How to Become a Certified Nursing Assistant (CNA)Edited by Nancy Lynn Swezey, BSN, RN, CNOR
People who have a passion for helping others and working in the medical field should consider becoming a certified nursing assistant, or a CNA. For some, becoming a CNA is an excellent stepping stone toward a more specialized medical career. For others, being a CNA can become a career in and of itself. CNAs have an opportunity to decide if a more advanced nursing career is right for them and, if they do take that step, their career can progress with a solid foundation and background in every aspect of patient care. Many advanced practitioners who started out as CNA’s consider it an essential experience for both their character and professional development in nursing.
What Is a CNA?
A CNA is responsible for helping patients and clients manage their healthcare needs and daily living activities, like bathing, dressing and eating. They provide hands-on healthcare assistance, and they also document appropriate patient information for multidisciplinary use in care planning. This level of patient care allows CNAs to develop strong, trusting relationships with their patients. CNAs work under the supervision of a registered nurse (RN) or a licensed practical nurse (LPN). Similar jobs include nursing assistant (NA), patient care assistant (PCA), surgical nursing assistant, or state-tested nurse assistant (STNA).
What Does a Certified Nursing Assistant Do?
CNAs play an important role in helping a medical unit run smoothly, especially in health settings where the patients are medically complex and require several levels of care. Their general help in providing patient care gives RNs and doctors the freedom to focus on providing medical care and expertise. CNAs are trained to carry out any of the following duties and responsibilities:
- Repositioning or turning patients who are bedridden
- Organizing supplies for the RN or medical doctor
- Obtaining vital signs of the patient
- Responding to patient calls or bells
- Bathing patients
- Dressing wounds
- Preparing rooms for newly admitted patients
- Cleaning patients’ rooms and bed linens
- Assisting patients with eating, including measuring and recording food and liquid intake
- Documenting obtained information about the patient
- Helping patients with eliminations
- Assisting with certain medical procedures
- Stocking supplies
- Brushing patients’ hair, shaving and brushing teeth
Ultimately, different care settings will dictate different levels of responsibilities and scope of practice. In some workplaces, CNA’s may perform phlebotomy and point-of-care testing such as glucometry and EKG. In other cases, CNAs may have almost no patient contact, such as CNAs who work in an operating room where they may simply transport patients and provide equipment. CNA scope of practice is based on state laws, institutional policies, and unit nursing needs.
Where Can a CNA Work?
CNAs can work in hospitals, rehabilitation centers, adult day care centers, continuing care centers, and other long-term care facilities. CNAs are certified to work in an inpatient hospital setting, but some gravitate toward settings where they have more patients or clients with whom they can establish longstanding care relationships, such as in residential facilities. A CNA’s role in the clinic or outpatient setting may resemble that of a medical assistant, by welcoming the patient, taking vital signs and assisting with any diagnostic or procedural necessities, as well as clerical work. As urgent care clinics continue to expand in popularity, the need for qualified staff to support medical teams also expands. CNAs are starting to fill this gap in personnel.
As with any nursing role, it is important that CNA’s consider the quality of their interactions with patients as important as their clinical skills. Essential qualities of certified nursing assistants include:
- Physical strength
- Organization and prioritization
- Strong time management skills
- Clear communication
- Flexibility and patience
Different health care settings and patient populations will require different levels of patient interaction. Being able to provide culturally-competent, professional, and compassionate patient care are crucial components of effective work as a CNA. Empathy, for example, is especially essential when working with patients who may be nearing the end of their lives.
Career Outlook and Demand
According to the U.S. Bureau of Labor Statistics, employment for CNAs is estimated to jump 11 percent between 2016 and 2026. This growth projection is faster than the average for all other occupations and is due, in part, to the aging baby boomer population. As life expectancy increases, the aging population is expected to require care assistance for a longer period of time. One factor potentially working against CNA job growth is that many nursing homes rely on government subsidies to fund employees. Because nursing homes rely on Medicare and Medicaid, CNA job prospects in this setting are contingent on government funding policies.
In 2018, the median salary for a CNA was $28,540 per year, according to the U.S. Bureau of Labor Statistics. A CNA’s annual salary, however, depends largely on their employer. In 2018, a CNA working in a government health setting, for example, earned a median salary of $33,800, while a CNA in a home health setting earned a median salary of $27,290.
