Let me start off by saying that this post is not intended to offend/insult anyone! I want to hear peoples opinions and point of views on the matter, so PLEASE, do not have my head.
So, I have been reading quite a few post from nursing students who are now questioning if nursing is for them. Those questions are not based on their grades, its based on their experiences in the clinical sites. Some are grossed out by what they have seen, others claim they didn't think it would be like that, and more than a few don't think they are cut out for It, and do not have the patience to deal with "difficult" patients.
So this is my question; should nurses be required to be a CNA (for at least 3 months) before they enter the field of nursing?
Please remember, this is only a question not a recommendation in anyway. I am really curious because I have seen people spend all that money only to drop out because once exposed to the reality of nursing they find out that its not something they can handle. Also, it would prevent them from wasting their money, and or preventing other prospective students from getting into the program who would really love the nursing profession.
1. You'll gain on the job REAL life experience, that will compliment what is being taught during clinicals.
2. You'll gain insight into whether nursing is really for you. As there is a difference between real life nursing and theory/book nursing.
3. You'll gain the opportunity to sharpen your clinical skills.
4.Real life experience reinforces the textbook, and really helps to solidify textbook concepts!
A few schools here in IL do require a CNA license prior to admission into the RN program. However, none (that I know of) require that you have, actual CNA employment experience.
Here are my thoughts. Your idea is a good one in theory, but what you've laid out will go one of three ways:
1) Prospective student will get certified, interview, land job, get trained, work your mandatory 3 months and say "Oh heck no! This is NOT for me" and quit.
2) Prospective student will get certified, interview, land job, go through training, hit the three month mark and think "Oh YES! I was BORN to be a nurse". Will proceed with his/her dream while working as a CNA for the experience/money/connections.
3) Prospective student will get certified, interview, land job, train, get to 3 months and think" Yep, confirms what I thought, I want to be a nurse" and will quit the job to focus on becoming a nurse.
In 2 out of 3 examples, whatever facility hires and trains said CNA loses said CNA at the magical 3 month mark. LTC's in particular could become a revolving door of potential nursing students dipping their toe into the world of healthcare because of this silly requirement. Not to mention, the work of a CNA is very unlike what a person will do as a nurse!
My school required that you successfully complete the CNA class before applying, mostly so we had the basic skills of toileting, ambulating, turning, etc and could perform those tasks with confidence---they just don't have time to teach those things in nursing school!
1. You'll gain on the job REAL life experience, that will compliment what is being taught during clinicals.
2. You'll gain insight into whether nursing is really for you. As there is a difference between real life nursing and theory/book nursing.
3. You'll gain the opportunity to sharpen your clinical skills.
4.Real life experience reinforces the textbook, and really helps to solidify textbook concepts!
A few schools here in IL do require a CNA license prior to admission into the RN program. However, none (that I know of) require that you have, actual CNA employment experience.
I disagree with all of your points, and this is why.
1. During clinicals in RN school, the goal is to learn about your patient's disease(s), how they are affecting him, how to interpret his lab values, how to assess him properly and what your findings mean, what drugs he is on and how they could negatively affect him/what the desired outcome actually is, what diagnostic procedures he is scheduled for and how they might affect his condition, amongst more. A CNA does none of these things, except maybe looking for skin breakdown when turning patients. While working as a CNA will have helped an RN student be accustomed to the clinical setting and doing basic tasks like taking vitals, bathing, etc .. these are by no means impossible things to learn quickly. So beyond those things, having been a CNA will hardly help with your main duties as an RN student in clinicals.
2. And there is a difference between observing a nurse work and being the nurse who is working. Just as someone said that doing clinicals in a hospital only gives you a glimpse of what working in a hospital is like, being a CNA in a hospital only gives you a rough idea of what nurses do. It can in no way be a determinant as to whether or not one should continue pursing nursing. Unless they are just so grossed out by poop/other bodily fluids that they can handle it, in which case they would quit during 1st semester anyway.
