Is it necessary to be a CNA b4 nursing school?

jjjoy, LPN · Mar 6, 2008

Several wizened nursing professionals have told me, independently, that nursing school is not about teaching you everything you need to know to be a nurse. Students gain as many, if not more, skills during the first six months of work as a graduate nurse than we do in all of school. No, nursing school is about changing your head, converting a non-nurse into a potential candidate. This is sort of the same thing the military does in boot camp. Time spent in nursing school is a period of psychological adjustment just as much as a time of instruction.

Interesting perspective. I wouldn't expect nursing school to teach EVERYTHING you need to know to be a nurse. Of course, that's impossible. But isn't boot camp something like six weeks?! Heck you'd have finished a two year military commitment in the time it takes to go through nursing school.

And learning MORE during the first SIX MONTHS of work than in two years?! Of course, you will learn new and different things when you start working in any field as compared to the training, but I'd hope two years worth of instruction was more than just an attitude adjustment.

I know nursing school teaches more than that. But I know I felt sorely prepared for the practicalities of nursing whereas I didn't feel that I needed SO MUCH reinforcement (overkill) on nursing diagnoses, therapeutic communication, turn-cough-deep-breath, the importance of skin care, etc. I got that they were important only the 100th time it was reiterated! But every program is different. Just a little vent!

swee2000 · Mar 6, 2008

the community colleges admit soley from the waitlist and do not care about CNA training.

I beg to differ. Not all technical schools rely on just the "wait-list" system. At the technical school I attended, CNA training was(and still is) a requirement of the LPN or RN nursing programs AND had to be completed before a student could be accepted into/allowed to start a nursing program. No exceptions were made.

swee2000 · Mar 6, 2008

Many specialties are hiring new grads and these new grads do just fine. Ironically, the few that had problems adjusting went to regular floors-I think because of all the understaffing etc. The old idea that new nurses must spend a year or two in med/surg is fast falling by the wayside.

While this doesn't apply to everyone, here is a real example of why it may be beneficial for some, if not all, students to work as CNAs(or other patient-care positions) before &/or during school. Last summer, my manager hired an inexperienced, new, graduate RN to work on the Med/Surg unit. And when I say "inexperienced", I mean she never worked a day in her life as a CNA. She had taken the CNA training & certification course prior to starting the nursing program, but that was several years prior & only because it was a requirement. Otherwise, her only other patient-care experiences came during clinicals. While there's nothing wrong with the decisions she made, it became very apparent during nursing(RN) orientation that she could not, or did not know how to, do simple tasks.....like manual BPs, making beds, etc, let alone some of the more important, complex ones(like starting IVs). This resulted in LOTS of frustration all around, from the new grad to the preceptors to the manager. However, one can't entirely blame the new grad; rather, if management had thought these things through & before they spun out of control, the orientation may not have been extended or resulted in more $$$ being spent trying to bring the grad up to speed.

From that point on, management decided that ALL new, graduate RNs, and regardless of prior healthcare experience(including as CNAs)**, would have to spend at least 1 week(during the beginning of their orientation) working with, and as, a CNA on the unit. This way, the unit educator & the grad's preceptors would get immediate feedback via observations of what the grad did or didn't know(especially in terms of "the basics"); in turn, the new grad would become accustomed to the unit's system & way of doing things.

**The only exception allowed is if the grad worked as a CNA on this unit or somewhere else in this facility and received good evaluations(per management's discretion).**

swee2000 · Mar 6, 2008

In my class of first year nursing students the CNA's are all better prepared for exams, better at completing AM care in clinicals, and have a greater practical knowledge of "how things get done in a hospital" than the rest of us who have little or no experience with nursing care. (I had extensive experience in the military but it was so long ago that I don't credit it for much.)
Several wizened nursing professionals have told me, independently, that nursing school is not about teaching you everything you need to know to be a nurse. Students gain as many, if not more, skills during the first six months of work as a graduate nurse than we do in all of school. No, nursing school is about changing your head, converting a non-nurse into a potential candidate. This is sort of the same thing the military does in boot camp. Time spent in nursing school is a period of psychological adjustment just as much as a time of instruction. CNA's (in my opinion) have already made this adjustment and are therefore far ahead of the game.
So to address the original poster's question :typing I think that CNA experience, while perhaps not "required," would be valuable to any nursing student.

