How To Apply For Reciprocity In Another State

HOW TO APPLY FOR RECIPROCITY IN ANOTHER STATE

What is reciprocity - By Federal and State Laws, you must pass a State prescribed course and test in order to work as a nursing assistant in a nursing home. You also cannot work as a nursing assistant in a nursing home in any state unless you are approved by that state.

If you already are Licensed, Certified, Registered or State Approved in your own State and want to move to another state, you will need to request reciprocity. This means that you are asking the new state to recognize the approval you received from your home state.

How to request reciprocity

1. The first step is to contact the Nurse Aide Registry in your home state and request a "Application for Enrollment By Reciprocity". Ask them if you should send the completed form to them or to the state to which you are moving.

2. Then contact the other state and ask them the same thing. Some nursing assistants have been able to fax their request directly to the state they are moving into rather than with their home state. Do not take chances, ask. Be sure to get the name of those who talk with you and their phone numbers. Call them by name while you are talking so they remember you.

3. If the agency in your new state says it is acceptable for you to fax or mail info, then do this right away. Be sure to clarify the fax number and the mailing address. Then fax or mail your info to the attention of the person you spoke to. Ask them what items you will need to fax or mail but be prepared to send at least the following:

Copy of your Social Security Card
Copy of your drivers license (or other photo ID)
Copy of your present State approval
Copy of a recent pay stub or something to document that you have worked in a nursing home in the past two years.
Tell them where you are moving from and where to and where they can send the new card.
They may ask for other info as well

4. When you send your info, include a brief note to thank the person who took time to talk with you and ask them to call you if they need more information.

Automated lines

When you call, you may get an automated line. Most automated lines are free 800 numbers and can provide some good information. Do listen and be prepared to write down numbers, but also always try to get a connection to a real person.

HOW TO FIND A TRAINING OR TESTING PROGRAM IN YOUR AREA

Every nursing home in the country must be prepared to provide for training and testing for their nursing assistants, and should have information about the training and testing sites that are local to you. In some states, the training and testing is conducted by nursing homes, some use community colleges and still others use independent agencies. The best way to get information about the training and testing programs in your area is to talk to a trainer or DON in your area. If this does not provide the needed information, contact the Area Agency on Aging or the NATP agency in your state.

Continuing Education or Just Another In Service?

A Perspective For CNA’s

We have all been there. In a room at work, sitting in front of a TV monitor watching YET another in service video. Usually no one is actually teaching us anything. And often we are doing this in a hurry to make sure we have enough “hours” to count towards our state requirements for yearly on going training.

This is not the fault of the CNA. Because of budget issues and time factors, many nursing homes and other facilities do not bother to consider that CNA’s deserve better in services, better continuing education. Everyone agrees that CNA’s deliver 90% of all hands on care, yet we are often the last to receive important new information to help us stay up to date with new practices and procedures. Many CNA’s do not feel supported by their management teams to request attending seminars and conferences. And many CNA’s don’t really care- they have a life outside of work and don’t feel they should have to spend extra time learning things they think they already know.

I would like to address the first issue mentioned above- budget and time concerns- this might catch the attention of the management of a nursing home. This is really a simple to fix in my opinion. There are so many talented people who work in nursing homes, hospitals and similar facilities. We have dieticians, activity professionals, pastors/priests, nurses, OT’s, PT’s, Speech therapists. These are just a few folks who have a wealth of knowledge that can be shared. Some topics for consideration might be:

• Nutrition and Dehydration (DT)
• Socializing and Activities for residents (Activities Director)
• Religions- learning the basics (Pastors)
• New skin care protocols (Nurses)
• Understanding the Nursing Process (Nurses)**
• Feeding Techniques (Occupational Therapists)
• Range of Motion Exercises (Physical Therapists)
• Special communication devices and techniques (Speech Therapists)
**Many CNA’s do not know exactly what the nursing process is.

Also, many facilities have specially trained psyche nurses and doctors who regularly make visits. This person is a great resource for helping CNA’s learn to cope and deal with behaviorally challenged residents. I have heard from CNA’s who work for forward thinking organizations that actually request from their CNA’s what THEY would like to learn about.

