Job Duties of a CNA Working in a Nursing Home

The largest segment of US population is made up of elderly individuals. Government estimates show that by 2030 almost one out of five Americans will be at least sixty five years old. Advancing age does not come without health problems, and a large number of people will need to be treated and cared for in long term care facilities. The majority of the clients admitted in nursing homes and other long-term care facilities are elderly, even though younger, disabled adults are also admitted when their families can not provide them constant care. The primary care givers in terms of basic care and help with activities of daily living in nursing homes are Certified Nurse Aides (CNA). The need for qualified, caring, and hard-working nurse aides has never been greater. CNA jobs are available in long-term care facilities for nursing assistants who wish to work full time or part-time.

Becoming a CNA requires the completion of a state-approved nurse aide class and passing the certification exam. Many states have passed legislation for tuition reimbursement programs, which is offered to those who become employed within one year of passing the CNA certification exam. Most states have made certification mandatory in order to work as a nurse aide in any licensed nursing home or long-term care facility. A nursing assistant's job in long-term care does not come without challenges and experienced CNA agree that it takes a dedicated, hard-working individual to succeed when one makes the transition from the sheltered CNA class environment to the real world. It is wise to know what to expect once you secure a nurse aide job and thus be prepared for the journey ahead.

In a nursing home a CNA is usually assigned to one of three available shifts, each of them requiring eight hours of work. Due to the intensive nature of hands-on work as well as aide patient ratios, the nurse aide shifts in long-term care facilities are usually no longer than eight hours in contrast to the twelve hours shifts commonly practiced in hospitals. It is common for a nursing home unit to house an average of forty patients and have four nurse aides assigned to these patients on any given shift. Many nursing homes will try very hard to staff their units appropriately and have the optimal number of CNA providing client care on any given shift. However, nurse aide staffing shortages are common in long-term care and often lead to difficulties in completing job assignments, dissatisfaction and burnout. A well-balanced patient load for a single nurse aide throughout one shift is around ten clients. When a fellow co-worker does not show up for her shift or when the unit is understaffed, expect each nurse aide to provide care to an average of fifteen to twenty patients.

Job duties of a nurse aide in long-term care focus on assisting the client with activities of daily living, making beds, feeding, transferring, turning every two hours, answering call lights, measuring vital signs, and recording patient data. Depending on which shift you work, your CNA duties may slightly differ from those performed during another shift. A typical morning shift starts with the nurse aide waking up the client, helping with toileting, bathing, and dressing, changing linens and making beds, transferring the client to a wheelchair when appropriate, and assisting with feeding. A CNA may use mechanical equipment to help with frequent patient transfers from bed to wheelchair, and it is also responsible for measuring client's pulse, temperature, and blood pressure. Some residents need blood glucose readings prior to eating as well as oxygen saturation and weight measurements. The next step is recording the collected data in the client's chart. If at any point during the shift the CNA observes an unusual client behavior or an abnormal reading in the vital signs measurement, she should promptly notify the LPN or RN in charge. First shift ends at three in the afternoon and the second nurse aide shift begins.

The second nurse aide shift is almost identical to the first in terms of the care provided to residents which are now prepared for the night. The third shift takes place during the night hours, and it may falsely seem easier in terms of work load. Optimally two nurse aides are assigned on a unit during the third shift but most of the time only one CNA is present. The nurse aide is responsible for all forty patients on the unit, and she must provide basic care whenever any of them need assistance. Some patients will not need care throughout the night but those are only a few.

Most nursing home residents need to be turned and repositioned every two hours to prevent bed sores, some will need changing due to incontinence, and others may need a snack if they are suffering from diabetes and must eat every couple of hours to maintain a certain blood glucose level. All these are the tasks performed by a nurse aide working the third shift. A CNA working in long-term care needs to be caring, compassionate, and patient, as well as be willing to listen, and help those who can't help themselves. It is important to remember that a large number of the residents in a long-term care facility do not have much contact with their families or friends, leading to isolation. The attention and comfort a nurse aide provides does impact resident's lives by making them feel cared for and less lonely in a nursing-home environment.

Questions, Comments, Suggestions

Mallory C. on September 09, 2014 at 07:17 PM
I am a pre-nursing student. I have only two more classes left to take before I can start applying for nursing school. I have to wait a year until I can actually get accepted, and I was thinking about becoming a certified nursing assistant. This will allow me to get some experience under my belt before I begin the nursing program. Do you think it is a good idea, or should I just wait to start nursing school? The problem is that I want to obtain a job in the medical field, but no one will hire me because I do not have much experience. I have only worked at a dermatologist's office over the summer. I heard becoming a CNA and getting the experience, really helps you with clinicals in nursing school. Any information you can give me will be great!

Admin on September 10, 2014 at 06:08 PM
I think enrolling in a nursing assistant course is a great idea. You have one year before you begin a nursing program and this time will be used wisely if you work as a certified nurse aide. First of all you will learn the basic nursing skills required in the beginning of any nursing program, such as changing beds, giving a client a bath, assisting with other activities of daily living, repositioning, measuring and recording vital signs. You will be very comfortable interacting with clients and performing all these skills by the time nursing school starts. This is a big advantage over other students which are not familiar with these concepts and skills. Completing a nursing assistant course will not only give you confidence, but will provide some income once you pass the CNA state exam and obtain a nurse aide job. You may choose to work part-time during nursing school as well, and you may do so at the hospital or facility where your clinicals are conducted. Overall, I think it will greatly benefit you to complete a nursing assistant class at this time.

How can I tell if my CNA certificate is active? If it is not active how do I go about renewing it?

How can I get a copy of my CNA certification?

My CNA certification has recently expired. Who do I need to contact for certification renewal?

Is there any way to study from the CNA book on your own, sign up for clinicals and take the exam without attending a CNA class?

Can a nursing student take the CNA exam?

CNA Resources

Being a Successful C.N.A

Besides knowledge and proficiency there are many qualities which define a competent CNA. Our list includes the answers of residents, families, and those of experienced nurse aides who have been in the health care field for an extended period of time. Most of the qualities listed below represent the reasons and motivational factors driving new individuals to become certified nurse aides.

A competent CNA shows support for others, as well as patience, compassion and empathy. To become a good nursing assistant one needs to understand the meaning of being a team player. An effective nursing assistant learns to become a good listener who cares about and understands the needs of the residents, has a helping nature and a positive attitude. Both patients and co-workers appreciate a smile, an upbeat personality, as well as someone who takes pride in their work. A nurse aide job requires good organizational skills, patience, good judgment, and effective communication.

CNA Training Programs

Nurse Aide Registries