CNA Training – Certified Nursing Assistant

Just like in any job, you are expected to act in the most professional manner. This especially applies in the field of health and medical care. It is important that you are able to carry out your duties properly while respecting the rights of your patients and residents. Here are some tips on how to maintain professionalism while working as a CNA or a Certified Nursing Assistant.

1. Make sure that you always maintain a professional appearance that is expected from a health care provider. Always keep your clothes or uniform clean, neat and ironed to prevent infections. Check if what you are wearing has holes or stains; if it does, change to a more decent-looking outfit. You should also avoid wearing too much or strong-smelling perfumes or body products which patients or residents might be sensitive to. You should also avoid wearing too much makeup. Keep your nails short and clean and avoid wearing nail polish as much as possible. Remember that if you want to have the image of being a professional and good CNA, you need to dress the part.

2. It is also important that you are at work when you are expected to. In order to be professional, you should avoid being tardy or absent, except when it is unavoidable. As a matter of fact, CNAs are usually expected to report to work even if they themselves are sick. Since CNAs are exposed to all kinds of patients, some of which have contagious illnesses, you can expect to be more sick than you have been before being a CNA. Because of this, you should take all measures to maintain good health and to know which medications to take for certain common illnesses. Eat well and get enough rest. If you have small children, make sure that you have preset arrangements of who could take care of them if they get sick so that you would not have to miss work.

3. You should also always be honest in everything you do and maintain integrity as you perform your duties. Lying would never get you anywhere, regardless of what profession you have. If you are a CNA, lying can get you into a lot of trouble, which is you should report everything objectively and carry out only the tasks that have been asked of you to do.

4. Maintaining a good, wholesome and positive attitude is also a must n order to be professional in your job as a CNA. By having this kind of attitude, you would be able to get along well with the doctors, nurses and the other members of the medical team. It would also make your patients feel good that they are being cared for by a good CAN. This type of attitude would also help in giving you enough motivation to be dedicated in the work that you do.

5. Lastly, make sure that you are very careful in using your employer’s resources. This would include using the phones, computers and fax machines at the nurse station as well as making use of the medical and office supplies in the facility you are working in.

If you are a CNA or a Certified Nursing Assistant and have started to look for facilities where you can work in, you need to know that there are several things that you need to remember when being interviewed for the job. Here are some tips that could help you out in landing a CNA job, whether you are new or a seasoned Certified Nursing Assistant.

1. First off, you would need to make sure that you have a decent and professional-looking appearance. Remember the old adage that first impressions last. Make sure that you would be dressing conservatively. Do not wear jeans and tee shirts or short skirts and skimpy tank tops. You should also wear underwear. Do not wear sneakers and open-toed sandals. Limit the number of jewelry and accessories that you have on. Your clothes should be clean and neatly pressed, or at least wrinkle-free. Your hair should also be pulled up and out of your face. Your nails should be short and clean.

2. Make it a point that you arrive early in your interview. Sleep early so you would not have a hard time waking up if you have an early interview. It would be good to be at the office or facility at least 30 minutes before your interview to give you time to prepare and relax.

3. Once you are at the facility or office where you would be having an interview, you should treat everyone you see, meet and talk with kindness and professionalism.

4. Never address your interviewer by his or her first name, except when you have been told to.

5. Never chew on gum or smell of smoke. If you want to chew gum to relax yourself before the interview, be sure to throw it out before the interview. If you smoke, make sure that you do not smoke before the interview. If possible, smoke before leaving the house and before taking a bath so that there would be no remaining smell of smoke on your body and clothes.

6. Be sure to keep your phone on silent, as you would not want any alerts of incoming calls or text messages disrupting the interview.

7. Always smile and maintain eye contact with the interviewer. However, do not stare.

8. Sit up straight and still in your seat. Do not slouch or do any mannerisms such as fidgeting which can distract your interviewer.

9. Maintain a positive, confident and enthusiastic attitude whenever you talk or respond to the interviewer’s questions. However, be careful, not to be aggressive or pushy. Be yourself at all times.