Some of the ideas shared with me were:

Working together issues- communication with peers; how to deal with negativity in the workplace; how to re-direct angry co-workers, how to deal effectively with superiors….

Keeping up to date with all the new skin care protocols. Many, many a CNA has shared with me their despair of being certified years ago and not being told/taught about new trends. An example given was from one CNA in GA who told me about how she always massaged her residents’ reddened skin after washing the area. Of course new evidence suggests we don’t do this but she never got this, and she first learned of it online 13 years after she became a CNA.

Documenting/Language: I am always amazed at the numbers of CNA’s who just do not understand how important their role is in the entire care giving process, part of which is good documenting. Down this road also comes a need for CNA’s to understand and know the English language well enough to communicate with residents. It would always be a good investment to send foreign speaking aides to a local college to learn ESL (English as Second Language) classes. Not only is spoken language covered, but written language as well.

With a little thought, planning and research anyone can come up with content for the above mentioned ideas- online there are many good web sites to tap for info. Local colleges will work with facilities and may even come onsite to do training.

Finally I would like to address those CNA’s who think they know everything and don’t need any extra education. Smile- you’re not alone but you are going to become a DINOSAUR real fast. The young and up-coming CNA’s are motivated by learning and continuing to learn. You deserve to have opportunities to better yourself, to deliver better care to your residents. Since you have to keep your “hours” up to date, wouldn’t you rather learn something new and different vs. sitting in front of that silly monitor watching an infection control video that is 7 years old??

Nursing Home Scope & Severity Rules

Scope and Severity

The federal government's enforcement process requires the Health Facilities Division to assign scope and severity levels for deficiencies. After these have been determined, they are given a letter designation.

The level of the deficiency is determined both by scope, how widespread the problem is, and severity, how much potential or actual harm it has caused to residents.

Level Scope Severity
A Isolated No actual harm, potential for minimal harm
B Pattern No actual harm, potential for minimal harm
C Widespread No actual harm, potential for minimal harm
D Isolated No actual harm, potential for more than minimal harm
E Pattern No actual harm, potential for more than minimal harm
F Widespread No actual harm, potential for more than minimal harm
G Isolated Actual harm that is not immediate jeopardy
H Pattern Actual harm that is not immediate jeopardy
I Widespread Actual harm that is not immediate jeopardy
J Isolated Immediate jeopardy to resident health or safety
K Pattern Immediate jeopardy to resident health or safety
L Widespread Immediate jeopardy to resident health or safety

Scope:

Assesses how widespread the deficiency is in the nursing home. There are three levels of scope:

An isolated problem-when one or a very limited number of residents are affected

A pattern of problems-when more than a limited number of residents are affected or when the same problem has occurred in several locations in the facility and/or the same number of residents have been affected by repeated occurrence of the deficient practice;

Widespread scope means the problems causing the deficiencies are found throughout the facility and/or there are systemic failures in the nursing home that have affected or have the potential to affect a large proportion of the residents.
Severity:

Assesses how much harm may occur or has occurred to residents as a result of the deficiency.

There are four levels of severity:

Level 1: Represents no actual harm but has potential for minimal harm;

Level 2: Represents no actual harm, but potential for more than minimal harm. A level 2 deficiency could result in minimal physical, mental or psychosocial discomfort or has the ability to compromise the resident's ability to maintain or achieve highest possible function;

Level 3: Represents actual harm that is not immediate jeopardy (i.e. life-threatening). A level 3 deficiency means a resident has been negatively impacted and his/her ability to maintain or reach the highest functional level has been compromised;

Level 4: Represents immediate jeopardy to resident health or safety. A Level 4 deficiency requires immediate corrective action because serious injury, harm, impairment or death has been caused, or could be caused to residents.
Deficiencies are cited at the highest severity level. If a deficient practice has minimal impact on most affected residents, but has a severe impact on only one of the residents, that deficiency will be cited at the highest severity level observed.

Professional Boundaries

In this article, I want to present a concept that should be well understood by all CNA’s. Here, we’re going to discuss what can happen when we become overly attached to a resident, or their family and the implications this has upon the facility.

