CNA Job Description & Duties

Certified Nursing Assistants are in high demand all across the United States. In fact, based on the latest predictions from the Bureau of Labor and Statistics, the need for skilled staff will be drastically increased over the next few years, compared to many other professions. There is no doubt that CNAs will play a huge role in the growth of the health care industry in the coming years. To help you prepare for your role as a nursing assistant, we have outlined a basic CNA job description, listing the major duties and responsibilities of this profession.

CNAs are typically working under a licensed vocational nurse or a registered nurse, who helps patients with their healthcare needs.  It may not be possible for nurses to stay up to date for every single patient in their care. As such, CNAs bridge the gap.

CNA Duties & Responsibilities

Cnas have a huge range of different duties and responsibilities. Here I have categorized them so you can have a better idea of what is expected of this profession:

Planning

Most of the planning is done by the patient’s doctors, nurses, and senior specialists. But CNAs can help through observation. Since they spend a lot of time with the patients, they can assess their overall health and well-being. They are also responsible for taking vital signs such as heart and blood pressure rate, as well as temperature. They also need to measure the patient’s height and weight, among others stats, sometimes on an ongoing basis.

Working closely with nurses, the CNAs may be requested to retrieve lab samples like urine and stool for a more thorough analysis. They can also act as liaisons for the nurses and the patients. They need to keep track of the patient’s output and input (e.g., food, urine, stool, etc.). CNAs also assist in infection control.

Assistance and Care

A bulk of the CNA’s responsibilities focuses on two things: assistance and care. The tasks are often routine, but they are essential to ensure a patient’s comfort and quality of life.

Being a CNA means wearing several hats. The reason why people hire CNAs is so that they have someone who can assist with the provision of basic care. Basic care is broad and includes physician care, inpatient hospital care, outpatient medical care, preventative health services, and emergency services just to mention a few. Accepting a CNA job means you have accepted to do all the above. In more detail, the core functions of a CNA include the following:

• Take and monitor vital signs like blood pressure and heartbeat periodically. The idea is for any critical values to be flagged in time. A critical value is a test result that indicates the need for rapid medical attention to prevent any significant patient mortality or morbidity. These values make it easier for a patient’s condition to be stabilized in time before it spirals out of control.
• Serve food to patients and help them eat. More often than not, a patient may not be able to eat because they are too weak for example. Thus, A CNA is expected to ensure that the patient is fed because their body needs the food to sustain itself and also help in the recovery process. Such help may also extend to other routine daily activities such as bathing and grooming.
• Turn bedridden patients and lift them into and out of bed. In case a patient cannot move voluntarily, a CNA will be expected to ensure the patient is as comfortable possible by moving them either in bed or taking them out for a stroll in a wheelchair. In the same breath, CNAs will also provide bedpans used for toileting and empty them every so often.
• Answer phone calls and take messages. A CNA may be expected to talk to people who attempt to reach out to the patient they under their care and at times also take messages. People reaching out to the patient aids their recovery process as it makes them feel loved and also that people care about them.
• Examine patients for blood in their urine, wounds or bruises. This is particularly important for patients who are not able to speak or express themselves properly for example patients in a comma or children.
• Keep patient areas clean and sanitized. This goes along with restocking necessary supplies such as toiletries and changing sheets.
• Perform simple procedures such as non-sterile dressings. This may also extend to the collection of samples such as sputum, urine, and stool from patients.
• Maintain work operations by following work policies strictly. This involves all manner of duties from filling in required forms and documenting the care given for future reference to logging vitals.
• Protect confidential private information. This is usually in line with what the law stipulates for example in the HIPAA Privacy Act.
• There are minor functions that will usually be blanketed as others. They include carrying out post-mortem procedures, promoting client safety and well being as well as adhering to set standards and following industry rules. Minor as they may be called, they are also important in the overall picture of a CNAs work.

Communication

CNAs are expected to communicate at all times with the patient as well as other health care professionals. That’s why they are usually asked to log their observation as soon as possible or to call the attention of the immediate nurse if something is amiss. They are often asked to submit a report right after every shift. Beyond that, nursing assistants should provide not only timely but accurate assessments of the patient’s condition. This has to be done with extra diligence as they are bound by confidentiality agreements.

