The stability and monetary benefits that the CNA profession offers is greatly increasing demand of Certified Nursing Assistants. More people aspire to become healthcare professionals and consider CNA as the easiest gateway with stable, long lasting, recession proof jobs and whopping salaries.  To become a Certified Nursing Assistant, you require certain basic qualifications.  These are simple to acquire but you would not become a licensed professional or certified nursing assistant if you do not gain the CAN certification.  Here we cover all the basic information you need to know about CNA training and Certification.

Mandatory Requirements for a CNA

A person who desires to be a CNA necessarily needs to undergo CNA Training programs and CNA certification examination to meet the requirements stated in OBRA-87.  The OBRA-87 was initiated by congress for proper care of patients in hospitals as well as various healthcare centers. Make sure that the CNA training course you attend is an accredited one.

Pre-requisites for CNA certification

There are certain pre-requisites for gaining CNA certification. You need a basic GED or High School Diploma.  You should have completed state and federal government training program.  You should not have any criminal record or any negative record.  This clause is reviewed under Health Care Worker Background Check act and is applicable to any healthcare professional.  You also need to clear the competency evaluation test.

CNA Certification

There are various hurdles before you get your CNA certification. You will have to undergo a definite training program of 75-150 hours, varying depending on place and requirement.  The CNA training includes theory courses as well as hands on training on various equipments you may have to come across later. Once you are well versed with this, you can go in for the next step towards certification.  There will be a written evaluation of all the skills you learned in classroom.  It is only once you clear the written test and do well in it that you will be eligible to gain certification. Once you are certified, you are legally allowed to nurse the patients.  The certification however expires and needs renewal after a period of two years.

CNA Certification Exam

The CNA Certification Exam tests your written knowledge as well as skills.  Only once you clear these exams will you be listed in the Nurse Aide Registry. The written exams contain an average of seventy questions that check your knowledge and assess you for the same.  The written tests follow the multiple choice format and are always presented in English. Your required score to clear these exams and the cut-off marks may vary in each state.  For those who are not fluent in English, they can even request to appear the test in Spanish.  In some instances you may also orally answer the paper if you are fluent with the language.

CNA Skills

During the hands on practical test, you will be assessed for the nursing skills that you have mastered on undergoing the training program. You are taught around twenty-five CNA skills.  Randomly you will be assessed for any five of these skills.  The CNA Skills for which you may be tested include a list of daily chores you may have to handle while working as a Certified Nursing Assistant.  A few of them are listed below to give you a picture.

• wash hands
• clean dentures
• record blood pressure, body temperature, radial pulse, respiration
• dress and feed patients
• transfer from bed to wheelchair using transfer belt

Remember, while testing your skills one thing you will be watched for is your sense of hygiene.

For those aspirants who are looking to secure career in health care industry as a certified nursing assistant (CNA), gaining requisite knowledge is essential which can be obtained through various ways.  There are specialized community colleges, campus training, hospital organized CNA training and online CNA training that serve as different forms for obtaining requisite CNA education.  Completing the CNA training courses is not enough to secure a career in the nursing assistant field.  To  qualify as a certified nursing assistant, every aspiring student must first accomplish the requirement for CNA Certification by passing the CNA examinations.

NNAAP or National Nurse Aide Assessment Program exam in United States is the fundamental and main CNA certification.  According to statistics it is understood that over millions of CNA aspirants underwent this examination.  The examination is administered in various sections which also include written evaluation, oral and skill evaluating sections.  The written examination section is based on multiple choice questions that are related to important relevant aspects that should be known by a CNA candidate.  In oral examination section multiple choice question are supplemented with 10 fundamental comprehension questions; this section is available in both English and Spanish languages.  The skill evaluation segment of the CNA certification exam is designed to check the ability of the candidate in performing different relevant tasks under various settings as required by a professional nursing assistant.  In this test the candidates are required to demonstrate their skills and all that they have learnt during the course; this is done under surveillance of evaluation officers and nursing staff in complete hospital settings.

