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Thanks!

Once an NA has her Ohio STNA Certification (Ohio), how long is it good? Seems to me a person has to work so many hours in the first year, but then what? I guess my REAL question is this: if a person obtains her STNA Ohio Certification but doesn't find a job as a nursing assitant until nearly a year later, does she have to retest again? Does she have to take the classes again? Thanks for any info.

The system is not perfect. Ideally, you should probably wash your hands: 1. BEFORE gathering linen from clean linen storage. Otherwise you'd be contaminating the linen you are taking into the resident's room with anything picked up since you last washed your hands. 2. BEFORE gathering equipment in the patient's room. Otherwise you'd be contaminating everything you gather with germs on the doorknob. 3. BEFORE performing patient care which should be just before putting on the gloves. 4. AFTER performing patient care. FOUR TIMES. Not practical nor possible during a busy day. From my experience (limited, for sure) what I witnessed was nursing assistant's breezing in and out of patient's rooms and not washing hands every time.

I passed. This is what I did. I did the intro thing: knock, call out patient's name ("Mrs. Smith?" e.g.), "Hi, my name is.......and I'm going to assist you with....... First, I'm going to wash my hands and then I'll gather my equipment (including gathering gloves)." Then after gathering equipment, pull the curtain, adjust the bed rails and bed height as needed. And THEN PUT ON THE GLOVES and perform the skill. To me there is a flaw in this system because the gloves are not being put on just-washed hands and I think this would be the ideal. However, the gloves are sterile and you don't want to wear them while you are gathering the equipment, pulling the curtain, adjusting the bed, as this could definitely contaminate the gloves.

If you aren't a licensed nursing assistant I'm assuming that the facility that hired you knows this and that they are providing all of the training. Is this correct?

I will tell you what I was told in class. For the TEST to get licensed, absolutely take the respiration rate for a full minute. Elderly people do not necessarily breathe in perfect rhythm so counting the respiration for 15 seconds and multiplying by 4, for example, may not give you an accurate record of their respiration rate. In "real life" on the job, I think it is still most accurate to do it for a full minute. It does seem awkward to just stand their but I do think it gives you the best idea of their respiration rate.

'Scared to death?' What you're experiencing is normal for anyone who learning a new job. No matter what job you would get that would be totally new to you would bring some anxiety. I recently started a new job. I had difficulty sleeping and lost five pounds, which I didn't need to lose. It was mostly nerves. Everything was so new to me and my new job was in a field I had no experience in. I felt like walking out numerous times. But instead of looking at the WHOLE JOB, I tried to focus on the duties of each day, one day at a time. Nevermind that there was so much to learn. I only needed to learn so much in that one day. And little by little, as I tackled a new and unfamiliar part of this job, I have gained a confidence I never knew I had. Now I am happy and confident. The confidence came about partly because I have learned new things. But mostly the confidence came about because I didn't quit. I think you should just make up your mind what you want to do and jump in and do it. Don't worry about what you don't know. As time goes by, you will learn all you need to do this job successfully. Marie

I took my nursing assistant classes at a nursing home, took all my tests there and did my clinicals. When I passed the final exam, along with performing the clinicals correctly, I was CERTIFIED. However, I then had to pass the state's exam in order to be LICENSED. Certified and licensed are not the same thing. The state gave a written test and we also had to do the skills tests and be graded on that. In Ohio, we are called STNA (State Tested Nurse Aide) which is equivalent to a CNA in other states. So to sum it up, I became a nursing assistant when I became certified by the local nursing home. I then became a STNA when I successfully passed the written and skills test issued by the state and I am listed in the the state registry. Now from talking to others, they interviewed and some were even hired by nursing homes after they were certified (but not before). However, one of the requirements of their keeping the job was that they had to become licensed by the state within four (???) months of becoming certified. I don't think there is one way this is handled. I think different states and different facilities have different rules. I do think that whoever does hire you will probably require you to become licensed at some point. And even if they don't require it, they should pay more if you are licensed. Hope this helps a little. Marie

To my surprise, I found the opposite to be true. While doing my clinicals in LTC, I was amazed at how appreciative and uncomplaining the residents were. For the most part, the residents in long term care have come to accept that they will not be returning to their homes. They have lost many of their possessions simply because there is no room for this stuff in their tiny private or semi-private rooms. Their health situations have pretty much placed them at the mercy of those caring for them. I would go home each day and reflect upon my own life - how much I had in the way of health and the freedom to come and go whenever and wherever I wanted. For those few residents who are not very pleasant to be around, my guess is that they are still coming to terms with their situation. These residents are the ones that need our understanding the most.