Additionally, CNAs may also need to communicate directly with the patients, especially in informing them of any various procedures that have to be done. Communication can be as simple as providing instructions to the patient when assisting a patient in standing up or carefully sitting down in a wheelchair.

Emotional Support

CNA classes include more than just anatomy and health care training. They also deal with psychology, since nurse assistants are expected to communicate, empathize, understand, and even form bonds with their patients. Remember, there’s no successful partnership if there’s no sense of trust.

CNAs may be requested to perform massages or back rubs on the patient in order to prevent muscle atrophy. Some patients may also need them to be around during critical moments of their life such as surgery. They are also responsible for the patient’s hygiene, as well as the cleanliness of the surroundings. If the patient requires isolation, CNAs are expected to help strictly implement the rules.

Important Qualities of CNA’s

To be a CNA, you must possess some very important qualities because you will be working directly with people that need help. They will need someone that will care for them and respond to their needs.

• Patience – This is a big part of the healthcare profession. It shows that you will put the needs of the patient first no matter what their demeanor may be. This may be difficult some days but they will without a doubt appreciate that you are willing to help them regardless of their frustration.
• Empathy – Putting yourself in the shoes of others helps you understand their situation better. For example, if a patient is bedridden and you put yourself in their shoes, it will be easy to understand why you have to provide them with a bedpan during toileting for instance. Empathy also has a direct impact not only on what you say to patients but also how you say it. Patients will want to express their feelings and emotions to you as a CNA and understanding and recognizing those emotions will allow you to better help them. They want someone to connect with and as a CNA, you will be looked to as someone they will want to reach out to.
• Communication – By directly interacting with patients, communication skills are vital especially when relaying information to nurses and doctors. You may observe something regarding a patient and being able to communicate is essential.
• Strong Work Ethic – As a CNA, you will be required to do a lot and the willingness to go the extra mile for the patient will be invaluable in the eyes of not just your patient but also in the eyes of your peers, you are working with.
• Responsibility– This is necessary to ensure that the CNA’s own safety and health are also safeguarded. Personal protection equipment such as gloves is highly recommended to avoid the spreading of communicable diseases. While lifting and moving clients from one location to another, a CNA ought to use effective body mechanics lest they harm themselves in the process and render themselves incapable of taking care of their clients.
• Dependability– This is very important and has basic elements such as coming to work on time and consistently carrying out assigned duties satisfactorily. Typically, this quality is usually a demonstration of a CNA’s commitment and helps a client and those around them rest easy knowing they can rely on a CNA to take good care of their loved one.
• Flexibility- There are situations when things do not go according to the script. For example, if you were to provide basic care until the sibling of a client got back home only for them to arrive four hours late, it would be absurd to leave before they come back. The ability to adjust accordingly and do what is right for the patient in every particular situation is a good quality to have. It requires a CNA to be open-minded as anything can happen at any time with little or no notice whatsoever.
• Being Considerate– This involves being cognizant of other people’s feelings especially those who are directly involved with the patient you are handling. Being considerate helps nursing aides become effective in their work as they get to put things into perspective and do right by most people involved if not all.
• Respect– It is important to respect other people’s beliefs, culture, language, and values. This will enable a CNA to cater to the needs of a client without being judgemental or at the very least explain why a client does a particular thing in a particular manner. The emphasis here is on the fact that as a CNA, you do not have to agree with everything. However, so long as it does not put a client’s life at risk, you are not allowed to oppose as you are simply there to make their life easier and not change their way of living.
• Accountability– Providing basic care boils down to being accountable. A set of tasks is handed over by a supervisor to you as the CNA and it is your responsibility to ensure all of them are done as well as can be. Any challenges that you encounter in the course of your job should be discussed with your supervisor as soon as possible to come up with workable solutions.

Who Do CNAs Work With?

