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Specializes in geriatrics,cardiology. Has 20 years experience.

Does anyone have any suggestions to assess literacy in a cna? I was told that I can not ask or make a direct reference to this concern. When given materials to read she states she doesnt have her glasses. I was also told that I cannot demand that she has her glasses....I think it does intefere with her documentation requirements of her job. HELP:thnkg:

We notice it because we have written menus. I usually am just pretty frank and ask the patient, because it alters how we do most everything. I've had several patients just tell me "I don't read."

We notice it because we have written menus. I usually am just pretty frank and ask the patient, because it alters how we do most everything. I've had several patients just tell me "I don't read."

I don't think she's talking about the patient.


Specializes in Hospice, LTC, Rehab, Home Health. Has 20 years experience.

If you have doubts about the CNA's ability to read/understand written instruction, I would give her assignment verbally and check back with her frequently. If it is just her documentation that you are concerned about I would refer that issue to the DNS, staff development person with specific examples of the documentation that has raised your concern.

oops. I thought it was cna's assessing literacy..oops.

classicdame, MSN, EdD

Specializes in Hospital Education Coordinator.

ask HR if there is a literacy requirement in the job description. Then ask how they determine it. Then ask can they test someone (probably Educator would get involved and there are many tools out there for testing). This way it is out of your hands. Involve risk mgt if needed.

HouTx, BSN, MSN, EdD

Specializes in Critical Care, Education. Has 35 years experience.

You are very right to be concerned. At the very least, you should be very careful delegating anything to this cna if you are unsure about her literacy. If this has an impact on your productivity it should be discussed with your immediate supervisor. The issue should be handled in a way that is respectful to the cna and honors her worth as a care provider.

As an educator, I have encountered many people who have succesfully 'passed' for literate in the workplace until they are faced with a situation that exposes their inability to read. These people are usually very bright and pleasant to work with - relying on memory and their workplace relationships to get them through the day. For instance, they frequently 'trade' tasks - offering to do physical labor in turn for someone else's assistance with reading. The first defense - when asked to read- is usually that they forgot their glasses.

Illiteracy is a complex issue. There are many root causes and different degrees of inability. For instance, some people are completely capable with numbers, but unable to interepret letters. Others have severe dyslexia that prevents them from recognizing letters at all. Diagnosis and interventions are best left up to professionals in this area. It is waaaay outside the expertise or scope of practice for hospital/clinical educators. In my city, we can contact our local Literacy Council to obtain free assistance for adults with literacy problems.

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 15 years experience.

I've unfortunately encountered many coworkers (nursing and non-nursing) whom I have suspected to be functional illiterates. Never would I attempt to embarrass the person or expose one's illiteracy to the world. These people are living in a personal hell that they would like to very much keep private, so I would never confront them about their inability to read and comprehend the written word.

When I was working in the low-paying retail sector, many of my older coworkers would approach me to complete their paperwork for vacation requests and other simple tasks. Any person who could read at a second grade level would have been able to fill in the blanks on these forms. However, the excuses that saved face were "I'm tired," "I left my glasses at home," or "My writing is sloppy." Now that I am in the nursing field, I have worked at facilities that require all staff to complete written statements when an incident occurs. Some of the CNAs cannot write well enough to complete a statement, and others write at about a third or fourth grade level. Some staff members will ask you to read their paperwork to them.

In general, many of the illiterates that I have met are sharp, dependable, loyal, and wonderful workers who are very comfortable with the spoken word. Their conversational skills and descriptions of people, places, and things are impeccable. They have also invested plenty of effort and virtually a lifetime trying to cloak their lack of mastery of comprehending the written word.

In this case, a confrontation of the person's illiteracy will serve no good purpose without a feasible solution to the problem. Regretfully, illiteracy is a complex problem with no simple solutions.


Specializes in ortho, hospice volunteer, psych,. Has 20 years experience.

i am not a teacher but i am married to one. i just showed him the post and he had a couple of ideas off the top of his head.

1. check and see what resources your local library and/or literacy council might have. he said they'd have some suggestions.

2. have a remedial level composition person from a nearby college or university present an inservice

on basic writing skills -- writing in complete sentences, turning thoughts into statements etc.

3. have a nursing program instructor give them a "refresher" course on notes writing. he said s/he will be able to separate learning disabilities from marginal literacy and functional illiteracy.

his other comment was that presenting the above ideas as "being treated as professionals who are improving themselves" instead of "you dumbells who can't even write or read well" will work better.