One of the better changes for some LTC facilities is consistent staffing. However, this staffing model has created some unintended consequences.

CNA’s develop long term relationships with those we are charged to care for. We grow to love them and will do all the little “extras” for them. Usually this doesn’t present a problem for anyone. But there are times when our relationships become unhealthy- for us, for the resident, for the other residents we’re assigned to; to our peers and to the facility we work for.

Over Attachment
In nursing homes, CNA’s can become too attached to a certain resident, in different ways. The CNA will be very upset if they are not assigned to care for this resident, or, will use their relationship with this resident as an excuse for being exempted from floating to other units. The CNA might spend inordinate amounts of time with this resident, and therefore shortchange the others assigned to him/her. The aide will always cater to this residents’ every whim before all others. This resident will have more needs than all others as well- and these “needs” will increase as times moves along.

Sometimes, the resident develops a fondness for an aide that isn’t healthy. The resident becomes dependent upon the aide’s presence to be happy. He or she refuses to allow other aides to work with him/her. Residents have “bad” days when their favorite aide isn’t at work. I have seen residents who believe they are “in love” with their favorite aides, especially those with mild dementia. I’ve also seen aides who care for patients in short term rehab centers develop “crushes” on these patients. The age difference between patient and aide isn’t that far apart.

Other assigned residents are neglected. Often. Or, the needs of these residents are tended to by the CNA’s peers. This creates a problem for everyone. Resentment sets in and working relationships suffer.

Being Objective
A huge problem with this arrangement, as it’s often called, is when the aide loses his or her ability to be objective. This is a serious concern. We must be able to truthfully report the conditions of our residents. This includes, but isn’t limited to, the residents progress or decline in all areas: Ability to speak, bath, dress, feed self, walk- are all very important. The CNA who is too close to certain residents isn’t able to accurately describe the resident’s true abilities.

This effects the resident directly: A resident who cannot really dress herself can be assessed as being able to do so. This might end up in a care plan…and other aides who work with this poor resident will get frustrated at THEIR ability to motivate this resident. Families are told their loved one can still dress herself when in fact she cannot, and hasn’t been able to perform this task for awhile.

We have professional boundaries
CNA’s are considered to be the professionals in the care giver-patient relationship. A CNA is expected to maintain a therapeutic relationship and not anything else. We have the upper hand because of our knowledge and skills. We are responsible for the care we deliver. Within the ethical discussions on this subject, the care giver always has power over the patient. Many times these relationships are for the benefit of the care giver and not the patient.

When the care becomes intertwined with personal friendships and over-advocacy, it’s not healthy. What is OVER ADVOCACY? It’s when we demand residents be given care, therapies and attention they don’t truly need. This is often where over attachment to a resident’s family starts. This is another whole problem- and the legal implications are high.

Ask yourself these questions. And be honest. If you can answer more than two of these with a YES, then YOU are crossing the professional boundaries. And setting yourself up for a lot of trouble.

* Have you ever spent off-duty time with a patient/family?

* Do you keep secrets with patients/family?

* Do you become defensive when someone questions your interaction with a patient/family?

* Have you ever given gifts to or received them from a patient/family?

* Have you felt possessive of a patient/family, thinking that only you could provide the care the patient needs?

* Have you ever flirted with a patient?

* Have you chosen sides with a patient against his or her family and other staff?

If you find that you’re overly attached, how to manage that? It’s not easy. The first step is recognizing you have a problem. Then, its a matter of distancing yourself from the resident. For some aides this is best done gradually. For others, a total cut off is appropriate. Many times, when the bosses see these problems, they’ll assign the aide to another unit altogether, effectively ending the relationship. I don’t think this is a good way to do this.

A CNA can ask for a change with their assignment. Being open and honest about this will almost always result in getting the changes you seek. Part of being PROFESSIONAL means keeping staffing issues to yourself. The urge to tell the resident, or the family, a change has taken place might be very high. Its best to leave these discussions with the nurse. And, after the resident and/or their family is informed, THEY will prod the CNA for information. Again, professional boundaries must take precedent over individual staff needs.

A note about being attached to resident families.
It’s not as common as resident-CNA friendships. But its much more dangerous. And, many times these relationships are initiated by the CNA.