Certified nursing assistants work with a number of other people in order to provide quality care. Here’s a brief primer on just a few of those people, and what they do:

1. Physicians, doctors and physicians assistants are at the top of the food chain, so to speak. They have several years of post-graduate schooling as well as time as an intern. They are qualified to make advanced medical decisions, perform a number of procedures and are generally the top-line medical professionals for advanced care.

2. Dietitians and physical therapists are specialists who perform a role that helps those people who are in need of specific rehabilitative care. Certified nursing assistants may be asked to interview patients to ensure they are maintaining the right food intake, and they may help patients perform exercises in line with the recommendations of a physical therapist.

3. Social workers are more involved with the community aspect of a rehabilitative or nursing facility. They may help find policy options for residents that require the aid of certified nursing assistant. CNAs may also work with social workers to provide enrollment or other information to improve resident’s accessibility to various initiatives.

4. Home health aides and other staff members at nursing facilities also play a critical role and are likely the staff members that certified nursing assistants will interact with the most. The skills and duties of these roles overlap to a large degree, however CNAs must have more healthcare experience and will likely perform more tests and other work with patients.

5. Administrative and training staff are not necessarily seen often by patients, but they are critical to the upkeep of most facilities. Expect these staff to help with ensuring that you as a certified nursing assistant remain within the regulations, fill out forms exactly and make sure that everything is in tip top shape.

Where Do CNAs Work?

After completing CNA training you will need to look for employment. A common question is where do CNAs work? Where can they find jobs that will fulfill their lives and allow them to use their training? The generic answer is hospitals, clinics, nursing homes, and hospices. Below is some information about the requirements and job functions of CNAs in these different facilities.

Certified nursing assistants work in a variety of facilities. You can find CNAs working in:

• Assisted Living Facilities
• Clinics
• Doctor Offices
• Nursing Homes
• Home Health Care Agencies
• Hospices
• Hospitals
• Urgent Care Centers

Nursing Homes and Assisted Living Facilities

Only nursing homes are mandated by the federal government to hire certified nurse assistants. Other facilities are not required to have any on staff and may hire nurses exclusively.

In assisted living facilities and nursing homes, nurse aides provide personal care and support with activities of daily living for residents. This can and does include dressing, eating, physical transfers from bed to chairs, transporting via wheelchairs, and toileting. Many residents are unable to perform these activities themselves and must rely on aides for many of their basic needs.

Aides also provide emotional support and comfort to residents. Many residents suffer from anxiety, depression, and dementias in addition to any physical limitations. Some residents may have no family and their only link to human contact is the staff in their facility. CNAs receive some training in psychology during their course and will learn how to offer this support while maintaining the dignity of the resident.

In other facilities, the aides may perform the duties traditionally associated with nurses. Preparing patients for surgery, taking vital signs, and administering some medications. The duties that these aides are allowed to perform will vary by state, sometimes by county.

Doctors’ Offices

CNAs that work in offices and hospitals may go by a different name. These aides go through specialized training and may only enter some special courses after working for a set number of hours or months as a ‘regular’ CNA. Courses for these aides may be for memory care, medication dispersion, rehabilitation, or hospice care.

Hospitals

A hospital is an institution offering health care, specialized treatment, and short term care. In a hospital setting CNAs work with a wide range of patients from children to the elderly. Their duties can change based on the medical condition of the patient and what care they might require. For instance, CNAs in the emergency room often take patient vitals and settle the patient to wait for the RN and doctor. On other floors, CNAs may check in on patients, record vitals, and obtain medical documentation that will help the doctor do his/ her job. CNAs tend to ask the patient what occurred, their reason for being admitted, and then do simple procedures like drawing blood.

Clinics

Clinics are another area where CNAs work as an aide to gather information and prepare it for the RN and doctor to help progress the level of care to a solution. Often the CNA is the first person to see and welcome the patient inside the office.

Hospices

Hospice care also called palliative care, is a term for a specific kind of support in one of the several different types of facilities. For the most part, people working in hospice facilities are treating and caring for patients with terminal injuries or illnesses. People residing at hospice facilities are at the final stages of life, there is nothing more that modern medicine can do to help them. It is up to the staff to keep the patient as comfortable and as pain-free as possible for their final days.

