Tips for the Certified Nursing Assistant (CNA)

This post is written for the CNAs but it also is a great resource for CNA students, new nurses and nursing students starting clinical!

Congrats on passing your state test/certification and becoming a CNA! Also called STNA, PCT, PCA, etc. Essentially- you will be working as a nursing assistant. Helping patient and residents with activities of daily living and checking vital signs. Some facilities you may also do things like blood sugar checks, blood draws, EKGs, and more! (Note- it is important to know what your state and facility both allow you to do as a CNA.)

A CNA is an absolute vital member of the healthcare team and I want to thank you for choosing to joining! I worked as a CNA before nursing school in both a skilled nursing facility (nursing home) and in home health. I also have worked several shifts in the hospital as a tech when we were short staffed. It is a very hard but important job.

Some tips for the new CNA:

  • Show up to the floor ready to work. It’s frustrating when you are ready for report and the on-coming shift is going to breakfast, sitting at the desk, etc. Get report and relieve the previous shift. Then be ready to start baths, breakfast trays, vital signs, blood sugars, whatever needs done! It will make your (and your patients & nurses) day go better.
  • Listen to other CNAs report and how people give you report so you can learn how to give an effective report. Write down the report you get from the other CNA! Important information to know about your patient include:
    • Code Status (do you need to start CPR if they are unresponsive?)
    • Diet (Can they eat? What can they eat? Does it need to be a certain consistency?)
    • Fluid restriction (sometimes patient can only have a limited amount of liquids and this must be monitored)
    • Ambulation (Can they walk? Do they need assistance? A device? Are they on bedrest post procedure?)
    • How often do they need vital signs? Are they a blood sugar check? How often?
    • Are they on oxygen? (Make sure it’s on them when you round!)
    • Are they on precautions? (Cdiff, Covid, etc- what do you need to protect you & the patient)
    • Anything else you need to know about this patient?
    • Note: If you don’t get this information in report, or to double check information- you should be able to look at a care plan for CNAs or the patient’s chart. If not or you have questions- ask the nurse!
  • Pay attention to your patient’s skin! You get a chance to really observe, more than nurses many times. Pay attention to their sacrum/coccyx (back side), fingers, toes, etc. If you see any skin concerns- report them please!
  • ASK the nurse questions if you have them. Sadly, some nurses are not as kind as they should be (they are often overworked and stress as well). Don’t let that stop you. The patient/resident comes first. If it becomes an issue, report to management or your charge nurse.
  • Wear comfortable shoes and scrubs! You will be walking miles during a shift. You will be squatting, bending, and lifting. Make sure you can move in your scrubs and your shoes are comfortable. Also- compression socks are life saving! Make the investment. Your body will thank you!
  • Pack a lunch, bring snacks, and bring plenty of hydration! An 8 to 12 plus hour shift is long. You don’t want to be hungry and low energy!
  • Know the normal range of vital signs and if you get something abnormal- report it! If the patient is okay, recheck the vital sign first. Some troubleshooting tips:
    • BP- Before taking- does the patient have limb restrictions!? Sometimes we can’t use an arm or leg because of surgeries etc. Maybe hospitals put a band on these extremities. Make sure the cuff size is appropriate for the patient. Make sure the BP cuff is in the correct position. Have the patient lay on their back or sit with legs uncrossed. Ask them not to talk while you check the BP.
    • O2 saturation- Ask the patient to take a few deep breaths. Make sure the pulse ox (finger probe) is on correctly and they patient has their oxygen on if it’s required. Do they have fake nails? If so you may need to try their ear or toe.
    • Temperature- did the patient just take a drink? Is the thermometer under their tongue?
    • Pulse- Irregular heart rates can cause the patient’s heart rate to read incorrectly. Are they on a heart monitor?
    • Respirations- Does the patient feel short of breath? Did they just get up to the bathroom?
    • When possible- get vitals before going to the bathroom or getting the patient up! And again- if it’s not within range- report it, please! This is vital to the patients well being and care.
  • When placing a chuck (draw sheet/pad under a patient)-put the chuck lower than you think you should. The top of the chuck should be around the patients waist, if not lower. When you go to pull the patient up, the chuck will move! If it’s not low enough, it won’t do you any good for the next boost (and won’t help keep the sheets dry and clean).
  • You can put depends (pull up underwear) on a person with their pants/shoes on. Life changing. YouTube Video for this CNA magic.
  • Getting patient’s to the bathroom is a great time to ambulate them in the hall (after of course) if needed. Also it is a great time for ADLs. They can brush their teeth, change, bathe, and shave while in the bathroom! Work smarter, not harder. Time management and clustering care are essential to surviving a shift
  • Round on your patients. Nurses are busy too and we depend on you to work as a team to help keep patients safe! Some hospitals have rounding schedules, if not you should try to lay eyes on your patients at least every 1-2 hours. Physically walk in the room. Are they comfortable in bed/chair? Is the floor clear? Is their bedside table and belongings in reach? Is their oxygen on? Are the breathing? (yes, you need to make sure they are breathing.)
  • Teamwork makes the dream work. Team up with other CNAs and nurses. Ask for help, and also be willing to help.
  • You may be some of the only human contact a patient or resident gets in a day. Many of them are scared and have never been this vulnerable before. Be kind. Smile. Be patient! It makes all the difference to a patient and their family.

If a patient looks different. Sounds different. Acts different. Anything. Report it to the nurse!! I have had CNAs report patient with low oxygen, experiencing a stroke, and more. They literally saved the patient’s life by recognizing the change and reporting it. This includes home care. I had to call 911 for a client while I was a home health CNA as well and they were admitted to the hospital. You have the power to save a life. Speak up if you suspect anything!

Thank you for all the work you will do to not only help your patients, but to help all the healthcare team- especially nurses! I can’t tell you how much I love and appreciate CNAs and how much they have taught me and helped me during my career as a nurse. Some of my worst shifts were made better by an amazing CNA. Your work is important and matters so much! Remember, we all were new and we all have faced the steep learning curve on entering healthcare. You’ll learn the little tricks to make your day better. You’ll improve your time management. It will get better and you will succeed. If you have any questions- please contact me! I would love to connect.

Disclaimer: This is general information. Please refer to your state practice act and facility/institution policy and procedures for your practice guidelines.

1 thought on “Tips for the Certified Nursing Assistant (CNA)”

Melissa Weaver

Well written heart felt post! I know CNAs and nursing students will appreciate the advice!

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