CNA educational requirements are fairly straightforward, though they vary by state. The topics that are usually covered in any educational CNA program include:
- First aid, CPR and AED
- Infectious disease control
- Taking and recording patient vital signs
- Workplace safety and protocol
- Activities of daily living, patient hygiene, and patient interaction
- Range of motion exercises to accommodate patients who require rehabilitation
- Communication skills, teamwork, and team building
- Certain point-of-care testing
Many CNA programs have specific prerequisites that must be met before enrolling. These prerequisites typically vary, but generally include the following two:
- Going to an orientation or information session
- A high school diploma, GED or a reading and math assessment
Applying to CNA School
When applying to CNA school, it is helpful, but not necessary, for prospective students to have completed coursework or have previous experience in patient care, such as bathing, grooming or feeding patients. It is also helpful to have a basic understanding of human anatomy and physiology, nursing tasks, nutrition, health conditions, and healthy habits. Program administrators will not only evaluate a candidate’s experiential and academic background, but they will also assess personality traits. They may look for a CNA who is ambitious, patient, empathetic and willing to address all patients’ needs with compassion and tact.
Continuing education for CNAs is essential for two reasons. First, it is typically required in order to remain licensed. Continued education affords CNAs an opportunity to explore more advanced training and degrees, and ultimately to qualify for higher level nursing positions. It is especially valuable to keep current in the field of healthcare which is ever-evolving. According to federal standards, CNAs must have at least 12 hours of continuing education each year in order to stay certified. Examples of CNA continuing education courses include:
- Information about HIV and AIDS
- Tips for avoiding medical errors
- Resident and patient rights
- Providing effective emotional support for patients
- Proper documentation in healthcare settings
- Elderly patient care, especially amid the growing population of aging baby boomers
- Information about current medical procedures and breakthroughs relevant for CNAs
In order to be certified, CNAs need to pass state requirements to practice, which usually includes a training program, clinical hours, as well as a written and practical exam. These educational programs are typically offered at community colleges, high schools, technical schools and local hospitals. It is important for prospective CNA students to thoroughly research programs to ensure they fit their respective needs and preferences.
To pass the certification exam for a CNA license, students have to demonstrate proficiency in some of the essential job functions. These job functions may include, but are not limited to:
- Helping a patient use a bedpan
- Changing linens on a bed while a patient is still in the bed
- Helping dress a patient with a weak arm
- Feeding a patient while they are sitting in a chair
- Checking for radial pulse
- Moving a patient using a transfer or gait belt
- Emptying a patient’s urinary drainage bag and monitoring output
- Repositioning patients with proper body mechanics and care
Beyond education requirements, CNA-hopefuls can expect an extensive job application process including background checks, health clearance and immunization, and potentially extensive interviewing and application processes.
Frequently Asked Questions
How Long Does It Take to Become a CNA?
Programs to become a certified nursing assistant can vary in length based on the state and the educational setting, but in general, the process takes an average of six to eight weeks to complete. The federal minimum training requirement for CNAs is 75 hours, but certain states and care settings require prospective CNAs to invest a significantly larger amount of time in education. Some align their educational requirements with those of the National Academy of Medicine, which calls for a 120-hour training minimum, while others require more.
What Is the Difference Between a Medical Assistant and a CNA?People sometimes use the terms medical assistant (MA) and CNA interchangeably, but there are important differences between the two. An MA focuses on both the medical and administrative needs of a patient. They administer injections and medications, record a patient’s health information and are also responsible for office tasks. A CNA may be considered more holistic, ensuring that quality of life is maintained while they assist with activities of daily living. CNAs assist patients with their health, while also offering a level of companionship.
How Can One Become a CNA for Free?
In many states, there are opportunities for those seeking to become a CNA to take free courses in order to pursue certification locally. These courses include traditional classroom lectures and talks, training in essential CNA skills and supervised clinical practice. Free CNA certification training courses can often be found through local Red Cross offices, nursing homes, long-term healthcare facilities and other healthcare settings that have a high need for CNAs. Taking free certification courses is a way for potential CNAs to decide if the career path is right for them before committing their own resources. Be sure to understand the terms of the course, as some require a commitment of employment after completing the certification as a means of paying for the course.
How Long Does a CNA Certification Last?
In a majority of states, CNAs must renew their certification every two years with the state’s nursing board or licensing authority by filling out a renewal application. To have a licensure certification renewed, a CNA must prove that they have worked as a certified nursing assistant for the past two years. In many cases, applicants who have not worked as a CNA within the previous two years must retake the certification exam.