Often times:
A family will block out all others in the facility and depend upon the aide for all communication. The aide will be put into situations they are not trained and educated to handle. Every word the aide speaks will be heard and recalled. If the aide doesn’t have the right information, or misspeaks, a lot of trouble can arise, legally.

The aide will become a spy, for the family. CNA’s are privy to some information that is private and confidential. The levels of care for other residents is an example. When we have over bearing families seeking information from aides who are all to willing to share, it creates huge management problems. It sets the stage for a turbulent relationship between the FACILITY and the family.
Some aides like to think families have some super power over a facility. This is simply not true. Government regulation and oversight have “power”; as do legal standards.

Other aides will use the family in an effort to be assigned to the resident they want. From my experience, these residents are almost always the ones who are considered “easy to do”– and the aide is simply seeking a guarantee of being assigned to this resident. There has been some evidence of aides seeking permanent assignment to certain residents in hopes of getting some monetary award. These situations are always unethical. The aides involved in this should be terminated from employment and barred from working as aides ever again. They are opportunists.

No matter whether a CNA is overly attached to a resident or their family, it’s not usually healthy. Most times the only way to stop the problems associated with these relationships is to separate the aide and resident. Perhaps, consistent staffing would better serve all if the assignments changed every so often. A couple times a year and all aides would be required to change no matter what family requests are. We all want what is best for the residents. Sometimes though, in order to insure this is happening equally across the board, we have to make adjustments and changes.

Breaks: State Laws

A lot of CNA’s ask what their rights are regarding breaks, meals and getting paid for such. Here are two lists of state statutes about breaks. Usually, rest breaks are paid; meal breaks often are NOT unless one works through it.

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Rest Breaks

California

Paid 10-minute rest period for each 4 hours worked or major fraction thereof; as practicable, in middle of each work period. Not required for employees whose total daily work time is less than 3 and ½ hours.

Colorado

Paid 10-minute rest period for each 4-hour work period or major fraction thereof; as practicable, in middle of each work period.

Illinois

Each hotel room attendant — those persons who clean or put guest rooms in order in a hotel or other establishment licensed for transient occupancy — shall receive a minimum of two 15-minute paid rest breaks and one 30-minute meal period in each workday in which they work at least seven hours.

Kentucky

Paid 10-minute rest period for each 4-hour work period

Minnesota

Paid adequate rest period within each 4 consecutive hours of work, to utilize nearest convenient restroom.

Nevada

Paid 10-minute rest period for each 4 hours worked or major fraction thereof; as practicable, in middle of each work period. Not required for employees whose total daily work time is less than 3 and ½ hours.

Oregon

Paid 10-minute rest period for every 4-hour segment or major portion thereof in one work period; as feasible, approximately in middle of each segment of work period.

Washington

Paid 10-minute rest period for each 4-hour work period, scheduled as near as possible to midpoint of each work period. Employee may not be required to work more than 3 hours without a rest period.

States not listed do not require paid rest periods. All of the eight States with paid rest period requirements, also have meal period requirements.

SOURCE

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Meal Breaks

California

½ hour, after 5 hours, except when workday will be completed in 6 hours or less and there is mutual employer/employee consent to waive meal period.

Colorado

½ hour after 5 hours, except when workday will be completed in 6 hours or less. On-duty meal period counted as time worked and permitted when nature of work prevents relief from all duties.

Connecticut

½ hour after first 2 hours and before last 2 hours for employees who work 7½ consecutive hours or more.

Delaware

½ hour, after first 2 hours and before the last 2 hours, for employees who work 7½ consecutive hours or more.

Illinois

Each hotel room attendant — those persons who clean or put guest rooms in order in a hotel or other establishment licensed for transient occupancy — shall receive a minimum of two 15-minute paid rest breaks and one 30-minute meal period in each workday in which they work at least seven hours.

Kentucky

Reasonable off-duty period, ordinarily ½ hour but shorter period permitted under special conditions, between 3rd and 5th hour of work. Not counted as time worked. Coffee breaks and snack time not to be included in meal period.

