more education for CNA's?

Antikigirl, ASN, RN · Mar 13, 2005

HI ya Washington, Oregon here...same exact story! Our CNA's do med passes, direct care, simple dressing changes, neb treatments, and colostomy changes. A lot to do, but my CNA's do it so very well, and it all comes down to getting the training.

Alas...they use to have several weeks to learn all this...now it is maybe one week because of the recent turn over (mostly because our CNA's are thinking..why not get paid a nurses pay for doing it...and go to nursing school..I don't blame them at all!!!!). Now we are getting a rush of non certified caregivers...and I feel they need a lot more training!!!!

Just recently the management chose to not hold CPR classes for CNA's anymore because of cost. I about blew a gasket! They are the first to find a patient in trouble and they need those skills to help..and they want to help, they are with those patients as much as their own family! I am working on this, and trying to find a way to convience the facility that they need this training so badly!

Other training has been asked of me for the CNA's also, from inservices about common things that they aren't getting information about. Like MRSA, what is it and why am I scared? S/Sx of elder abuse, Hints to save your back once it has already been wrecked from lifting...etc. I may be able to teach these types of classes soon, and will become an instructor for CNA's at our facility based on what they want to know, while another nurse will teach what they have to know (this was a request of the CNA's because they like my teaching style and they were tired of just that one nurse teaching..LOL!).

May not be much...but I am trying to do my part as the team and help the CNA's out as much as they help me!

As far as going into nursing...remember..that nurse you see at work...do you want to be running around like crazy, doing all the paperwork, and so on? If you do...go for it! If you say....well, I don't know...then think about it some more . Most of my caregivers that I talk to said "well I don't want to be running around crazy like you..." and I say "welcome to nursing 101 sweety! LOL!!!!!!!! Something to consider! It is the reason now a days why you guys do more and I don't see this trend slowing or stopping any day soon :("....

Good luck :)

allamericangirl · Mar 13, 2005

The question was if CNA educational requirement should be expanded, not if the CNA scope of practice should be expanded. Some areas of the country have lessened their educational requirements for CNA to 12 hours! There is a difference in learning more and being given more range in the scope of practice. I definately wish that More clinical hours had been added to my requirements for CNA education. I would be going to an employer with much better skills, and self assurance.

If the CNA's scope of practice were to be increased then this would overlap into RN/LPN/LVN nurse's scope of practice possibly suggesting a need for less licensed nurses and more CNAs since they could perform more advanced tasks. One would think that if CNA's where given additional more advanced duties to assist the RN then that would give the LTC, hospital, etc. an excuse to increase the RN-patient ratio since in the administration's eyes the RN/LPN would theoretically have less to do.

dbsn00 · Mar 13, 2005

The question was if CNA educational requirement should be expanded, not if the CNA scope of practice should be expanded. Some areas of the country have lessened their educational requirements for CNA to 12 hours! There is a difference in learning more and being given more range in the scope of practice. I definately wish that More clinical hours had been added to my requirements for CNA education. I would be going to an employer with much better skills, and self assurance.

Since the question is about expanding the education requirement then YES, it should be required.

allamericangirl · Mar 13, 2005

I LOVE your post! These are the things we were taught in our class, only in 88 hours plus clinicals, and not two years of classes. Our instructor told us our class was actually the basic nursing class for their LPN program. The class had the added HHA requirements, which I am not interested in and wish that we had it would have been more geared to hospital service. It was a good class, but I felt that a few more weeks wouldn't have hurt.

Second, I am now a CNA and have been for 11 years, and have noticed that in LTC CNAs are often asked to do things outside of their license because the nurses are so swamped, and everyone knows the acuity of patients just gets worse and worse, so- should CNA's get more initial training? If so, what kinds of things would it help nurses if CNA's could do? Do you ever wish your aides knew more?
Another thought- what if being an aide wasn't a thankless dead end job but the beinnning of a nursing career path? Am I dreaming?

Well When I was a CNA back in the dark ages of 1974 .It took 2 full years to become a CNA 2 It was called Hospital occupations course .The first 6 MTS were in the classroom .Where we learned all the abrev.. Latin terms ,how to chart How to be a PT as well as care-giver how to do PT diets .How to give total bed baths how to do Foley set IV drips How do do NG tube feedings, Oral care. Skin care several types of back care. Death and dying care how to prepare a body to go to morgue. How to work in DOU ,CCU ICU ,X-ray ,ORTHO, Cancer unit ,Dietary ,Pharmacy and central supply Did decubitis care Most of all the treatments .The only thing we did not do was Pass med's or do needle sticks .We did everything else pretty much . Most of which was taken from our scope of practice in the 80 in California. The first 6 months you became a CNA. Then the second 6 months You were given the title of CNA1 .Then If you did the full 2 years including summer You were given the title of CNA2. just under the LPN license and you could take the board for LPN after becomeing CNA 2.at age 18.

Before we were allowed to go on the Floor we were even taught to role play with our other students .I feel this is one of the biggest problems today in nursing People just don't know how to interact with PT's They just don't teach it. We were taught in school to Introduce our self to the Pt tell and explain what we were going to do for the Pt have them help when they can.

Example Hello Mr Garcia I am your CNA today I need to take you down to X-ray in this wheel chair I know your having a little trouble with your left side so I will first be bring you to a sitting position then we will transfer you into the chair moving your body to the right into the chair .So help me as much as you can.

I am forever getting after My CNA's on this subject .To throughly explain what you can do for the PT.and being friendly to the PT .The more you explain the less your PT will work against you.The more glad they will be that you are there CNA.

Some nurses do not even have this skill either they will shove pills in the Pt's mouth without setting them up fully in bed and do not tell the Pt what pills there taking.I had this happen last year when I was in the hospitial.

