Working as a certified nursing assistant (CNA) means you will be required to have a long list of healthcare skills. It also means you will have a substantial amount of responsibility placed upon you. You will be working under the direction of a licensed practical nurse (LPN) or registered nurse (RN) performing important patient care tasks and helping improve the quality of their care and their lives.
Responsibilities of a CNA
The role of a CNA can vary a bit depending on where you work. You can work in a specialized role in a hospital unit, or you may be part of a nursing home staff. The day to day responsibilities can be quite different between locations such as those. However, there are some generalized responsibilities that most CNAs can expect when they begin their career.
- Taking vital signs
- Transporting patients
- Assisting patients with activities of daily living like feeding, bathing, and hair care
- Accurately collecting and reporting patient data
- Observe and respect patients’ rights
This, of course, is just the tip of the iceberg. Ultimately, a CNA is a critical component of the healthcare team. They are often the most frequent point of contact for patients, and a CNA’s communication skills are critical in carrying out care plans and reporting back progress or issues to the nursing staff.
The Nurse Hierarchy
As mentioned previously, a CNA works under an LPN or an RN. These nursing positions require a greater amount of education and training to obtain, thus why they are the ones calling the shots.
RNs are at the top of the food chain as it requires a four year degree to become a registered nurse. They are responsible for preparing a care plan and evaluating patient data. An LPN must complete a one year program to gain their accreditation, and they perform tactical nursing duties under the direction of the RN. A CNA can achieve their certification in a matter of as little as four weeks, and they are responsible for providing basic care to patients and assisting with activities of daily living – following instructions from the RN and/or LPN.
What qualities make a successful CNA?
After passing the CNA exam and completing a state-certified course anyone who meets the basic requirements can technically be a nursing assistant. Those who excel in the position tend to have certain qualities that make them a great fit. To truly excel in the role, the following skills are very beneficial.
- Communication. A CNA’s communication skills are paramount to their success. This includes verbal, non-verbal, and written communication skills. Constant interaction with patients means you’ll constantly need to inform them as to what you’re doing, whether it’s helping them get into a wheelchair or giving a partial bed bath. On the opposite end of the communication spectrum, you’ll need to become an active listener who can pick up on subtle cues from your patients and then effectively record and relay that information back up the chain of command to doctors and nurses.
- Physicality. Working as a certified nursing assistant can be physically taxing. Helping patients through physical therapy, assisting them getting in and out of bed, and other daily tasks require strength and stamina. A lack of these traits can make the job difficult and potentially dangerous.
- Patience. This is a hard job and you will be tested from time to time by difficult patients, co-workers, and other caretakers. This is true for most healthcare positions. Having the patience to work through the hard times is a common characteristic among successful CNAs.
How to successfully communicate as a CNA
What does it take to effectively communicate as a CNA? Several things.
- Keen observation skills. While this may not be the first thing you think of when it comes to communication, it’s critically important when dealing with patients and acquiring the information you will need to report to the healthcare team. Subtle changes in a patient’s behavior or visible changes in their appearance can all be critical pieces of information you need to catch to assist your patients.
- Prompt reporting. Being able to process information and decide what needs to be communicated quickly is a huge part of being a CNA. If a patient’s complaints or non-verbal behavior suggests a potentially serious health issue, you need to be able to clearly communicate that information quickly to the appropriate staff.
- Accurate documentation. While this may seem rudimentary, it’s important that basic data is neatly printed in legible handwriting on all documentation. You will need to have proper equipment (no pencils!) and use appropriate medical terminology and abbreviations where necessary in line with current nursing practices and following the protocols set forth by your employer.
As you are likely aware, the healthcare industry is prone to lawsuits. When a person or a business is responsible for someone’s health, it’s vital that protocol is followed to the letter. As a CNA, your day to day responsibilities may put you in a position to be liable for a number of potentially damaging legal issues. Some of the most common are listed below.
- Neglect. Not performing basic duties such as failing to perform hygiene or provide prescribed care can lead to negative health consequences for patients and legal trouble for the CNA being neglectful.
- Abuse. Verbal or physically abusing a patient can also be grounds for a lawsuit.
- Negligence. As the staff member that typically has the most contact with patients, a CNA is often put in a position where they can be found guilty of negligence. Improperly performing day to day duties and harming a patient can certainly lead to problems for the CNA.
Fortunately, if you do your job correctly, you should be able to steer clear of any major liabilities. Remember your training, follow the rules of your organization, perform only duties within your scope of responsibilities, and defer to an LPN or RN if you have questions and you should be in good shape.
The Patient’s Bill of Rights (PBoR) is a set of rules adopted by the American Hospital Association in 1973, later amended in 1992, to provide guidelines for hospitals and caregivers. The PBoR was designed to create more effective and collaborative patient care, and is something CNAs need to be aware of as they perform their duties each day.
You can read the full Patient’s Bill of Rights here, but in short it provides guidelines to ensure patients and families understand their rights and the responsibilities of their healthcare providers. Some basic concepts of the PBoR cover the patient’s rights to:
- Considerate and respectful care
- Current, understandable information about their diagnosis
- Request and discuss information about procedures, treatments, and risks (except in the case of emergency or reduced decision making capacity)
- Financial implications of treatment options
- Know the identity of those providing treatment
Ultimately, the point of the Patient’s Bill of Rights is to ensure collaborative care. It also is designed so the individual receiving treatment, along with their family members and surrogates, are involved in the critical components of the decision making process.
Morals and ethics. Maybe more than any other skill, a CNA won’t make it without having a high degree of morals and ethics. You’ll be dealing with sensitive patient information regularly, and also dealing with people in sensitive situations. Utilizing your interpersonal skills while exercising respect for your patients and co-workers is absolutely necessary to do the job. Every year there are CNAs who get into legal trouble for negligence or abuse. Demonstrating ethical behavior comes in many forms as a CNA, some ways that successful CNAs show their ethical behavior includes:
- Keeping patient information confidential
- Being responsible with their work schedule so that patients are not left unattended
- Always showing respect for patients and staff
Yes, there are many roles and responsibilities that come with being a CNA. While the job is challenging, that’s also what makes it so rewarding.