3. One can learn how to take a pulse in about 10 seconds. One can learn techniques for changing patients, turning them, transporting them, etc during clinical and on the job. These are not skills that require intense learning to get a grip on. While having much practice with these basic skills can be nothing but a bonus for RN students, it should by no means be a requirement. As a past clinical instructor of mine said, "You can teach a monkey how to take a blood pressure or insert an IV. It's the critical thinking that goes into assessing and intervening that makes an RN different from unlicensed personnel."
4. While that is true, it can also be a hindrance. Tests are usually written based on what the book says. If you, as a CNA, witnessed an RN inserting a catheter a certain way, and you answered a question regarding proper technique based on that experience .. you're going out on a limb and assuming that nurse you saw did it correctly. Another thing, diseases are presented in 'textbook' examples.. what if the woman with heart failure that you cared for as a CNA didn't have edema, and because of that, you assumed it wasn't a symptom when taking an exam? So I agree it can help, but it's more likely to hurt because 9 times out of 10 (made up statistic!), a practicing nurse probably won't do things by the book. Let's just be real. So if you're used to seeing something one way, and you read it in the book another way, it could be even more confusing.
So I agree that CNA experience helps, but once you get down to the critical thinking that is so central to practicing as an RN, the help that having been a CNA lends is pretty minimal. That's why I don't think it should be a requirement for RN school.
There's a ASN school in my area that only accepts students with CNA licenses from certified schools. I considered it, and looked into the process. It would have taken me 3 months and $1500 to get the CNA. All that money and time for a license I'd never use. I considered it a $1500 application fee, and nixed that school. I got me a BSN instead. :)
We don't expect MD's to be PA's or nurses first. We don't expect lawyers to start as paralegals. Why does nursing have this obsession with starting at the bottom? I'm a BSN-only, and have encountered an attitude from those who were LPN's or CNA's or even ASN's first. I'm not sorry I catapulted over the ladder instead of climbing it. You could have, too.
I don't need to work as a CNA to know their job is demanding, exhausting, and unappreciated. I see it every day as I watch them work. My hospital is short PCTs, and we do float nurses into PCT jobs. I'm dreading the day I'm expected to do that job.
MD's have residencies and their 3-4 year of med school is basically clinicals.
Lawyers, often work as law clerks/legal aids prior to or while enrolled in Law School.
The "they don't have to do it" defense is not really a good one. Experience is better than anything and that is what the OP is vouching for.
I disagree with all of your points, and this is why.
1. During clinicals in RN school, the goal is to learn about your patient's disease(s), how they are affecting him, how to interpret his lab values, how to assess him properly and what your findings mean, what drugs he is on and how they could negatively affect him/what the desired outcome actually is, what diagnostic procedures he is scheduled for and how they might affect his condition, amongst more. A CNA does none of these things, except maybe looking for skin breakdown when turning patients. While working as a CNA will have helped an RN student be accustomed to the clinical setting and doing basic tasks like taking vitals, bathing, etc .. these are by no means impossible things to learn quickly. So beyond those things, having been a CNA will hardly help with your main duties as an RN student in clinicals.
Working as a CNA puts you in the environment and establishes a foundation to build off of. I never stated and hopefully didn't insinuate that RNs and CNA's have the same scope of practice... However they do work in the same environment.. and working in the environment (that you're hoping to gain entry to) will be more of a benefit than harm.
2. And there is a difference between observing a nurse work and being the nurse who is working. Just as someone said that doing clinicals in a hospital only gives you a glimpse of what working in a hospital is like, being a CNA in a hospital only gives you a rough idea of what nurses do. It can in no way be a determinant as to whether or not one should continue pursing nursing. Unless they are just so grossed out by poop/other bodily fluids that they can handle it, in which case they would quit during 1st semester anyway
Yes it is a difference. But what is the alternative? Observing is better than nothing. It can't hurt. It can't hurt to see a procedure you're learning in school done over and over again. That's better than doing it once or twice in clinicals and never seeing it again.