10. Never say anything negative about your previous employers.

11. Listen to all the questions your interviewer asks to be sure that you would be able to provide the appropriate answers. Some questions that you may be asked during the interview would include: when you left your last job and the reason why you did so; the length of time that you have been without any job; what you liked most and least with your last job; if you prefer working by yourself or with a team; your reasons for wanting to work with that particular facility; the reasons why the facility should choose you over the other applicants; and if you are considering any other jobs with other facilities.

12. Lastly, make sure to ask questions to clarify any concerns that you have with the job.

There are several skills that CNAs or Certified Nursing Assistants should learn to develop to make sure that they would be able to do their work properly. Since CNAs are sometimes considered as the eyes, ears, noses and hands of nurses, the most important skills that they should have would be their observation skills. These skills would be what they would be using as they perform their responsibilities as described by the nursing process.

There are basically two types of observations which can be made by nurses: subjective and objective. Objective observations would be those which are based on actual facts. They can also be measured. Some examples of objective observations on patients would include bruises, vital signs, blood in the urine, visible symptoms of skin conditions and others. On the other hand, subjective observations are those which are made by the patient since they are dependent on the opinion of the patient. Although subjective observations are just as important as the objective observations, they cannot be measured.

It is important that CNAs know how to properly make objective observations without being biased or without relying on guesswork. An example of an incorrect statement by a CNA would be: “Mr. Lee says he feels like vomiting. He does this every time he needs to take a bath!” The correct statement would be: “When I was assisting Mr. Lee to take his bath, he said that he felt like vomiting.” Another incorrect statement would be: “Mrs. Banks walked ten feet today and stated that her knee hurt when yesterday, she walked for more than a hundred feet and her knee was fine. I think she is just being lazy.” The correct one would be: “Mrs. Banks walked for ten feet today and said that her knee hurt.” In short, when making observational statements, CNAs should not make assumptions or diagnose conditions. The job of the CNA would be to make observations and report.

To observe, a CAN should: use his or her eyes such as when looking for broken skin, open cuts and woods, checking if there is blood in the urine and if there are changes in the eating and speaking patterns of the patient; use his or her sense of touch such as when checking the pulse or temperature of the patient or when feeling for bumps and lumps in the skin; use his or her ears when checking blood pressure readings and checking if the patient has any respiration problems; and use his or her nose to smell foreign odors or other bodily odors which can indicate a health problem.

Keep in mind that all observation done should be accurate and should be made in a timely manner. Once observations are made, nurses should be notified of any unusual findings.

Similar to other types of professions, there are certain rules and laws that should be followed by CNAs. These would be the laws which have been passed by local, state and the federal governments. As a CNA, if you are unable to abide by them, you may be found liable for any resulting injuries or damages. You would be able to avoid breaking any laws by doing several things. Here are some of them.

1. First off, make sure that you know, understand and follow the practice rules that have are being enforced in the state where you are working in.

2. You should only perform the tasks and the skills that you have been trained for. In the event that you are asked to do tasks which you have not been trained for, you should seek the advice of your immediate supervisor and ask for guidance.

3. Perform the tasks and duties assigned to you with utmost care and in the way that you have been trained.

4. Continue to learn or seek for further education that would help you improve your skills and capabilities.

5. In any situation that you are uncertain on what you need to do, always get the advice of your immediate supervisor.

6. Before carrying out your duties, make sure that you completely understand the directions given to you.

7. Know and understand the policies and procedures of the facility you are working in; and follow them.

8. Never harm or cause any harm to your patients.

9. Always respect your patient’s personal property.

To give you an idea of some of the most common legal issues which are associated with the work of CNAs and how to avoid them, here are some examples and circumstances.

Negligence

This would be the failure to provide the level of reasonable care to the patient, resulting to injury. It is usually caused by rushing work and by not thinking first. Some examples would be when you give your patient a bath and then because you did not check the temperature of the water first, the patient gets burned. Another would be when you give a food tray to a patient but do not double-check and the food turns out to be for another patient. As a result, the patient you gave the food to eats the food with the wrong consistency, making him choke.

Theft

This happens whenever you get any personal property of a patient, whether it is small or big, cheap or expensive.