It takes a special kind of person to be able to work in hospice care. You must be a dependable and compassionate person to be able to work in any type of end-of-life situation. Many people find fulfillment in these types of jobs and, probably more than any other nursing situation, these workers are appreciated and needed.

Should you decide you want to work in a hospice environment, you need to first make sure that you can psychologically handle death and dying. It can be a very painful process, even for those who are giving care to the ill. You will develop emotional attachments to your patients and, when they pass away, the toll it can take on your psyche can be monumental.

You also must be prepared for the emotional response the patient will have from visiting friends and family. Though the patient might be ready to pass on, the family may have real trouble dealing with the inevitable. Grief is already a difficult thing to bear, but a prolonged and painful death is very hard for loved ones to process.

One way that can help you decide if hospice care is right for you is by volunteering at a facility that provides this type of care. As a trained medical professional, you will need to decide in what capacity you would like to volunteer, whether you would like to assist the medical staff or the patients directly. This will help you gain valuable experience with death and dying, and will show you whether you have the correct mentality to be able to serve in this area.

One thing is certain: Hospice care is very much in demand and careers in this field are secure and stable. Anyone who can handle a career in a hospice situation will find meaningful, challenging work and a strong sense of self. Many people who work in this field say that their occupations have given them a much stronger appreciation for life itself.

Travelling CNAs

You may have heard of traveling nurses. These nurses travel the country and sometimes even the globe in order to take care of patients. They make higher wages than most nurses that stay in one area, this is due to the unique needs of traveling.

Did you know that there are also traveling nurse aides? These nurse aides may not travel around the world, but they do travel from facility to facility and sometimes to different states in order to help facilities in need of staff.

Most of the time these traveling aides stay in their home state. Others may find that they can make a much higher wage by working in another state. One such state that brings in aides from another state in Connecticut. Nurse aides that are certified in New York state can apply for a license to work in Connecticut. The license or certification is reciprocated by the state and costs between $50 and $75. The license is good for two years and the aide is then free to work anywhere in the state.

Aides that travel to different states usually choose a state that practices reciprocity with the state they are licensed in. The reason is that the aide will not need to take classes or a test in order to receive their certification in the reciprocating state. They will only need to provide a copy of their home state certification, then pay the fee for their certification in the other state.  An aide can hold certifications in all 50 states if they have the time to train or visit each state.

This creates a great money making opportunity for aides. They are able to travel away from home and sometimes work only a few weeks a month. Some aides may only work for a few months a year when they are in need of cash.

This also creates great opportunities for employers as they can bring in aides from other states to fill the gaps in their staffing. There are no enough people in each state to fill the aide roles for facilities. As traveling aide jobs become more popular, the staffing needs of more facilities can be met. This is good news for residents and aides that are familiar with low staffing problems.

Correctional Facilities

Job opportunities in the medical field come in surprising places. While hospitals, doctors offices, nursing homes and home health care agencies are always hiring, one place that many people do not even consider are jails and prisons. Every prison facility in the country has on-site medical care, and these jobs can be lucrative and rewarding.

As most jails and prisons are run by local or state governments, the people they hire are often government employees, meaning these jobs come with great pay and medical benefits as well as retirement packages. Many people in the nursing profession who take jobs at these facilities stay on for long periods of time. Though the environment can be tough, it can also be very rewarding.

Health care in prisons is improving and, as such, quality medical staff is in demand. From doctors to nurses to certified nurse’s assistants, are called upon to deliver medical care in these unique environments.

Though some prospective prison employees are concerned about safety in the workplace, the truth is that jails and prisons can be some of the safest places to work. The prisoners are always under guard and their movement throughout the facility is tightly controlled. The civilian staff are important, especially to the inmates, and are always treated with respect.

A care giver’s role inside a prison or jail is basically the same as it is any other place in the medical field. The patients are still suffering from the same ailments that elderly patients must deal with, though the seniors in this environment may be less likely to admit they are in pain or dealing with depression. The prison environment is different, but in the role of elder care, the CNA’s job is almost always the same and the emotional rewards that come from helping others is just as enriching.