Maine

½ hour, after 6 consecutive hours, except in cases of emergency and except where nature of work allows employees frequent breaks during workday.

Massachusetts

½ hour, if work is for more than 6 hours.

Minnesota

Sufficient unpaid time for employees who work 8 consecutive hours or more.

Nebraska

½ hour, off premises, between 12 noon and 1 p.m. or at other suitable lunch time.

Nevada

½ hour, if work is for 8 continuous hours.

New Hampshire

½ hour, after 5 consecutive hours, unless feasible for employee to eat while working and is permitted to do so by employer.

New York

1 hour noon-day period

30 minute noonday period for employees who work shifts of more than 6 hours that extend over the noon day meal period.

An additional 20 minutes between 5 p.m. and 7 p.m. for those employed on a shift starting before 11 a.m. and continuing after 7 p.m. 1 hour in factories, 45 minutes in other establishments, midway in shift, for those employed more than a 6-hour period starting between 1 p.m. and 6 a.m.

North Dakota

½ hour, if desired, on each shift exceeding 5 hours.

Oregon

½ hour, with relief from all duty, for each work period of 6 to 8 hours, between 2nd and 5th hour for work period of 7 hours or less and between 3rd and 6th hour for work period over 7 hours; or, less than ½ hour but not less than 20 minutes, with pay, with relief from all duty, where employer can show that such a paid meal period is industry practice or custom; or, where employer can show that nature of work prevents relief from all duty, an eating period with pay while on duty for each period of 6 to 8 hours.

Rhode Island

All employees are entitled to a 20 minute mealtime within a six hour work shift, and a 30 minute mealtime within an eight hour work shift.

Tennessee

½ hour for employees scheduled to work 6 consecutive hours or more.

Washington

½ hour, if work period is more than 5 consecutive hours, to be given not less than 2 hours nor more than 5 hours from beginning of shift. Counted as worktime if employee is required to remain on duty on premises or at a prescribed worksite. Additional ½ hour, before or during overtime, for employees working 3 or more hours beyond regular workday.

West Virginia

20 minutes for employees who work 6 consecutive hours or more.

Guam

½ hour, after 5 hours, except when workday will be completed in 6 hours or less and there is mutual employer/employee consent to waive meal period. Not considered time worked unless nature of work prevents relief from duty.

Puerto Rico

1 hour, after end of 3rd but before beginning of 6th consecutive hour worked. Double-time pay required for work during meal hour or fraction thereof.

SOURCE

Staffing Ratios

Each state is able to mandate it’s own CNA:Resident Ratio. Only 8 states have mandated actual numbers…the rest either have no numbers, or use some formula of hours of care to be given and most allow the care of nurses to be included.

Staffing ratios- CNA/Resident– per state:

AK NONE

AL NONE

AR DAYS: 1:6 EVENINGS: 1:9 NIGHTS: 1:14 (This can include nurses)

AZ NONE

CA NONE

CO NONE

CT NONE

DC DAYS: 1:6 EVENINGS: 1:10 NIGHTS: 1:15

DE DAYS: 1:7 EVENINGS: 1:10 NIGHTS: 1:15

FL NONE

GA NONE

HI NONE

IA NONE

ID NONE

IL NONE

IN NONE

KS NONE

KY NONE

LA NONE

MA NONE

MD NONE

ME DAYS: 1:5 EVENINGS: 1:10 NIGHTS: 1:15 (This can include nurses)

MI DAYS: 1:8 EVENINGS: 1:12 NIGHTS: 1:15

MN NONE

MO NONE

MS NONE

MT **Complicated formula used; 4 hours care for each resident; no actual mandated numbers of staff**

NC NONE

ND NONE

NE NONE

NH NONE

NJ NONE

NM NONE

NV NONE

NY NONE

OH 1:15

OK DAYS: 1:6 EVENINGS: 1:8 NIGHTS: 1:15

OR DAYS: 1:10 EVENINGS: 1:15 NIGHTS: 1:20

PA NONE

RI NONE

SC DAYS: 1:9 EVENINGS: 1:13 NIGHTS: 1:22

SD NONE

TN NONE

TX NONE

UT NONE

VA NONE

VT NONE

WA NONE

WI NONE

WV NONE

WY NONE

SOURCE (pdf)

Everything You Wanted To Know About Being A CNA

You’ve decided you want to become a Certified Nursing Assistant. You’re excited and want more information about this career. Some questions you might have deserve answers, and here we will try to do that.

