizes equipment;
• Labels and stores patients’ and/or residents’ clothes and turns over valuables to person designated by
  the facility;
• May assist with care and moving of room furniture, fixtures and supplies to help keep patients and/or
  residents safe and comfortable;
• May assist in cleaning, laundry, resident feeding, and resident transportation, as needed.

A nurse assistant should expect a degree of physical activity as part of the job. While you don’t have to be a body builder,  you also don’t want to find yourself unable to get out of bed after your first day at work!

Along with the a Certified Nursing Assistant’s duties comes the satisfaction of helping others, and of knowing that you are a crucial member of the overall health care environment. Job satisfaction and self-esteem – along with good pay and the security of knowing there will always be jobs available – are some of the rewards you can expect in this career!

This test has both theory and clinical testing. The CNA Training is available online that you can take up from home at a very affordable price. The period of training may range from two weeks to several months depending on the demands from the state. This training explains the theory and shows few clinical findings.

For your clinical, or hands-on training, arrangements can be made at a hospital or nursing home. This will help in good clinical experience. Once completed, you should be fit enough to care for physically or mentally sick, injured, or disabled individuals in hospitals, and nursing homes.

With CNA training, as a Certified Nursing Assistant, you will be able to perform the following health care jobs confidently: Measuring vitals signs like temperature, blood pressure, pulse rate, and respiration. Recording the case history for every patient. Moving patients when required. Helping the patient exercise as the advice of a Physical therapist. Dressing the wounds for patients. Feeding the patients, also with food tubes. Inserting catheters and removing them as advised. Disinfecting the patient’s room and belongings. Communicating well with the patients Reporting the day-to-day development of the patient to the registered nurse or doctor.

As a Nurse Assistant, you will gain confidence and expertise in many basic health care jobs. This is also what will be expected of you in your CNA test. You will have both theory and practical tests. Theory test, you can clear with just what you have studied. As far as practical is concerned, it is not just the intelligence that is tested. You are tested for presence of mind. They check how are you able to face the situation. How confident are you. How boldly are you moving around and doing your duty. How neat are you able to keep the surroundings.

These are the requirements that this training program will equip you with. This CNA training program equips you with all the required amount of confidence and knowledge that will take you through this CNA test with flying colours. After becoming a Certified Nursing Assistant some people make their career in this line itself, whereas some of them consider this training program as a stepping-stone to become registered nurses (RN). The CNA training program is a boon for the already certified individuals who just need a brush up to renew or reapply for the certification.

By: Clare Absher RN, BSN

Am I Right for the Job?

To be a nursing assistant, you must have compassion and a desire to help people. It is not an easy job, but it can be very rewarding. As an RN in long-term care for many years, I have observed the dismay that new CNAs feel when overwhelmed by the workload and fast pace. When faced with challenging situations, nursing assistants who seem to be able to manage stress best are those with true compassion for the people who they are caring for. Nursing assistants who view their occupations as “just a job that pays the bills” usually are not successful and likely to have made the wrong career choice. Patience is crucial to the job, along with self-confidence and a certain level of maturity. Good interpersonal skills with an emphasis on being a team player are especially valuable traits for all health care workers.

How do I become a CNA? (Certified Nursing Assistant)

I receive numerous inquiries regarding becoming a C.N.A. and respond accordingly that it is not as difficult as one may think. However it is important to know that every state is different in regards to amount of time required for training and testing and the type of environment you’d like to work in. For information on specifics, you can contact your State Nurse Aide Registry and/or State Licensing Board. I have also included a link to state by state list of agencies that offer CNA training programs for your reference: Directory of Nursing Agencies that Offer CNA Classes.

Remember when researching in your area that CNAs are known by many names such as Nursing Assistants, Nurses Aides, Orderlies, Patient Care Technicians, Home Health Aides and more, depending on where you live and work. Keep in mind that if you are hired at a healthcare facility, you must prepared to submit to a background check (criminal) and a drug test as this is now a requirement.

Regardless of where you live you will need to be trained. Often, local healthcare facilities especially nursing homes will advertise free classes OR “Be paid while you learn.” These classes are offered usually to those with no prior healthcare experience and can run anywhere from 2-6 weeks fulltime. Be mindful that these facilities will require that you work at their facility for a certain amount of time in exchange for this training and sometimes will also pay for the state test. Another option for training is to attend CNA classes at a local community college or become trained through the Red Cross. These classes generally last longer possibly up to 6 months and can cost anywhere from $300 to $600 for training. The main benefit is that your training is more extensive and I have observed CNAs often are more confident due to feeling better prepared. Many CNAs quickly learn that on the job training is what matters most and although this holds true for many jobs it is especially pertinent in health care settings. After training you will then need to take the state test to become certified and it is usually done at a specific place and on a specific date pre- arranged by your trainer. Some places will allow you to work, upon completion of your CNA training, up to three or four months after classes without your certification. The test includes a written and clinical portion. The written portion is founded on good common sense principles and reviewing your class notes and handouts is always a good idea. I have included this link for taking actual practice tests in each state to further prepare.

Practice Tests

CNAs report that often it is the clinical part of the test that many find more difficult due to their nervousness. While the state examiners expect some nervousness they will focus more on observing your basic care-giving skills. While taking the practical portion of the test, you will be asked to demonstrate several nursing assistant skills. Remember safety measures such as locking the wheelchair, using a gait belt with transfers, and raising bed rails when completing patient care. Keep in mind a patient’s dignity and privacy needs at all times. Knock on door before entering, close privacy curtains and cover patients as much as possible when providing care. Introduce yourself, identify your patient by name in a professional manner, and explain each step of your care prior to proceeding. Be sure you put gloves on before performing any kind of care that would require gloves including any contact with body fluids. Always remember when you are asked to demonstrate a skill, to first use proper hand washing technique prior to performing the skill requested.

How to Decide on a Good Place to Work?

One very helpful method is to check the Nursing Home Inspector section on our site. This tool will allow you to determine how a facility has performed for the last three annual inspections and any recent complaints that were registered. This is an excellent screening tool providing a baseline and means of comparing homes against each other. Another good way to learn more about a facility or agency is simply by word of mouth. Talk frankly to other CNAs as well as the families with loved ones in facilities or with Home Care Agencies. Make a visit to the facility and talk to the staff about what they do and don’t like about their workplace. Learn about the orientation you will be given as well as ongoing nursing supervision and in-services provided. Most importantly, you need to sense an atmosphere of positive respect towards CNAs from all members of the health team in a particular facility or agency.

CNAs are in Great Demand!

Being a Nursing Assistant is not for everyone, and many care facilities have been experiencing great difficulty recruiting and retaining qualified staffing in recent years. Our country has experienced a crisis in the area of the direct care-giving field with shortages in CNAs rating among the top causes. The pay scale often does not reflect the difficult nature of the work expected of nursing assistants. All too common short staffing with resulting frustration in an effort to provide quality care contributes to this astounding turnover rate. The shortage of caregivers combined with growing long-term care needs of our elderly population is basis for the great demand for CNAs and resulting numerous job opportunities. If you decide to choose this field of work never think or say “I’m just a CNA.” On the contrary, always remember that you are a respected and valuable professional member of the health team who provides vital care.

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