3. One can learn how to take a pulse in about 10 seconds. One can learn techniques for changing patients, turning them, transporting them, etc during clinical and on the job. These are not skills that require intense learning to get a grip on. While having much practice with these basic skills can be nothing but a bonus for RN students, it should by no means be a requirement. As a past clinical instructor of mine said, "You can teach a monkey how to take a blood pressure or insert an IV. It's the critical thinking that goes into assessing and intervening that makes an RN different from unlicensed personnel.
You will not be proficient in anything in 10secs. Studies state that repetition is the mother of learning..not performing something for 10secs. I wouldn't trust anyone to take vitals on me that just learned 10secs ago.
And working can definitely help with critical thinking skills..unless you're suggesting that the work of CNA's does not require critical thinking skills?
4. While that is true, it can also be a hindrance. Tests are usually written based on what the book says. If you, as a CNA, witnessed an RN inserting a catheter a certain way, and you answered a question regarding proper technique based on that experience .. you're going out on a limb and assuming that nurse you saw did it correctly. Another thing, diseases are presented in 'textbook' examples.. what if the woman with heart failure that you cared for as a CNA didn't have edema, and because of that, you assumed it wasn't a symptom when taking an exam? So I agree it can help, but it's more likely to hurt because 9 times out of 10 (made up statistic!), a practicing nurse probably won't do things by the book. Let's just be real. So if you're used to seeing something one way, and you read it in the book another way, it could be even more confusing.nt
Most nurses will tell you this is how I do it...but this is the way the book tell you. Most of them know how to do it by the book.
And being a CNA is not going to hurt and will most likely help students. A friend of mine was able to get her facility to switch her from a CNA to a student nurse position, and the nurses helped her a lot. She was also able to perform some things under the supervision of the nurse or was allowed to closely observe and ask questions.
I'm not going to get into hypothetical scenarios. Fact is experience is a good teacher. On the job observation/ training is better than reading it in the book maybe performing it once and never seeing or doing it again..which is the case in many programs..
So I agree that CNA experience helps, but once you get down to the critical thinking that is so central to practicing as an RN, the help that having been a CNA lends is pretty minimal. That's why I don't think it should be a requirement for RN school.
With so many hospitals and older nurses complaining that new grads are lacking clinically I find it odd that so many are against working as a CNA...as every little bit helps.
I see a lot of New grads complaining about not being able to find jobs, its baffling that so many are against becoming a CNA or student nurse to gain additional experience and increase their marketability.
I will be working as a CNA and student nurse while in school... I want to observe/experience/learn all I can.
Working as a CNA puts you in the environment and establishes a foundation to build off of. I never stated and hopefully didn't insinuate that RNs and CNA's have the same scope of practice... However they do work in the same environment.. and working in the environment (that you're hoping to gain entry to) will be more of a benefit than harm.
Basically, you're saying that working as a CNA familiarizes one to the setting where a student nurse would do their clinicals. That's nice, but by no means grounds for making it a requirement.
Yes it is a difference. But what is the alternative? Observing is better than nothing. It can't hurt. It can't hurt to see a procedure you're learning in school done over and over again. That's better than doing it once or twice in clinicals and never seeing it again.
The alternative is not doing it at all, as is currently the option. Yeah, you can see procedures done that you yourself will be doing, but you can also do that with YouTube. I still don't think that's enough to make it a requirement.
You will not be proficient in anything in 10secs. Studies state that repetition is the mother of learning..not performing something for 10secs. I wouldn't trust anyone to take vitals on me that just learned 10secs ago.
And working can definitely help with critical thinking skills..unless you're suggesting that the work of CNA's does not require critical thinking skills?
How much repetition would it take for one to learn how to take a pulse, then? I think you took my post a bit literally. The point was, it's a very basic skill that does not take much time at all to learn.
CNA's do not assess, and they do not intervene. The furthest their 'intervening' should go is calling for the nurse. They are not trained to do much else. Perhaps you could say it requires critical thinking to determine whether to get the nurse or not, but that's where it ends. That is simply their scope of practice. It will not help with the critical thinking that nurses need to make their clinical decisions, because working as a CNA will not require one to make those decisions.
