Does anyone remember when aides didn't have to be certified? - page 2

Another discussion brought to mind the days when I was a nurses aide. Not a CNA. Does anyone remember those days? I have always had high regard for nurses aides, certified and otherwise, but I... Read More

  1. by   msdobson
    Quote from Tweety
    I think education and certification is an excellent idea and while I don't have any documentation to back my presumption up, I doubt care would deteriorate.
    I have to throw in with Tweety again (I'm sensing pattern here...)

    Here in Sunny California, our NA's have been certified for some time, now. But I remember working both as an NA and then a CNA when the state finally realized that the LTC patients weren't getting the care they should.

    We had some real idiots working in my facility back then.

    Abt. 90% of the kids we hired off the streets didn't last the week. Our Admin and DON spent all of their time trying to plug the holes and hire MORE bodies.

    Now, those same bodies have to go through a CC CNA course before being allowed to work in ANY LTC facility.

    So, basically, the state has shunted the job of weeding out those who WANT to be a CNA to the local colleges.

    Those kids who understand that it won't be another episode of ER usually do really well. Those that have no clue, or who've neve been IN a LTC facility, get the point mighty quick and think of a new career.

    Meanwhile, the CCs provide the LTC facilities in our area with qualified CNAs who have a solid grasp of the scope of practice (along with a quick course on urine, feces and projectile vomiting.) :chuckle

  2. by   NRSKarenRN
    [FONT=PenumbraSansStd-Semibold]I've always acknowledged Jane and Miss Sylvia, nursing assistants who taught me patient care as 18yo working nights in LTC facility in 1974 as ones who got me started on the right foot into healthcare along with Mrs. Law RN who insisted on dignity for the aged and in firmed ...along with a dry bed and making due with minimal supplies.

    [FONT=PenumbraSansStd-Semibold]Owner of the home was definitely into financial aspect. Thankfully nursing staff had very high standards and those NA's who slouched were not tolerated for long. That was not the case everywhere.

    [FONT=AGaramondPro-Regular]The Nursing Home Reform Act, adopted by Congress as part of the Omnibus Budget Reconciliation Act of 1987 (OBRA ’87), was designed to improve the quality of care in long-term health care facilities and to define training and evaluation standards for nurse aides who work in such facilities. Each state is responsible for following the terms of this federal law. These standards were the start of certification for nursing assistants in long term care and home health agencies.

    [FONT=AGaramondPro-Regular]National Nurse Aide Assessment Program (NNAAP™) is an evaluation of nurse aide-related knowledge, skills, and abilities. The NNAAP Examination is made up of both a Written (or Oral) Examination and a Skills Evaluation.
    [FONT=AGaramondPro-Regular]The purpose of the NNAAP Examination is to make sure that one understands and can safely perform the job of an entry-level nurse aide.

    [FONT=AGaramondPro-Regular]No one should be paying thousands of dollars for CNA program as Federal Government has reimbursement program if employed in LTC facility

    [FONT=AGaramondPro-Regular][FONT=PenumbraSansStd-Semibold]REIMBURSEMENT FOR TRAINING AND TESTING[FONT=AGaramondPro-Regular]

    [FONT=AGaramondPro-Regular]Long-term care nursing facilities are responsible for the
    [FONT=AGaramondPro-Regular]full payment of training and testing costs if you are
    [FONT=AGaramondPro-Regular]employed or offered employment as a nurse aide at the
    [FONT=AGaramondPro-Regular]time you enter a nurse aide training and competency
    [FONT=AGaramondPro-Regular]evaluation program. [FONT=AGaramondPro-Bold]Federal law prohibits these charges
    [FONT=AGaramondPro-Bold]from being imposed on you.

    [FONT=AGaramondPro-Regular]If you are not employed with a long-term care facility at
    [FONT=AGaramondPro-Regular]the time you are accepted into a nurse aide training and
    [FONT=AGaramondPro-Regular]competency evaluation program, but become employed or
    [FONT=AGaramondPro-Regular]receive an offer of employment within twelve (12) months
    [FONT=AGaramondPro-Regular]of completing the program, you will be reimbursed by the
    [FONT=AGaramondPro-Regular]long-term care facility that employs you.