There may be some elderly inmates that will challenge the CNA’s ability to offer assistance. When working in a prison, it is a fact that the elderly inmates are almost always criminals that committed serious, sometimes horrible crimes that will conflict with the compassion that is innate in all caregivers. This is usually the hardest part of the job. By the time most inmates have reached old age, they have worked hard to change their behaviors and some have played a key role in helping younger inmates find learning outlets, or have acted as role models to younger inmates that are in deep remorse about their own crimes.

No matter the case, humans are humans and eventually we all need help in our later years.

Restrictions on Services CNAs can Provide

CNAs may not legally provide care without the supervision of a nurse. Aides that advertise on websites and in local newspapers for in-home care cannot legally charge rates for CNA care or offer personal healthcare – they may only work as companions. The nurse may be either a Registered Nurse (RN)or a Licensed Vocational Nurse (or LPN/LVN). Certain states require that an aide may only be supervised by an RN.

It is important to note that any CNA employed by a staffing agency to provide in-home private care must take yet another course and be certified as a Home Health Provider or Home Health Aide. These aides are still under the supervision of a nurse. If the aide is not under the supervision of a nurse, the staffing agency must provide a nurse to ‘check in’ on the aide and patient.

A Typical Work Day for a CNA

Those who want to work in this field should possess patience, understanding, and attention to detail as well as a superior work ethic. Due to a shortage of workers who have attained their CNA certification, daily caseloads can at times seem overwhelming. In order to perform at peak efficiency while maintaining the best quality care, the CNA must be able to prioritize his/her daily activities and remain focused on the job at hand.

CNAs have a very demanding job where you may be on your feet all day. It is also possible that you may be lifting a lot of weight throughout the day in order to perform your job duties. Your job duties will be determined by the facility you are employed at. However, there are some similar tasks at all these facilities we can list here to give you a better idea of what to expect. Now that you are an aide to the nurses, you should expect registered nurses to give you job duties throughout the day and ask for your help when they need it.

Although one’s duties will depend on the facility, all nursing assistants provide clients with ADL tasks such as bathing, dressing, feeding and basic hygiene needs. These basic routines involve bathing either in a shower or with bed bath, hair care, brushing teeth or cleaning dentures, applying makeup, shaving, etc.

At times you may be asked to administer medication or treatments, which have been pre-measured by the nurse or doctor. You may also be required to put in catheters, suppositories, irrigation, enemas, or give massages.

At all times you are the patient’s aide and responsible for their personal hygiene, which means you will bathe, groom, shave, dress, or prep your patients for surgery. You will clean rooms, change the bedding and help the patient to the bathroom or on walks if they require it.

Depending on the care facility you may prepare, serve, and collect the food trays. Some facilities like hospitals have food service workers who bring, serve, and collect the food. Any patient call signals will be answered by you.

You will help the patient exercise, transport them to different parts of the facility and assist bedridden patients. Bedridden patients can develop bed sores if they are not moved around enough, so you may have to turn or reposition them for their comfort.

CNAs are part of the medical team, which means they are there to help, do what is asked, and help out in any way they can. You may have to answer phones, direct visitors, deliver messages, samples, or documents. It is also possible that you will be asked to explain medical instructions to both family and patients.

Listening to each patient as well as to their loved ones is also an important part of the job and family members may have special requests for someone who is in care such as keeping their fingernails cut or tying up their hair each day, etc.

Overall, job duties entail that you monitor your patient’s condition by measuring and recording food, liquid intake, and output, vital signs, and report any worrying changes.

There are clinical duties in any facility because you need to maintain a patient’s health and observe their changes, which require you to record the data. Furthermore, there will be times you might have to restrain patients if they become difficult to handle where you, they, or another person would be in danger of injury.

In all of this, nursing assistants have a duty to ensure that the dignity and confidentiality of each of their patients is the highest priority.

Being a CNA can be tough work. But states reward these professionals with a comfortable life through a decent salary and benefits – not to mention the practical experience working in a healthcare environment is invaluable if an employee decides to advance themselves in their nursing career. Most of all, however, a Certified Nursing Assistant gets something rarely found in most other jobs – fulfillment from helping others.