Most nurses will tell you this is how I do it...but this is the way the book tell you. Most of them know how to do it by the book.
And being a CNA is not going to hurt and will most likely help students. A friend of mine was able to get her facility to switch her from a CNA to a student nurse position, and the nurses helped her a lot. She was also able to perform some things under the supervision of the nurse or was allowed to closely observe and ask questions.
I'm not going to get into hypothetical scenarios. Fact is experience is a good teacher. On the job observation/ training is better than reading it in the book maybe performing it once and never seeing or doing it again..which is the case in many programs..
I have seen where clinical mates who were former CNA's failed their skills check off because they performed the skill how they were used to as opposed to how they were supposed to. In fact, there was a thread about a student experiencing this just a few days ago. My lecture instructor herself said former CNA's can be a challenge in clinical because 'old habits die hard'. Most hospitals have positions for student nurses, CNA not required. Being a CNA at that facility already may have helped her secure that position vs applicants on the outside, but that's a different issue and definitely not a reason for why RN students should have to have been CNA's.
That is what clinicals are for. If that is your argument, then it should be that RN programs should have more clinical hours, not that students should have to have been CNA's to get in.
With so many hospitals and older nurses complaining that new grads are lacking clinically I find it odd that so many are against working as a CNA...as every little bit helps.
I see a lot of New grads complaining about not being able to find jobs, its baffling that so many are against becoming a CNA or student nurse to gain additional experience and increase their marketability.
I will be working as a CNA and student nurse while in school... I want to observe/experience/learn all I can.
The answer to new grads lacking clinical skills isn't to require being a CNA; it's a more rigorous clinical practicum. As this is only loosely regulated, it's up to the school how many clinical hours a student gets. I said in a much earlier post in this thread that I think more clinical time is the answer as opposed to being a CNA. Having worked as a CNA will not likely have taught a nurse not to administer Lasix to a severely hypotensive patient, for example. It will not have given a new nurse the knowledge needed to know when to hold an opioid based on their patient's vitals. These are areas where new nurses often lack competency, and it's not something being a CNA will really help, because CNA's do not function in this capacity.
You have to remember that the original argument is NOT "Is being a CNA before nursing school helpful?", it's "Should being a CNA be required to apply for RN school?". No one is arguing that having CNA experience is helpful for a student nurse or even a new nurse. But there isn't a significant reason why it should be REQUIRED that one be a CNA before applying to RN school, in my opinion. Students who have been CNA's have an advantage during fundamentals (1st semester), but beyond that, they're usually in the same boat as everyone else.
Although it is a great experience, it shouldn't be required.
I don't understand when people say nursing was a calling for them. Once I took the prerequisite and showed a nurse is when I really start liking nursing and couldn't even imagine doing anything else, but nursing 😊
I wish I worked as an aid, tech, or MA... or in any other health related fields that there is; however, I stepped into nursing with a fresh perspective and no compassion fatigue, which I hope will stay like that for ever.
Specializes in Cath/EP lab, CCU, Cardiac stepdown.
But it's like seeing a photograph of someone vs meeting them face to face. The photograph may be revealing, but not as revealing as seeing that person moving, talking and observing their demeanor and personality. A photo seldom captures those aspects.
Clinicals certainly reveal more about nursing than being a cna. As a cna you're actually closer to the photograph analogy, because you're doing the work of a CNA, where as in clinicals, you're doing the work of a rn.
Please remember that nursing school do have clinicals that require you to do some of the tasks of an rn, where as being a cna you are limited in scope of practice. Helpful yes, but monumental or mandatory? Definitely not
Specializes in Cath/EP lab, CCU, Cardiac stepdown.
MD's have residencies and their 3-4 year of med school is basically clinicals.
Lawyers, often work as law clerks/legal aids prior to or while enrolled in Law School.
The "they don't have to do it" defense is not really a good one. Experience is better than anything and that is what the OP is vouching for.