I was told that it was not as important to do things in the exact order as written, but imperative to do them in the most logical way. And absolutely do all of the required steps because if you forget these, you will fail. My state puts these required steps in bold print. I divided my skill procedure into sections: Beginning Knock on Door Call Resident's name (Mrs. Smith?) Enter Room Introduce yourself ("Hi, my name is Marie and I am your nursing assistant.") Explain Procedure ("I am going to assist you with your dinner, brush your hair, get your vitals - or whatever) but first I will wash my hands (walk toward sink and "pretend wash") and then I will gather the equipment." Performing the Skill Gather all equipment, including gloves if needed, and take to residents bed, table or chair. Pull the curtain for privacy Lock the bed wheels (If this skill involves a wheelchair, LOCK the wheelchair brakes at the this time also.) Put up the side rails if needed and I would do this BEFORE raising the the bed (if you will be doing so) Raise or lower the bed as needed for the specific skill Put on gloves at this time. SKILL (Do the actual skill) Tell the resident when you are done - don't just stop and walk away. Rinse and dry equipment as needed and put it all away. Ending Go to resident and put bed in lowest position. If the side rails need to be lowered, do it now. Give resident the call light, smooth the covers and ask them, "Is there anything I can do for you?" Open the privacy curtain. "Pretend wash" your hands Tell the resident that you are leaving the room You have to do the above FOUR TIMES, once for each skill that you must act out. Obviously, you already did one skill when you actually washed your hands to demonstrate you knew how. I think when performing each skill, safety should be your priority. Remember to lock the wheelchair brakes and bed brakes. And don't forget the side rails. I knew of one person who failed the "Position Resident on Left Side" because she put the resident on her right side. So be careful here. My last suggestion would be to practice, to make this second nature. You don't want to pause often as the timer will be ticking away. Good luck. You will do fine. Marie

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I don't think you're crazy for wanting to stay in LTC. LTC benefits from having people like you. But you do seem to be ambivalent about this. Why not at least go for the hospital interview(s) and get a better idea of what that type of job will involve? That way, you won't feel so torn if, in the end, you decide to stay in LTC.

Congrats on getting the test done! I just finished mine and it felt like a load was lifted off of me. Three days later when I found out I had passed, it was kind of surreal (I really hate that word - Hollywood people use it all the time but it is appropriate here.) This crash course program with all of the book work, testing, clinicals and skills practice, practice, practice became a big part of my life. I even dreamed one night about placing a wheelchair next to the bed to practice ambulation and was trying to calculate how close to the bed the wheelchair could be and still move the foot/leg rests to the side in a locked position. Talk about stressing for the skills test! Anyway, I passed and I'm sure you did fine. You sound very conscientious and detail-oriented so you probably gave this alot of thought and practice. I also was a little concerned about the set-up using up my skills test time. The pretend patient had to put on a gown (as a robe) so I could take it off during partial bed bath. Also, in the transfer from wheelchair to bed the bed had to be raised (so that I would be tested to see if I remembered to lower it during the skill.) I was so concerned that I raised the bed to hurry things along because the proctor and pretend patient seemed to move rather slowly. All in all, I finished with 9 minutes left over. I had handwashing, mouth care, hair care, transfer from w/c to bed and partial bed bath. Really pretty easy stuff but I was so nervous that I almost made a disaster out of mouth care. The only deduction I got was I forgot to wipe the patient's mouth with a washcloth after brushing their teeth. And I had the washcloth on the overbed table but my mind went blank. Good luck and let us know how you did. Marie