In the healthcare industry, there are a variety of professionals that work hard, day in and day out, to serve their patients in a wide array of roles. One extremely versatile role in the healthcare industry is a Certified Nursing Assistant, otherwise referred to as a “CNA.”
CNAs work in several different environments including hospitals, homes, and assisted living communities. With the rate of adults requiring senior care rapidly increasing every year, the need for CNAs is stronger than ever. To understand the shifting role of the profession and the critical part CNAs play in senior healthcare, it is important to know what they do and how they are qualified to give fill the position.
Defining a Certified Nursing Assistant
Like most jobs in healthcare, certified nursing assistants are generally referred to by their acronym (CNA) for convenience. CNAs that are considered members of a senior’s healthcare team will generally work under the direction of one of the following professionals:
- Registered Nurse (RN)
- Licensed Practical Nurse (LPN)
- Licensed Vocational Nurse (LVN)
- Other healthcare professionals like a physician or psychiatrist
An LVN and an LPN are the same role, the name only differs depending on where you are in the country. In fact, one of the many confusing issues when it comes to senior care is who exactly does what on the healthcare team.
In an assisted living community (ALC) the role of CNA is clearly defined, but again, the location and region of the community can also dictate the name of the role. Some other terms that CNAs are referenced by include:
- Nurse Aide (NA)
- Geriatric Aide (GA)
- Nursing Assistant (NA)
- Auxiliary Nurse (AN)
- Patient Care Technician (PCT)
- Nurse Technician (Nurse Tech)
- Home Health Aide (HHA)
- Personal Care Assistant (PCA)
The International Standard Classification of Occupations (2008 rev) defines certified nursing assistants as “personal care workers in health services.” Generally, the correct and universal term is certified nursing assistant, and it is best practice to always use this name.
CNAs perform a variety of tasks within an assisted living community, which can include everything from taking vitals, to meal prep, medication administration, and even room safety checks.
Every facility and environment will require something different from a CNA, so it is generally a role that is suitable for flexible people. Other characteristics for a successful CNA include:
- Strength (both mentally and physically)
- Strong work ethic
- Communication skills
- Quick thinking (and reflexes)
While working under the supervision of an RN/LPN, CNAs must prove their competencies and abilities with patients prior to gaining any further responsibilities.
The Role of CNAs in an Assisted Living Community
Although some ALC environments can be fast-paced, the typical work shift of a CNA in an assisted living community is usually eight hours. Nonetheless, many people in the profession are so dedicated they often work overtime and/or double shifts. Understaffing problems may give rise to the need for longer hours as well. Although it is a busy job, most professionals will also tell you that it is highly rewarding.
The role of a CNA in an assisted living community can vary greatly by the location, but there are certain tasks within the position that all workers are expected to perform if they are classified as CNAs. The main role of the CNA is to assist residents with their activities of daily living—otherwise referred to as ADLs.
Activities of Daily Living
Although most individuals in an assisted living community can complete their daily tasks independently, some people may require a little extra help. A person’s ability to perform their ADLs is usually what doctors use to measure their capability of living alone. Although the needs of an individual can change over time, the following are the typical activities associated with the term “ADL.” A CNA will often assist in one or more of these activities.
Hygiene: Residents in an assisted living community are generally free to go about their day as they please, but should they need assistance with their hygiene, a CNA can help them perform those tasks. Hygiene is critical at the start of the day, as it will help an individual feel fresh, clean, and dignified. Hygiene-related tasks can include everything from brushing teeth, to showering, bathing, and combing hair.
In the event an individual is confined to their bed, they may be at risk of developing ulcers (also known as bedsores). In these instances, CNAs are required to keep these areas clean and properly dressed at all times. Helping patients with periodic movement or rotation is also important.
Dressing: Individuals may need help with dressing at different stages in their routine. If a person usually dresses themselves, they still may need help with laces, buttons, shoes, and socks. These are typically the areas that a CNA can assist a senior with to help them get ready for the day. An assisted living community rarely has a dress code and residents are usually free to dress as they choose (as long as it is decent).
Toileting: CNAs are trained to assist an individual with anything they need related to this activity of daily living. This encompasses everything from assistance to the bathroom, to adult diapers and changing a catheter.
Eating: Depending on the individual, a CNA may be required to assist with an individual’s nutrition, meal prep, and eating. It is a CNA’s job to make certain the residents are receiving meals with the proper diet and consuming the nutrients they need.
Mobility: Perhaps the most important job of any CNA is to ensure the safety of their patients. Because a staggering number of seniors fall each year–roughly 1/4 of Americans aged 65 and over–a CNA’s number one job is to make sure people have assistance with mobility.
As a vital part of ADLs, mobility is perhaps the most dangerous to a senior. In addition to guidance, the CNA should be looking out for safety hazards and anything in the path of ambulation. CNAs should also be assisting residents with daily exercise to the best of each individual’s abilities.
As the industry for CNAs grows, the tasks that define the position are changing. CNAs are also expected to help an individual perform a large amount of their instrumental activities of daily living (IADLs) as well.
Instrumental Activities of Daily Living
A 2010 survey of Residential Care Facilities by the Centers for Disease Control found that CNAs perform a variety of IADLs in addition to their typical services. IADLs include activities that, although are not vital to a daily process, are instrumental in a person’s life. These can include tasks like:
- Food Prep
- Cooking Meals
- Social Activities
The 2010 CDC survey found that 60% of CNAs were performing janitorial duties, 69% were expected to help with food prep, 52% assisted with transportation, and 87% participated in recreational activities. Although the job is changing on paper, many CNAs will probably tell you they have been doing most of these tasks all along.
Depending on the environment, there are some additional tasks that may be expected of CNAs. This can run the gamut of duties, but in an assisted living community, it generally means:
Charting: A certified nursing assistant may be expected to monitor and record vital signs, and in some cases, a resident’s activity throughout the day. This is to encourage seamless transition between staff changes and diminish the interruption of care.
Call Bells: Most ALCs have call features for each resident in their room. Much like a nurse button in the hospital, it can be used if an individual feels they need immediate assistance and cannot reach out any other way. CNAs are generally responsible for answering these initial calls, as they are usually for mundane items, such as asking for a glass of water or to adjust a room temp.
Companionship: It should not be overlooked that CNAs spend a lot of time with the residents in an assisted living community. Perhaps more than any other staff, CNAs should be providing overall companionship and positivity during all duties expected of them in their role.
Certified Nursing Assistants are not required to have a formal degree, but they do need to have various certifications and other training that varies depending on the state. The following is what is generally expected of an individual working to become a CNA:
- Pass a course (accredited)
- Pass the State’s required CNA exam
- Pass a practical exam and skills test
- Have a certain amount of on-duty hours working under supervision
- Register in the state the exams are performed
Once these requirements are completed, that person is considered eligible to perform CNA duties within that state. If a person chooses to relocate, they may have to start the process over depending on state laws. Classes to study for the exams are provided by the American Red Cross, amongst others.
Every CNA is expected to have a certain amount of training in the field prior to dealing with patients. An apprenticeship and/or training usually consists of the following topics/tasks:
- Anatomy and physiology
- Infection control
- Mental health issues
- Cognitive impairment training
- Body mechanics
- Personal care skills
In the context of the aging baby boomer population, a certified nursing assistant position is in growing demand. Their terms may differ, but the tasks are the same. CNAs help people perform their daily activities of life while providing compassionate care and attentive companionship. Contact Cobbdale Assisted Living for more information.