Similar to NNAAP, there are approximately 250 other CNA certification examinations available for those who have accomplished the prerequisite requirement of at least completing 9 to 12 months certified nursing training.  These certifications programs are approved by American Nurse Association Commission of Nurse Accreditation.  Potential candidates are also facilitated with placements in federal nurse aide registry and are allowed to renew their certificates annually.

Apart from the federal criteria for CNAs who exercise at clinics and nursing homes, every state has its respective requirements for CNA certification; and State Board of Nursing is a body that offers such CNA exams.  State Board of Nursing requires the candidate to be clean of criminal history, should be healthy and drug free.  To ensure that provided information about the candidate is true, several verifications are done such as background check, health examinations etc.  The States CNA certification is required to be renewed every year prior to the expiration date which is usually end of December.   During the renewal process the aspirant is also required to provide updated information.

Personality aspects are brought under consideration while applying for CNA certification.  It is obvious that every CNA aspirant may have dissimilar personal qualities; hence, some common personal qualities are focused while evaluation.  Every CNA aspirant is required to have patients while performing repetitive tasks on everyday basis, he/ she should be able to overcome or cope with monotony.  The most important personal quality that every CNA aspirants should have is caring nature.  A candidate should be a good learner and have desire to be forefront member of medical team.  With all these personal quality and skills CNA certification becomes easier to obtain.

If you wish to become a registered nurse (RN), you would have to spend four years at a nursing school and pay high tuition fees to complete the nursing program.  On the other hand one can become a Certified Nursing Assistant (CNA) in a few weeks after completing the necessary CNA training and it costs only a few hundred dollars.  There is always a possibility for a CNA to pursue higher studies to become an RN.  So what is better? Becoming an RN directly? Or work as a CNA before you become an RN?

Well, it is purely a personal matter.  There are many advantages of becoming a CNA before becoming an RN.  If you have an experience as a CNA, you are at least familiar with the routines, environment and procedures in the hospital setting; so you are ahead of the game when you join a nursing school.  You can absorb information easily at nursing degree program if you have prior experience as a CNA.  Your experience as a CNA would be particularly a huge help in clinical training in nursing schools.

Working as a CNA would give you great experience in direct patient care.  It will also help to make you a better nurse.  Many nurses consider the work of a nursing assistant as “grunt work”.  As an nursing aide you learn to be a team player-and you are not allowed to pass the buck.  So if you work as a CNA before joining RN program, you’d have a lot more respect for your nursing assistants. And that would reflect in your work relationships.  You would know what the nursing assistants are going through, and you will gain their respect as well.  However, you have to remember that respect comes from respecting people and not only because you walked in their shoes.

There are some nursing schools which require that you become a CNA before you even start their nursing program.  You would be glad that you took the CNA classes, as they would make you much more comfortable during clinicals.  While the RN knows how to do the nursing care,  a CNA does, she spends a much greater part of her time managing and supervising not only the nursing care, but other aspects of the patient’s care as well.  Looking back, you would realize that working as a nursing assistant was the equivalent of ‘Boot Camp’, which laid the foundation for your nursing career.

So we think it is a good idea to work as a CNA before going to school for nursing.  Experience as a CNA will also teach you more about what type of facility you’re better suited for and what type of nurse you want to become.  You will certainly have an advantage over your other classmates who do not have any work experience in hospitals, and would give that added confidence to your personality.  And it can save you from spending thousands of dollars and wasting many years of your life if you decide that nursing is not a career for you. Overall, being a CNA first would be a big plus for your nursing career.

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LPNs, often called as Licensed Vocational Nurses (LVNs) in states like Texas and California have a job role that falls somewhere between the CNAs and Registered Nurses.   By virtue of added experience and education, LPNs are usually self motivated.   They often assume the responsibility as a a mid-level manager. Registered nurses give more freedom and responsibility to LPNs than the CNAs.   Unlike an CNAs, the LPN is able to administer medication to patients, prepare IVs and set up procedural rooms.  And in many cases LPNs would be supervising other healthcare staff like nursing assistants and nurse aides.