Defamation

This would be making statements which are about another person in writing or verbally which results to the damaging of that person’s character. You should never make any announcements or statements, either verbally or in writing, about any patient or anyone without being sure that it is a fact.

Invasion of Privacy

It is important to make sure that CNAs are able to protect the rights of every patient to have their medical information kept confidential at all times. As a CNA, you should only discuss the medical condition of the patient with his doctor, his nurse/s and his close relatives.

False Imprisonment

Many nursing staff are usually confused about what false imprisonment means. It is basically defined by restraining the actions of the movements of a patient without getting the proper authorization. All patients have a right to go out of a hospital or a nursing home and there are only a few instances when CNAs and medical personnel can interfere with this right.

Also, the use of physical restraints on a patient requires orders coming from a doctor. When CNAs threaten to use them, it can be considered false imprisonment. Some examples of physical restraints would include vests, jackets, wrist, armor leg restraints, seatbelts, hand mitts, bed rails and others.

Assault and Battery

Assault would be the intentional attempt to touch or threatening to touch another person’s body; battery would be when you are actually doing so. In order to make sure that you do not break any rules that can lead you to being charged with assault and battery, it is important that you: inform the patient of everything that you would be doing; check if the patient understood what you said; ask the patient for any concerns or questions he or she might have; allow the patient to have some time to think; respect the decision of the patient to disallow any procedure; and never carry out treatment that has been refused by the patient.

Abuse

This is broadly defined as any harm done to a patient. There are many types of abuse such as physical, verbal, emotional, sexual and involuntary seclusion.

Physical abuse would include: the rough handling of a patient; hitting, slapping, kicking or punching a patient; and giving the wrong treatment to a patient.

Verbal Abuse would include: swearing while caring for a patient; raising your voice or yelling at the patient; calling the patient using unpleasant names; embarrassing the patient; teasing the patient; making threats; and using inappropriate words to describe the nationality or race of the patient.

Sexual abuse would include any behavior done which is seductive or sexually demeaning and harassing to the patient.

Emotional or psychological abuse would include: causing the patient to be afraid of you by threatening him or her or through other methods; making fun of the patient; demeaning the patient; and threatening to withhold treatment.

Involuntary seclusion happens a lot in many nursing homes. For example, a resident gets very noisy and disruptive, so a CNA moves him or her to another. Although this is a very hard spot to be in since you would want to do what is best for a majority of the people in the nursing home, you should never decide on your own when to move one resident to a secluded area. The decision should only come and orders should be given by a nurse. Some of the situations that are considered as involuntary seclusion would be: closing the door of a patient’s room when they want it to be kept open; placing a patient in a wheelchair far from other people; and leaving a patient without any way to communicate such as removing the call bell.

As a CNA, it is also important to check whether the patient is being abused by his or her family members or friends. In the event that you witness this, inform your immediate supervisor right away. Never attempt to decide on what actions need to be done to address this.

Being a CNA or a Certified Nursing Assistant usually means that you have sufficient CNA training and would be spending much of your time caring for patients, which is why those who are planning to become one are told beforehand that they need to be physically and mentally prepared for the job. However, do not be discouraged by the level of physical work that you need to put into this type of profession as you are entitled to breaks and meals that should be able to help in bringing back your energy.

Generally, rest breaks are paid while meal breaks are not unless you would be working through it. Here are the state laws which cover the breaks and meals of nursing assistants.

Rest Breaks

California: There should be a paid rest period of 10 minutes for every four hours of work put in or for every major fraction thereof. It is usually in set in the middle of the work period. This is, however, not required for nursing assistants with a total daily work time of less than 3 and a half hours.

Colorado: There should be a paid rest period not less than 10 minutes or every four-hour work period, which is also usually in the middle of the work period. 

Illinois: Every hotel room attendant or the people who clean and put the guest rooms in order should receive at least two paid rest breaks of 15 minutes each as well as a meal period of 30 minutes on every workday that lasts for not less than seven hours.

Kentucky: Nursing assistants should have a paid rest period of 10 minutes for every work period of four hours.

Minnesota: There should be a sufficient rest period for every four consecutive hours of work put in for any restroom activities.