1) What is a CNA?
A Certified Nursing Assistant is a member of the health care team. Always working under the direction of a nurse (RN or LPN/LVN) the CNA provides hands on nursing care to patients, residents, clients and customers in a variety of health care settings. CNA’s typically provide assistance with bathing, dressing, eating, toileting and oral care to people who cannot do these tasks alone. Also, the CNA is often the person who gets the vital signs, weights and height measurements.

The CNA has a high school diploma or GED.

2) Why be a CNA?
Why not? If you’re looking at a career in nursing, being a CNA is a great way to really test yourself on this goal. Being a CNA exposes you to many members of the health care team: You get to see nurses, physical and occupational therapists, doctors, med techs and assistants in action. You’ll soon know whether you have what it takes to further yourself in nursing; perhaps you’ll decide to move to another field of work within health care.
If you’re looking for a quick job – I say becoming a CNA might not be the right choice for you. Going through the training is hard work; being charged with caring for sick people isn’t something to be taken with a grain of salt. You have to the will and desire to help people…you’ll need patience and compassion. You have to be committed to a physically demanding job, with little tolerance for poor work ethic.

Career CNA: You won’t get rich doing this for a living. But you will gather experiences not often found in any other career. You’ll have pride over many accomplishments and you’ll make friends with people you would otherwise never meet. Being a CNA is one of the few careers where one can say they truly give it all for little in return. On the downside, your body will pay you back in a bad way if you don’t take care of it. You’re apt to hurt your back. If you get sick, plan to be at work irregardless- and PLAN on getting sick more often than other people get in other careers. As stated above, the pay is not going to be rewarding- but the other rewards are priceless.

CNA’s don’t earn a high salary. You should be very aware of this. Many of who have been doing this for a long time notice new aides coming into the field, who get disillusioned over the pay. We’re paid by the hour; that rate is dependent upon several factors which include how much experience one has; what region of the country one works in and where employment is at.

In general, CNA’s who work in long term care settings (nursing homes, assisted living) earn the least; those who work for staffing agencies and hospitals earn the most. Belonging to a union also has an impact upon pay. Overall, wages for aides range from 7.00/hr for a brand new CNA at an assisted living center, to 20.00/hr for a CNA with 20 plus yrs experience, working for an agency. The most common wages, I hear of, are in the area of 10.00 to 12.00/hr in all settings. Like I said you’re not going to get wealthy doing this work.

3) Where can CNA’s work?
In any setting provided there is a nurse to oversee the CNA’s practice. This is very important to remember. Always, CNA’s work under the direction of a licensed nurse. Don’t let anyone tell you otherwise. This is per federal and state statute, and it’s to protect the public. Only a licensed nurse can delegate duties to CNA’s. Doctors and therapists cannot. Families cannot. CNA’s cannot delegate to CNA’s.

Always keep this in mind- legally a CNA cannot practice on their own. Many aides place ads in newspapers offering their services as a CNA. This is illegal in all states! It’s okay to offer care giving services. It’s okay to use your experience as a CNA; but it’s never good to claim yourself a CNA who is providing the services. When you do this, you’re delegating. And breaking the law. Be careful with this.

CNA’s are found on the payrolls at:
Nursing Homes
Home Health Care Agencies
Assisted Living Facilities
Staffing Agencies
Hospitals
Hospices
Doctor Offices/Practice Groups
Day Care Centers and Schools
Medical Clinics
Urgent Care Centers
An interesting note on potential sources of employment: The role of the CNA is mandated by the Federal government for nursing homes only. Other health care settings are not required by law to hire CNA’s…this includes hospitals, assisted living facilities, doctors offices, ect. While all of these places DO hire CNA’s, for good reason, they don’t have to.