Well put!!

Scrubby · Mar 6, 2008

In Australia the general expectation most hospitals have of a newly graduated EN or RN is that they are capable of giving basic nursing care. If they don't show some sort of experience in a nursing home etc, on their resume then that can prevent them from gaining a place on a graduate nurse program (GNP). It's easier to employ someone who has these skills, rather than someone who will require more time training, and less productivity. To gain employment as an RN in most hospitals requires them to have completed a GNP somewhere. So really, not working as a PCA before graduating can impact on your career choices.

GadgetRN71, ASN, RN · Mar 6, 2008

While this doesn't apply to everyone, here is a real example of why it may be beneficial for some, if not all, students to work as CNAs(or other patient-care positions) before &/or during school. Last summer, my manager hired an inexperienced, new, graduate RN to work on the Med/Surg unit. And when I say "inexperienced", I mean she never worked a day in her life as a CNA. She had taken the CNA training & certification course prior to starting the nursing program, but that was several years prior & only because it was a requirement. Otherwise, her only other patient-care experiences came during clinicals. While there's nothing wrong with the decisions she made, it became very apparent during nursing(RN) orientation that she could not, or did not know how to, do simple tasks.....like manual BPs, making beds, etc, let alone some of the more important, complex ones(like starting IVs). This resulted in LOTS of frustration all around, from the new grad to the preceptors to the manager. However, one can't entirely blame the new grad; rather, if management had thought these things through & before they spun out of control, the orientation may not have been extended or resulted in more $$$ being spent trying to bring the grad up to speed.
From that point on, management decided that ALL new, graduate RNs, and regardless of prior healthcare experience(including as CNAs)**, would have to spend at least 1 week(during the beginning of their orientation) working with, and as, a CNA on the unit. This way, the unit educator & the grad's preceptors would get immediate feedback via observations of what the grad did or didn't know(especially in terms of "the basics"); in turn, the new grad would become accustomed to the unit's system & way of doing things.
**The only exception allowed is if the grad worked as a CNA on this unit or somewhere else in this facility and received good evaluations(per management's discretion).**

My main problem with all this is that some people are saying that it has to be CNA experience, which I do not agree with. Of course, having any kind of previous healthcare background is beneficial. I don't anyone here disputes that. I worked my way through school, 32 hours a week and took call on weekends, and despite some instructors saying that I was going to flunk out, I graduated with honors. Yes, I was fricken' exhausted most of the time, but it helped me more than hurt me.

I just don't see why it has to be CNA experience, that's all. It will help some people but not all. My ADN program does not require CNA training beforehand, and they have a great reputation for graduating good nurses.

Just a question, for those new grads that were not going to the floors, how did they work out the "CNA for a week" requirement? Some units(such as the OR) do not employ CNAs so do they make these people spend time on another floor? In my last hospital, there were no CNAs in ICU either and we had a few people get accepted there. Or was this just the new grads who would be working med/surg? The reason I ask this is if you have someone going to a specialty unit, that week or so could be far better utilized acclimating them to their own unit, IMO.

jjjoy, LPN · Mar 6, 2008

Just a question, for those new grads that were not going to the floors, how did they work out the "CNA for a week" requirement? Some units(such as the OR) do not employ CNAs so do they make these people spend time on another floor? In my last hospital, there were no CNAs in ICU either and we had a few people get accepted there. Or was this just the new grads who would be working med/surg? The reason I ask this is if you have someone going to a specialty unit, that week or so could be far better utilized acclimating them to their own unit, IMO.