CNA & LPN Salary Difference

The average annual CNA salary is around $27,000, and the average annual salary of an LPN is around $40,000, exceeding the average CNA salary by $13,000.  These salary figures will vary by experience,location, and employer.  The difference in he salary can be a good reason for a CNA to hope to transition her job to that of an LPN.

CNA to LPN Additional Education Requirements

If you are already working as a CNA, you’d happy to know that you can continue studying for LPN while maintaining your job as a CNA.  This is possible because most CNA to LPN bridge courses could be completed be part-time in the evenings or on weekends or even through distance or online programs.  It is also possible for you to get a study leave from your job for taking these courses; and after completing the LPN bridge program you can resume your duties as an LPN.  As a matter of fact, many hospitals, nursing homes and other employers often encourage CNAs working in their facilities to join CNA to LPN courses to advance their career in nursing.  Some employers may even offer to take care of the cost of your education. It is therefore better that you talk to your employer about your future career advancement plans.

A CNA should obtain the following skills if she decides to become an License Practical Nurse

• Administer prescribed medications to the patients
• Monitor glucose for patients suffering from diabetes
• Collect samples from patients for testing and to perform some routine laboratory tests
• Knowledge of injections
• Starting and administering IV fluid
• Documentation of the information and sending reports to RNs and other team members
• Teaching CNAs the process of sterilization of instruments and other objects.
• Assisting surgeons in operation rooms

Many community colleges and vocational colleges throughout the United States offer LPN/LVN programs.  The duration of these  courses vary depending on each state’s requirements, but on average it takes about two years to graduate from these programs.  LPN/LVN aspirants must also pass the national NCLEX-PN exam before they can start working as an LPN in a hospital or health-care facility.

The training/education required for an LPN bridge program depends on the state and type of specialty.  For example, In California, experience of at least 51 months in an acute hospital is necessary.  Clinical specialty requirements include two hundred hours in maternity or genitourinary, two hundred hours in pediatrics, sixty four hours in Pharmacology and additional sixty four hours in one of these specialty areas.  For other states, you’d need to refer to the guidelines by the board of nursing in your state.

In any profession, undergoing a formal training takes you a notch up in the ladder of success. Likewise, a nursing assistant who undergoes training formally can qualify to undertake the nurse aide certification course.  All you have to do is getting certified as a nursing aide after undergoing CNA training at a recognized institution.

Becoming a certified nursing assistant (CNA) requires state approved certification.  A nurse aide is not the same as a certified nurse aide.  The former is not certified whereas the latter has to undergo certification by the State Board of Nursing with whom the certified nursing assistant is registered.

A certified nursing assistant, therefore, performs all the tasks of a nurse aide and more.  As a result of it, a CNA will also earn far higher in comparison.  A nurse aide is qualified to help and aid patients who need physical assistance and even help in checking their vital signs.  But they are not authorized to use and apply the skills learnt by a certified nursing assistant.  The certified nursing assistant is empowered to work at health care facilities, doctor’s offices as wells as home health locations.

A nurse aide, who enjoys working and making nursing a career, can seek to qualify as a certified nursing assistant by choosing to undergo training to certify even while working as a nurse aide.  A lot of healthcare facilities take on nurse aides to work with them and this also helps them to take on additional training both on the job as well as formally so they can take tests and qualify for a higher position or change to a more paying department.  The earning potential and better job opportunities increase in proportion to acquiring professional certification as a nursing assistant.

Some healthcare facilities themselves offer programs for certification.  Certified nursing assistant programs are conducted by several health and community colleges as well as the American Red Cross.  For those who cannot attend in-house lectures, CNA courses are also available online.