First of all, residencies are actually training doctors in their scope of practice. A cna is not a rn. I can understand advocating for mandatory nurse residency or even longer clinical requirements. A prerequisite of being a cna is not expanding on nursing experience. Is it helpful, yes but in the sense that it familiarize you to the hospital setting, which you'll be plenty familiar with by the time you're done with nursing school.
Lawyers have no such "requirements", just because they often work as clerks or legal sides doesn't make it a valid counter point as the op wants mandatory cna, which clearly isn't the case for lawyers.
Experience is definitely a good thing, but is the experience efficient and absolutely necessary? The answer is no to both, because you Will or at least should be getting that experience in clinicals, when you're doing adls, turning, v/s, etc. It will also be much more efficient to expand clinical time rather than requiring cna, as your end goal is to be a nurse, not a nurse's aid.
Specializes in Cath/EP lab, CCU, Cardiac stepdown.
With so many hospitals and older nurses complaining that new grads are lacking clinically I find it odd that so many are against working as a CNA...as every little bit helps.
I see a lot of New grads complaining about not being able to find jobs, its baffling that so many are against becoming a CNA or student nurse to gain additional experience and increase their marketability.
I will be working as a CNA and student nurse while in school... I want to observe/experience/learn all I can.
To address your points, a lot of hiring managers Will not see cna experience as relevant nursing experience, certainly it's not what they're asking for when they post relevant clinical experience. Heck, they barely count clinicals, they're looking more for experience as a nurse. Advocate for longer clinicals, nurse residencies, but not required cna.
I don't see anyone not wanting to be a student nurse because you know, you have to be one to be a nurse. And let me tell you, being a cna Will not help you get a job in my area. New York wants nursing experience not cna experience. So really it's not that baffling for me.
That's great that you want to do cna work while going to school, but I stand by that it shouldn't be a requirement.
Specializes in Cath/EP lab, CCU, Cardiac stepdown.
@quietriot, it's so hard to quote your response because somehow your response is in a quote only and not in a post and I don't know how to quote a quote.But this is a response to your response to sjalv (to clear the confusion)
The experience that you get as a cna is not gonna harm you but certainly it's not such a monumental experience that it should be required. No one is arguing on whether it is helpful or not. But no it does not benefit you ENOUGH nor is it VITAL enough to be a REQUIREMENT. Besides, many nursing programs do or at least should make students do total care.
I've actually seen and done plenty of procedures in clinicals, not just once or twice. And regardless of that, you can only observe as a cna, which you can do on YouTube for procedures. In fact you can pause and rewind. Also like a motif, of course it can't hurt, but is it necessary, no. And I don't see how it's either observation or nothing. Skills lab, shadow a nurse.
Vitals signs are pretty basic, you do not need more than a class time's worth to learn it. To require a cna experience to be proficient in these skills is frankly overkill and not time efficient. Bp, pulse, rr, pulse ox are very simple to obtain. And do not doubt that you will repeat it over and over again in nursing school. You Will be more than proficient in it by the time you graduate. Heck, you should be proficient in it at the end of your first clinical. And also we are looking for critical thinking skills as a nurse not a cna. Cnas are not supposed to assess nor interpret the assessment besides the bare parameters. That is what the rn does. Helpful yes, big difference no, thus should be required, no.
Also a point I should make is that textbook is good, nclex is all about the textbook. No deviations. Real nursing comes during orientation and your first year on the job. So frankly, regardless of cna or not, you're still going to be a new grad and you're still going to go through orientation and training.
QuietRiot
292 Posts
Yes, I think CNA experience should be mandatory.
1. You'll gain on the job REAL life experience, that will compliment what is being taught during clinicals.
2. You'll gain insight into whether nursing is really for you. As there is a difference between real life nursing and theory/book nursing.
3. You'll gain the opportunity to sharpen your clinical skills.
4.Real life experience reinforces the textbook, and really helps to solidify textbook concepts!
A few schools here in IL do require a CNA license prior to admission into the RN program. However, none (that I know of) require that you have, actual CNA employment experience.