Advantages and Disadvantages of a CNA Job in LTC

Are there significant differences between a nurse aide's job in a long term care facility as opposed to a CNA working in home health care? The answer to this question may help a certified nurse aide choose wisely between several job offers which involve different work environments. Our analysis seeks to realistically illustrate the advantages and disadvantages of a CNA job in a nursing home while additional articles reveal the pros and cons of working as a nurse aide in home health care and hospitals. A certified nurse aide employed in a long-term care facility is responsible for providing basic patient care to a large number of residents.

The clinical component in every CNA course prepares you for the usual tasks required in nursing homes: answering call bells, measuring vital signs, feeding patients, helping with grooming, toileting, bathing, and oral hygiene, performing range of motion exercises, transferring patients, and assisting with ambulating. Transferring a client from bed to a wheelchair usually involves operating lifting equipment and a CNA must be trained to properly operate whatever equipment the nursing home uses. Aside from the responsibilities mentioned above which mainly involve providing help to clients with activities of daily living, additional CNA tasks are gathering dirty laundry, maintaining clean and orderly rooms, socializing with and providing emotional support to residents, and helping the LPN or RN in charge with postmortem care. A very important part of a nurse aide job in long-term care facilities is documenting the care provided to each patient and recording vital signs, intake and output, as well as weight measurements. The documentation is used by nurses and physicians to monitor and adjust a resident's plan of care.

There are several attractive features of being employed as a CNA in a nursing home as opposed to home health care or hospital settings. A long-term care facility usually offers a higher salary and more employee benefits to their nursing assistants than other health care settings. Most nursing homes units have at least two certified nurse aides working on the same floor and they often help each other with client transfers or in cases of combative resident behavior. Each CNA needs at least twelve hours of in-service education credits in order to maintain state-certification, which are provided by nursing homes at no cost for their employees. Long-term care facilities are known to offer extended work hours and overtime pay to nurse aide employees who are willing to work beyond forty hours per week. A certified nurse aide who completes her job duties in a timely and professional manner may benefit from yearly increases in salary as well as the opportunity to be sponsored financially for pursuing a nursing career such as a licensed practical nurse or registered nurse program.

Working in a nursing home is not every nurse aide's choice. One of the most frequently encountered complaint is lack of time to properly complete all the tasks of a typical work shift. Each task a nurse aide performs has an assigned time period but the alloted time is often inadequate and it does not take into consideration other important factors which cause delay. For example a bed bath should be completed in fifteen minutes but it takes longer when the resident is combative and non-cooperative. The extra time spent taking care of one client shortens the time dedicated to another patient and it is not uncommon to hear CNAs compare their nursing-home jobs to an assembly line.

Insufficient staffing is one of the common themes seen in long-term care, affecting both nurse aide employees and residents. Adequate, proper patient care is hard to come by when too many patients are assigned to a single CNA. Frustration, stress, and job burn-out are the results of inadequate staffing especially when the CNA to patient ratio becomes one to twenty. Completing all the required patient care often becomes impossible and nurse aides find themselves leaving out less important tasks, taking shortcuts, as well as rushing through any social interactions. A CNA work in a long-term care facility can often be hectic, fast-paced, and stressful. Unfortunately, the human component involved in the care of residents is often the first thing to be neglected when a nurse aide is short on time.

Questions, Comments, Suggestions

Shavera on August 18, 2014 at 09:53 AM
After becoming a CNA how much more experience, training or school has to be done to become a registered nurse?

Admin on August 18, 2014 at 11:32 PM
CNA training classes are usually between six and eight weeks long. During training you learn to provide assistance with activities of daily living to clients which are elderly, sick, or disabled. A registered nurse program involves a lot more studying than a CNA course. Associate degree nursing programs require at least two years of study and clinical practice, while bachelor's degree RN programs require four years of study and hands-on practice.

I am really interested in becoming a certified nursing assistant. I am in the military and we go out to sea continuously. I do not have too much time to actually attend a program until next year. Who offers online CNA classes?

How do I sign up for CNA training?

How long does it take to get a CNA certificate?

Do you have any advice for someone having to go to a CNA job interview?

Is it better to become a CNA or a LVN?

CNA Resources

Recruitment & Retention

What are some strategies that can be implemented at the state and facility level to improve the recruitment and retention of certified nurse assistants? One of the most important factors in retaining CNA staff is to offer realistic clinical training which prepares one for the actual working conditions in a long-term care facility. Another retention strategy is to make sure that a nurse aide job orientation is not rushed but allows the new employee sufficient time to accommodate and learn in the new environment.

Long-term care facilities are the primary employers of certified nurse aides. It is essential that every facility offers in-service training education hours, addresses working relationships between nurse aides and other staff, promptly resolves conflict of any nature, and provides leadership opportunities for CNA staff. Recruitment of certified nurse aides can be greatly improved if tuition reimbursement for CNA training classes as well as college courses is made readily available.

More states need to implement a CNA career ladder which differentiates between different skill levels and allows a nurse aide to advance within their practice area. Career ladders improve the recruitment and retention of health care paraprofessionals by enabling personal improvement and career development.

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