The professionally conducted certification courseware for nursing assistant comprises of hands on training on all tasks from taking vitals, patient care, report-writing, moving patients and making beds and even how to interact with the patient and his family.  Safety and efficiency are the bases for making a great nursing assistant and the course certification requires giving a written test and a demonstration of skills and tasks learnt during the course.

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CNA Practical Exam
In the practical exam for CNA, the state examiner asks the student to carry out a few clinical tests on a volunteer.  The student must follow fundamental measures of sanitation and patient hygiene before starting the test as the examiner watches.  Results of the CNA exam are usually declared by the examiner on examination completion.

CNA Theory Exam
On completion of the practical exam, the student takes a CNA theory test on topics covered in the clinical training coursework.  These tests can also be taken online on numerous websites for free.  Theory exam results are declared within fifteen days and a temporary license is issued followed by permanent registration by the State licensing board.  Most permanent registrations have a year’s validity, to be renewed annually.

The initial license registration fee is a large amount; annual renewal charges vary in different states and costs far less.  In some states there is a requirement for continuing education or remunerated employment of a minimum number of hours in a health facility, based on which the license is issued.

The State board sends intimation to the primary license holder at the registered address about sixty days prior to CNA license expiry date.  Change in address should be intimated to the State licensing board, or else the license will permanently elapse. CNA License renewal can also be made online.  Nearly half the CNA licenses are renewed online and the payment system is secure.

Basic requirement for renewal of an expired CNA certification is work experience as a CNA within the past two years.

If this criterion is fulfilled, information in a CNA License Renewal Form should be submitted to the Nurses Aide Registry for consideration.

In case the criterion is not fulfilled:

• Fill up the Nurse Aide Registry Renewal Form – 1st part giving personal details and 2nd section to be filled by one’s past or current health care employer.
• Date and sign the application and mail to the State address
• Allow 2 weeks process time or check online status of renewal
• If not employed at a health care facility in past 24 months, take the state certification exam again.

Visit the website for your state-specific information for more details on renewing your CNA license.

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The tests conducted for qualifying for a CNA position involves two aspects – the theory test and practical test. The training and tests are conducted for academics and clinical training. The theory can be done online, but clinical training involves working part-time with a health care facility, a nursing home or a local hospital.  Training may differ according to state requirements and could range from a couple of weeks to a few months.  Completion of the course prepares one to take the CNA as  a career, and to be able to give care to the mentally or physically sick, hurt, or disabled patients at a nursing home or a hospital.

The clinical part of CNA training for a Certified Nursing Assistant prepares the CNA to be able to check the vital signs of a patient like pulse rate, temperature, respiratory rate and blood pressure, moving patients in the correct manner, making and maintaining patient records, following exercise routine instructions as given by the Physical or Occupational Therapists, administering wound dressing for patients, inserting food tubes or feeding patients, inserting and removing catheters as advised, helping with disinfecting the room and belongings of the patient, explaining the routine to patient’s family, if asked and updating the doctor or registered nurse on the patient’s progress on a daily basis.

Working as a CNA will make you gain expertise in administering care and give you the confidence to assist and give care at any health care facility or hospital.  The CNA training also includes stress management, ability to judge patients’ emotional and mental needs, dealing with death and terminally ill patients and their families, and communication of both verbal and nonverbal nature.  It also includes techniques and skills to make a patient comfortable, make his bed, and assist with his bathing and dressing.

The curriculum for the academic or theory aspect involves physiology and anatomy, whereas practical tests involve the testing of your ability to handle any given situation.  Each patient is admitted with a different medical condition.  How you react to a given situation and the confidence you display in being able to deal with the patient’s needs form a part of the practical tests.  Even your keeping the surroundings neat and disinfected are subject to assessment under practical tests.

There is a growing demand for Certified Nursing Assistants today, mainly due to the rising numbers of the aging population.  There are plenty of job opportunities in this field at clinics, health care centers, hospitals and private homes, which is gratifying both from a humanitarian perspective as well as for gaining financial rewards.

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