Nevada: There should be a rest period of 10 minutes for every four hours or a major fraction thereof put in, which is during the middle of each work period. This does not apply for employees who have a total daily work time of less than three and a half hours.

Oregon: There should be a paid rest break of 10 minutes for each work segment of four hours in a work period and should approximately be in the middle of the work period.

Washington: There should be a paid rest period of 10 minutes for every work period of four hours and should be scheduled at the middle of the work period, as much as possible. Again, this is not required for employees who work for less than three hours a day.

Meal Breaks

California: Meal breaks should be a period of 30 minutes after five hours, except when the workday only lasts for six hours or less and when there is a mutual consent of both the employer and employee to waive the meal period.

Colorado: There should be a meal of at least half an hour after five hours. This does not apply if the workday only lasts for six hours or less. On-duty meal periods are counted as time worked and are allowed when the nature of the work prevents relief from the nursing assistant’s duties.

Connecticut: Meal periods should last for half an hour after the first two hours and before the last two hours of a work period lasting for at least seven and a half consecutive hours or more.

Delaware: Meal breaks should last for at least 30 minutes after the first two hours and before the last two hours of a work shift lasting for seven and a half consecutive hours or more

Illinois: Hotel room attendants should have at least two paid rest breaks lasting for at least 15 minutes each as well as a 30-minute meal break on every workday that lasts for seven hours or more.

Kentucky: Meal breaks should be 30 minutes; however, a shorter meal break might be permitted under special conditions. Meal periods should be scheduled between the third and fifth hour of the work period. Coffee breaks and shorter snack breaks are not included in the meal period.

Maine: Meal breaks should be half an hour and scheduled after six consecutive hours, except when there are emergency cases and when the nature of work can allow employees to have frequent breaks during the workday.

Massachusetts: Meal breaks should be half an hour for workdays which last for more than six hours.

Minnesota: There should be sufficient unpaid time for all employees who work for eight consecutive hours or more.

Nebraska: There should be a meal break of 30 minutes that should be taken off premises.

Nevada: Meal breaks should be half an hour for a workday lasting for eight consecutive hours.

New Hampshire: There should be a meal break of 30 minutes after five consecutive hours, except when eating while working is feasible and is permitted by the employer.

New York: There should be a meal period of one hour on a noon-day period. For employees who have a work shift lasting for six hours or more which extend over the noon-day period, there should be a 30-minute noonday period. Another 20 minutes for meals between 5 in the afternoon to 7 in the evening can be allotted for meals for employees who are working on a shift which starts before 11 in the morning and continues after 7 in the evening. The allowed period would be one hour for those working in factories, 45 minutes for those working in other establishments, scheduled in the middle of the shift.

North Dakota: There should be meal period of 30 minutes for shifts which are more than five hours.

Oregon: Meal periods should last for 30 minutes, with relief from all duties. This applies for work periods which last for six to eight hours. Meal periods should be scheduled between the second and the fifth hour for work periods that last for seven hours or less; or between the third and the sixth hour for work periods which last for more than seven hours.

Rhode Island: All employees should have a 20-minute meal period for every work shift that lasts for six hours or more and a 30-minute meal period for work shifts that last for eight hours.

Tennessee: There should be a meal period of at least half an hour for employees who are scheduled to work for six consecutive hours or more.

Washington: Meal periods should last for 30 minutes for work shifts that last for more than five consecutive hours and should be scheduled about two to five hours from the start of the shift. Meal periods can be counted as working time if the employee is required to remain on the premises or on a prescribed worksite. There should also be an additional meal period of 30 minutes for employees who are working for three or more hours beyond a regular workday.

West Virginia: Meal periods should last for 20 minutes for those employees who have work shifts of six consecutive hours or more.

Guam: There should be a meal period of 30 minutes and should be scheduled after five hours into the shift. This does not apply when the work day only last for six hours or less and when there is a mutual consent of the employer and the employee to waive the meal period. The meal period is not to be considered as time worked unless the nature of the work prevents relief from all duties.

Puerto Rico: There should be a meal break of an hour and should be scheduled after the third hour and before the beginning of the sixth consecutive hour of the work shift. If the employee is required to work on the meal hour, he or she would be entitled to double-time pay.