I could see where there might be some logistical issues or certain units where it wouldn't work or be appropriate, but as a concept, it makes sense to start the new RN off with basic care only, just for a short time, no more than a week, to ensure that there aren't any substantial gaps with the basics. Any discovered gaps could be quickly covered before tackling higher level care issues. Or if they can't be remedied, the nurse and facility can part ways before more is invested. If there are no problems, then great! I think it would also be useful for a new nurse to spend some time working with the unit secretary as well. The new nurse would be learning how orders are processed and what the common orders are on that unit without also having to worry about higher level nursing responsibilities. Again, not more than a few days.

Since too many nursing schools don't provide a great deal of "real world" clinical experience, it would also be helpful if there were more options out there for building and practicing one's skills after graduation. If a nurse has made it through school without mastering a certain skill or if they haven't practiced in a certain area for a while, there are few options for a nurse to practice those skills without just having to secure a job that uses them on the hope and expectation that they will quickly master whatever it is they aren't confident in. Maybe as the demand grows, more services for hands-on continuing nursing education will arise.

GadgetRN71, ASN, RN · Mar 7, 2008

My new grad program at my previous hospital was pretty good in that you received the basic new grad stuff(policies, procedure, nclex review), we had people come from different areas of the hospital to speak with us. We also had an "exchange program" After a certain point, we went to our unit.

I agree, there's nothing wrong in making sure that people have the basic skills. I think it helps that I come from a small state, so people pretty much know the reputation of the various nursing programs. In my program, we got plenty of clinical exposure and we started off with 6 weeks in a LTC facility to get the basics down. In my program, it was virtually impossible to graduate a nurse that didn't have the basics ..they would never have made it past the first few months.

Healthcare experience before or during NS is always a fine thing, but IMHO, it doesn't necessarily have to be CNA experience. In my program, we had pharmacy techs, surgical techs, unit secretaries, EMT's, and yes, CNAs. Most of us that had this experience came through with flying colors, but one of the best students in my class(both the book learning and clinical) never had any prior experience in healthcare(I think she had some sort of office job in business), and I knew a few that flunked out that were CNAs previously. So, I think nothing is ever a guarantee. All I know is that NS was one of the toughest but worthwhile things I ever did. I also think my 12 years of Catholic school helped too...I was accustomed to performing well while terrified! :lol2:

jjjoy, LPN · Mar 7, 2008

but one of the best students in my class(both the book learning and clinical) never had any prior experience in healthcare(I think she had some sort of office job in business), and I knew a few that flunked out that were CNAs previously. So, I think nothing is ever a guarantee.

I agree that there are no guarantees. On the other hand, there will always be a few exceptional students who will do well no matter what. So to say that "well, this person did just fine without XYZ" doesn't necessarily mean that it's a good idea to stop requiring XYZ before starting whatever training program is in question. The same is true the other. Just because a few do poorly despite having experience ABC doesn't necessarily mean that all with that experience will do poorly.

I personally would've liked to have had a separate a CNA course prior to nursing school because given the level of responsibility that we're preparing for as RNs, it seemed like a waste of valuable time to teach and practice bed baths and pulling patients up in bed in skills lab when there are so many other things we also need to learn and practice. Any program would have to cover those basics just to ensure consistency in expectations and cover any gaps, but to me it felt like enrolling in a gourmet chef class and spending the first several weeks learning how to wash dishes. It's good to make sure everyone knows how, but should the program actually have to *teach* it?

All I know is that NS was one of the toughest but worthwhile things I ever did. I also think my 12 years of Catholic school helped too...I was accustomed to performing well while terrified!