4) How does one become a CNA?
Once you’ve decided this is the work you want, set out to locate a training program. Many nursing homes offer the training; the Red Cross does classes too- contact your local chapter. Tech colleges are another source where training is offered. Some high schools also provide classes- but mostly for students and not others. More and more, small Medical Ed schools are popping up all over the country. Offering a variety of specialty training, a CNA program is often part of this.

Costs of training programs vary by region and by the source. College classes are the most expensive followed closely by these Medical Ed schools; typical for my area, NH- right now- the costs including books is 1500.00. One thing to remember when choosing a program is to make sure it is approved by your State board of Nursing or whatever State agency is charged with approving curriculum. This is vital to know. It does no good to take a course that isn’t approved.

Another important thing to know: Stay away from ONLINE and CORRESPONDENCE courses for Nursing Assistants. While these are great for basic knowledge most of these are not approved by most states. People who suddenly find themselves taking care of an elderly parent benefit most from these courses- not those with a serious interest in this as a career. You need clinical hours- real, hands on training in order to perform this work. You don’t get this with the online/mail order courses.

5) What Can I Expect During Training?
Plan on anywhere from 3 weeks of full time classes and clinical hours, to 8 weeks part time. You can expect to be challenged. Your knowledge will increase a lot. Some of the topics typically covered in a CNA course include:
Patient/Resident Rights
The Roles and Responsibilities of the Health Care Team
Legal Issues for Nursing Staff pertaining to the CNA
Medical Terminology
Infection Control
Medical Unit Environment- Safety and Proper Body Mechanics
Emergencies: Some states require CPR to be a part of this
Communication Skills
Documentation Skills
Patient Care: Vital Signs, bathing, dressing, moving patients, feeding, oral care, grooming skills
Patient Room Upkeep
…among many other skills. Most CNA courses cover the typical requirements and education you will need to be successful working in nursing homes, acute and sub acute care centers, perhaps some rehab and restorative nursing instruction is covered as well. You will learn about caring for adults, children and babies. Some of this will include caring for people who are dying, and, how to provide postmortem (after death) care. Most CNA courses do not cover all the skills required for employment at hospitals. Most of these places offer their own special orientation for this purpose.

You should expect to do a lot of reading, and take many quizzes to test your new knowledge. You should know that 100% of your attendance is very critical to your success in any CNA program. Clinical hours refer to the portion of your training that takes you into the actual heath care setting- usually the nursing home. Here, you will be given an assignment of residents (not more than one in most cases). You will be expected to use your newly learned skills to show your instructor you can apply them on real people.

6)What happens after my training is completed?
Your instructor will assist you with scheduling a Competency exam administered by your state. This exam is mandatory and you must pass it. It will test your knowledge and competency with skills. Once passed, you are certified. In some states, you don’t need to wait to work however…there is a federal ruling that allows nursing assistants to work while waiting to take their exams, for up to four months. Many places won’t allow you to do this, for legal reasons.

The Exam is done in two parts: A written portion and a clinical portion. The written test is usually not too difficult- and this web site offers sample questions for you to practice. The clinical part is a bit harder. You have to bring a friend with you in order to complete this portion. The friend will serve as your patient, whom you demonstrate to the examiner, your skills. Bring a GAIT BELT with you for use during your clinical exam.

The important skills the examiner will watch for will include infection control (hand washing!; GLOVES!), patient safety privacy and dignity. Remember to close the privacy curtain. Remember to identify yourself to your “patient”, and remember to identify the patient! You will be asked to perform several tasks- usually up to five skills, but no less than three skills. These might include a full or partial bed bath; offering a urinal or bedpan; a transfer into a wheelchair; a complete or partial set of vital signs; making an occupied bed…any skill you learned in your training is apt to chosen by the examiner. Be prepared but don’t sweat and lose sleep over this. Your training should provide you with the competence you need to pass the exam.

You will be told on the spot if you pass or fail. The examiner realizes you are nervous and will expect some jitters from you. Mistakes are not the end of IT; if you realize you made a mistake ask if you can re-demonstrate. Often this is allowed. If you do fail, ask about re-scheduling another test. Each state has different rules about how often a test can be re done and whether BOTH portions need to be re-done.

Good luck! If you choose to be a CNA, you will be rewarded in many ways.