Regarding what you can do to help the nurse and still keep within your scope of practice

1.If the PT calls for med's make a list and time for the nurse of when the Pt asked leave that copy on her med cart. I always left my nurse a running list of Pt med request.If PT's complain after taking a med report it to the nurse .Example I have a headache or feel faint 20 minutes after they have taken a med.

2 Changes in your PT if you notice changes like your PT looks more grey or Yellow. yellow eyes or they feel hot / cold or complain of being sick having loose stool ,vomiting make notes and report them to your nurse. Plain look a lot different than the day before.

3.any bruises ,decubitis ,redness on there Buttocks .

4. Changes in there mouth bad breath gums that look bad, coated tongue any oral problems .That weren't there before. Cough what did it sound like.

5.Report any thing in general out of the ordinary learn to signs and symptoms of changes to look for in your PT's

6 Toilet the Pt sounds easy But a lot of aides don't do it .Thus cause dignity issues with the Geri PT If you toilet a Pt 3 times on the shift You make everyones life easier.Just offer .Much easier to spend 5 minutes toileting then 10 to 15 cleaning the Pt up. Plus possible having the Pt get decubitis .look at the urine is it dark or smelly could possibly be a UTI report it.Ask the nurse if they would like a sample of it.

Put your self in the PT place would you like laying in urine and Feces No because it would burn and you'd be cold..

It helps the nurse a lot so they don't have to go looking for you to do care.So the nurse can do His /her care for the PT.

7.Learn how to check for possible injuries so you don't make bad mistakes by trying to move a Pt who has fallen.

Example On a possible broken hip you might see one foot rotated outward where the other foot and leg remains straight .You can also check the groin area To see if it flat there or if it has a bump there .If there's a bump on one side of the groin and that foot is rotated outward could be a possible fracture.Always tell your nurse and have them come down and check the Pt always when a PT has fallen .Note that sometime the PT is not imedeate pain with a FX.

If You take a little note book with you in your pocket. Be that nurses eyes and ears she will apeapreate you and trust you . You will then learn a lot in the process to help you along to be a good nurse later Nurse (She/ He )will share there knowlage with you . Learn how to assess your Pt's and read on the Internet ask questions and get to know signs and symptoms really well So you can report them to your nurse.

Trust me if all CNA would follow through on just really being good reporters and great eyes and just did the job there suppose to for that nurse it would make her/ his job so much easer.

These are just not skills taught any more and should be .

Be the best CNA you can be then your job won't feel so dead end.Then you will have great skill for nursing school. You will be ahead of the class.

Lanceman · Mar 13, 2005

The question was if CNA educational requirement should be expanded, not if the CNA scope of practice should be expanded. Some areas of the country have lessened their educational requirements for CNA to 12 hours! There is a difference in learning more and being given more range in the scope of practice. I definately wish that More clinical hours had been added to my requirements for CNA education. I would be going to an employer with much better skills, and self assurance.

As seen in the quote below, the OP specifically asked that since they were often asked to do things outside of their license/certificate should they get more initial training. I saw that as a question as to whether or not they should be trained in a broader scope of practice to do things not currently authorized under their state's CNA certificate. Just my interpretation, you point is very valid as well, more educational time can only help.

Originally Posted by germain

Second, I am now a CNA and have been for 11 years, and have noticed that in LTC CNAs are often asked to do things outside of their license because the nurses are so swamped, and everyone knows the acuity of patients just gets worse and worse, so- should CNA's get more initial training? If so, what kinds of things would it help nurses if CNA's could do? Do you ever wish your aides knew more?

Alicia18 · Mar 18, 2005

I just completed 88 hours of class room and 16 hours of clinical. I certainly wish that I had been given more hours of clinical. The 88 hours of class very well covered our scope of practice, but I do think that the clinical experience was too short. Yes, I certainly think that it would have been helpful to have more education.

Ditto. I found out how little I really knew when I started working.

Alicia18 · Mar 18, 2005

I have found that the CNA route is very much the start of a nursing career for most people. I'm planning on going to nursing school in a few years, as are about half the students in my class. The CNA who I worked w/ today at my first day of clinicals is graduating with his associate's in nursing in May. The other 2 CNA's at the hospital are applying to nursing school in the next year or so. I don't think you are "dreaming" at all. If you want to be a nurse, what is stopping you? I think that being a CNA will give you great experience.

I agree. I myself am going to take classes for nursing this fall. I think that many people seeing being a CNA as a great way to get experience and to make some money to pay those school bills.

Plagueis · Mar 22, 2005

As a recent graduate of a CNA program, I wish that there was more clinical time in my program. My program was 90 hours, I think. However, it seemed like that us students didn't get a chance to practice all of the skills that we were taught (the class had 3 times the students that it normally had), and it led some of us to be unprepared for the state skills exam. I took my skills test last week, and I think I totally failed it, partly because the skill scenarios that were presented in class were not the ones that were in the actual skills exam. In addition, there didn't seem to be enough time for everyone in the class to practice the skills with the instructor because of the record number of students in the class. (Although I'll admit I was totally nervous during the skills exam.) I think that if there's not enough time to work personally with each student, then more clinincal hours should be added to make sure that all of the future CNAs are comfortable with their skills.

germain · Mar 22, 2005

For my skills exam I washed a "patient's" feet- I kept thinking of the Pope! TO this day I pay special attention washing patient's feet. Someone told me that if you remeber to knock and explain the procedure to the patient, and don't do anything obviously dangerous like forget wheelchair breaks, you pass. I hope you did, if not its NOT the NCLEX, so you can just retake it. Good luck.