Too Funny! :lol2:

swee2000 · Mar 9, 2008

My main problem with all this is that some people are saying that it has to be CNA experience, which I do not agree with. Of course, having any kind of previous healthcare background is beneficial. I don't anyone here disputes that. I worked my way through school, 32 hours a week and took call on weekends, and despite some instructors saying that I was going to flunk out, I graduated with honors. Yes, I was fricken' exhausted most of the time, but it helped me more than hurt me.
I just don't see why it has to be CNA experience, that's all. It will help some people but not all. My ADN program does not require CNA training beforehand, and they have a great reputation for graduating good nurses.
Just a question, for those new grads that were not going to the floors, how did they work out the "CNA for a week" requirement? Some units(such as the OR) do not employ CNAs so do they make these people spend time on another floor? In my last hospital, there were no CNAs in ICU either and we had a few people get accepted there. Or was this just the new grads who would be working med/surg? The reason I ask this is if you have someone going to a specialty unit, that week or so could be far better utilized acclimating them to their own unit, IMO.

WitchyRN:

Regarding my comments, they referred to new, graduate nurses being hired to work on the Med/Surg unit ONLY. I have no clue what the other specialized units in my hospital(like OR) do with new nurses that have absolutely no experience.

But here's a curiosity question for you: While I respect those who feel there's no benefits to working as a CNA while in nursing school, I wonder how working as a unit clerk or in medical records, for example, could be any better? What true, patient-care experience does one get out of these positions that will help in nursing school & beyond?

GadgetRN71, ASN, RN · Mar 10, 2008

WitchyRN:
Regarding my comments, they referred to new, graduate nurses being hired to work on the Med/Surg unit ONLY. I have no clue what the other specialized units in my hospital(like OR) do with new nurses that have absolutely no experience.
But here's a curiosity question for you: While I respect those who feel there's no benefits to working as a CNA while in nursing school, I wonder how working as a unit clerk or in medical records, for example, could be any better? What true, patient-care experience does one get out of these positions that will help in nursing school & beyond?

The classmates that worked as unit secretaries did so because they were working their way through school, and the pay was slightly better than CNA pay. No working would have equaled no nursing school for these students. They worked with nurses who would come get them when they were going to be doing a procedure. They got exposure to lab results and orders. I think just the experience of working while you are in school is good, despite what many instructors feel. These unit secretaries(3 that I knew of) did well in school. I think what it comes down to is some people are just stronger students and quicker learners than others. For the people with no confidence, or those who are weak clinically, a CNA program may help them. What I object to is the "one size fits all" approach and the idea that CNA school is going to help everyone. I still think it should be optional. None of the schools in my area have a mandatory CNA requirement, thank goodness.

Maybe I just had a good group of classmates, or a good program, because we were able to move past the rudimentary skills within a couple of weeks. We spent 2 or 3 weeks in a lab environment, learning all the simple things(baths, bedmaking, and yes, butt wiping;)) and then moved to a LTC facility. After that, the remaining time in the semester was spent on a med/surg floor.

clamp · Apr 6, 2008

I started being a nurse assistant when I was 18. I am now 24 and getting ready to start nursing school and I have to say that 6 years and 3 hospitals later I am very thankful for my experiences prior to entering the program. As a tech you do a lot "servant" work, this is true, but you are also exposed to a lot of useful things besides just bed baths. Key terms and general processes get picked up from observing the professional staff around you. I definately think that I will enter into the program slightly ahead of the game, if only by a foot. Plus I never had to go to CNA school because most hospitals don't require a CNA certificate to tech with them. So if paying for the school is a problem I would suggest trying to get hired at a hospital. I agree that spending money on a CNA course is a waste of money when you relearn the stuff later anyhow. (This is exactly the reason I never went to CNA school). Plus another benifit of being a tech first is that your nurses (or most of them) are constantly cheering you on and giving you pointers on how to do better. They love to teach, they will pull you in to see procedures done and even explain them as they go. At least this has been my experience.

Whatever you decide is totally up to you...but my experience with it has been great and I would definately suggest it to anyone else.