While many people are familiar with the concept of a registered nurse, the work of Certified Nurse Assistants, or CNAs, is less well-known. CNAs are classified as 'unlicensed assistive personnel,' as opposed to licensed medical care professionals like RNs. Primary care technician, orderly, caregiver, nursing aide and direct care worker are all names for the CNA.
Assistive personnel have become more common within the current structure of the U.S. healthcare system. According to California's Board of Registered Nursing, managed care models of delivery emphasize the role of 'universal caregivers,' "which has unlicensed individuals performing functions which heretofore required a license…in settings such as assisted living, adult day care, and home care."
What do nurse assistants do? On a given day, CNAs will help bathe and dress patients, assist them in the bathroom, mind food and nutrition intake, monitor medicines and measure vital signs. Much of the time, this is 'the dirty work' that nurses don't have time to take care of. Nevertheless, real human beings with sensitive health conditions and dignity to maintain rely on CNAs to monitor their situation and help them get along in a way that promotes health, safety and well-being.
CNAs work in a variety of inpatient and outpatient settings, including assisted-living facilities, hospitals and clinics and, sometimes, acute care hospitals. In any setting, they need to be in good physical shape, maintain excellent communication with co-workers and superiors, and be responsive to multiple patients' needs at a time. Keep in mind that good stress management and 'people' skills will go a long way towards preventing burnout in this profession.
Just as a registered nurse, or RN, is "registered" with his or her official state nurse registry, certified nurse assistants are normally on their respective state registries. Every state in the US as well as the District of Columbia has a Nurse Aide Registry. To be clear, CNAs are trained, certified and registered - but not licensed. CNA programs must be accredited in the sense that they should be approved by the concerned state board.
The CNA Registry of a given state lists certified nurse assistants who meet both federal and state benchmarks through classroom training, clinical practice and due competency testing. In most states, prospective nurse assistants will have to undergo a criminal background check and garden-variety drug screening prior to practice. These tests are common and often required by law for healthcare workers.
In real clinical settings, there is often a gray area between unlicensed and licensed professionals' scopes of practice; overlap between the duties of CNAs and RNs is not unusual. Yet certain distinctions are sharply drawn. Only RNs, for instance, can perform and validate assessments, formulate nursing diagnoses, and design nursing plans of care.
If a task could potentially, if something were to go wrong, harm the patient - and that patient is medically fragile - the task is likely outside the scope of practice of a CNA. Where applicable, it is up to supervising RNs to make judgment calls concerning the scope of practice for a given task.
Nurse assistants are certified by the states in which they practice. Upon the completion of a qualifying certification program, graduates may take the National Nurse Aide Assessment Program competency exam administered by the state in which they wish to practice. It is this exam that empowers nurse assistants to provide care under the CNA title.
All CNAs must earn a Certificate of Training that serves as proof of satisfactory education before the state board or registry. Community colleges, vocational schools, or even the local Red Cross are good places to start looking for quality, affordable and state-approved CNA courses. Medical facilities frequently offer quality CNA coursework to the public. It's not uncommon for nursing homes and assisted-living settings to offer free CNA training that ends with a job at their facility.
An important part of any CNA program is the clinical practicum wherein trainees learn the ropes of direct patient care from an experienced worker-mentor. Usually this will take the form of supervised training in a state-approved medical setting. Different states have different requirements for the number of classroom hours and hands-on clinical training that must be completed. All states, however, require proof of certified nursing assistant training.
CNA certificate programs typically take between 6 and 12 weeks to complete. A high school diploma is a minimum requirement for both entry and later employment. In these programs, students learn fundamental nursing skills, anatomy and physiology 101, basic nutrition and best practices for infection control.
Some students choose to complete a CNA-to-RN career pathway. This track would be useful, for instance, to get to know the field of nursing a little bit better before committing. Those pursuing such a path would normally go on to earn either an associate's degree in nursing (ADN) or a bachelor's degree in nursing (BSN).
The CNA-to-RN path is relevant only if a student eventually wants to become a nurse. There is no need to otherwise pursue a bachelor's degree to become a CNA. In most cases, it will not confer any particular advantage.
A common specialization is the CNA-Medication Aide, or CNA-M. Nursing assistants complete coursework in this area to learn to administer certain noninjectable medications to anyone except very young children. Qualifying applicants must be in good standing with their state registries and have at least a year of full-time CNA employment. Many states require the successful completion of a standardized medication course to earn the title.
There are also secondary certifications available which are specific to special populations, such as the elderly. A Geriatric CNA certification would, for example, qualify the holder to work as an assistant in a nursing home for seniors. The coursework for geriatric aides focuses on segment-specific features such as dementia and Alzheimer's, long-term disability and self-care, and issues concerning death and dying.
We found 346 schools offering nursing assistant degree programs in the U.S.
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