    [FONT=AGaramondPro-Regular]Reimbursement will be made on a prorated basis. You will
    [FONT=AGaramondPro-Regular]be reimbursed for half the costs of training and testing
    [FONT=AGaramondPro-Regular]after you have worked at the long-term care facility for 130
    [FONT=AGaramondPro-Regular]hours and for the remaining half of the training and testing
    [FONT=AGaramondPro-Regular]costs after you have worked an additional 130 hours.
    [FONT=AGaramondPro-Regular]You must provide written documentation to the long-term
    [FONT=AGaramondPro-Regular]care facility to support your request for payment.


    Standards HAVE improved but not staffing ratios to keep up with intensity of patient care needs...that is what's hurting faciliteis these days.
    Last edit by NRSKarenRN on May 13, '07
  3. by   sissyboo
    I don't remember the time...but the hospital I worked for now requires aides to be certified. There are some who are still there who were grandfathered in....but they've been with the hospital more or less since it opened.
  4. by   CHATSDALE
    in louisiana if you get fed money the facility has to 'certified' some of the private pay facilities do not require a certification but the residents get as good or better care there because the patient/aide ratio is kept low
    i know nurses who started out as 'off the street' in particular i remember her saying that when she grad hs her and a friend went job hunting and they went into a nursing home without an idea of what went on there..they both got jobs, her friend in the kitchen and she got the aide job...she said her friend was so shocked 'THEY HAVE YOU DOING WHAT?'
    she must of found her calling because she is now a nurse mgr on a cardiac floor
    sometimes life leads us into directions we never dreamt of
  5. by   NRSKarenRN
    Any facility that gets reimbursed for patient care under Medicare or Medicaid is required to have certified staff.

    Assisted living facilities or personal care homes that are private pay don't have such requirements.
  6. by   tryin4newlife
    I am currently an aide that is not certified. I have one year of clinical nursing school under my belt and that is the minimum requirement at my facility. Those starting wages are crazy to read starting wage sounds much better now a days - although tragically enough there are many places that you can actually make more flipping burgers than caring for people.....What a crazy world...
  7. by   sunnydaydream
    I became a CNA in 1998 when I was 16. I luckly knew what I was getting into thanks to following my mom around for years (she has been in LTC for around 35 years now). The one thing that I didn't know about was all the gossip and drama from the CNAs! Geez...

    Like any other profession I feel there are the good ones and the bad ones and although I have never known CNA work as not certified I feel that certification allows the facility to know whether the CNA is somewhat comepetent in what they are doing and that there isn't a legal case against them (as like with nurses).

    I wish employers would look more closely at who they are hiring and see if the person really wants to do the job and just doesn't want the check (hence them taking more smoking breaks than necessary, taking more breaks than necessary, and not taking care of the residents as they should). It bothers me that an employer will fire someone for not showing up to work, or worse, and then hire them back in a month or so... just to "have the bodies". Right now I am working at a facility where there are two CNA's to 55+ residents at night, on day shift it "lightens up" so that each CNA has around 15. (If only they would realize these residents DON"T sleep at night!)

    I will be graduating in December with my ASN and have learned much in my nine years of being a CNA. Prioritizing is the biggest... the second is knowing what kind of nurse I want to be and what kind I don't want to be.

    To the CNAs that do a good job keep on keeping on!
  8. by   jill48
    [font=book antiqua]i was never an aide or a cna before becoming a nurse. the only time i have ever worked with aides who were not certified was when they were actually getting their training at that facility to earn their certification. and they actually worked harder because they were "under the microscope" and being watched and evaluated. my mother was an aide when i was a little girl and i believe she was not certified.
  9. by   P_RN
    It's not a requirement here either. The equal would be taking a short course and becoming a patient care tech-ekg, phlebotomy , treatments etc.
  10. by   DDRN4me
    I was an aide and cook in a nursing home for elderly women in 1976; trained by an "old fashioned" group of nurses who wore whites and caps and poured meds into med cups using a card and passed t hem with a tray!!!

    Nurse Edna was very strict but kind and if you didnt measure up to her exacting standards you were out. Our ladies received the best of care and we had very few falls and no bedsores. we worked extremely hard but what a wonderful basis for a career!!!