When you are a CNA working in a nursing home you are run ragged. There is no time for anything. When you are a CNA working in a hospital, things get so crazy that you can easily forget which room you are supposed to be going to. However, if you are a home health CNA than your life is actually yours and your patients actually get the attention that they need! Of all the CNA jobs I have had, home health is hands down the easiest and most rewarding one, and here is why:

• When you do home health, it is just you and your patient. There is plenty of time to get things done properly and get to know your patient.
• Working away from a facility allows for much more flexibility as there are no bosses looking over your shoulder while you work.
• If you have an agreeable client you can work your hours around your needs. If your child has a doctor’s appointment during the time you are supposed to be at your patient’s home, you can arrange a different time with your patient so you can do for your child.
• The work is typically very light. The majority of home health patients do not really need as many hours as they are given. If you are scheduled to be with a patient for 3 hours each day, chances are that you will actually be doing work related duties for an hour or so. The rest of the time belongs to you and your patient.

For me, the most wonderful part of home health is the relationships you can develop. I have been with my patient for 3 years. While your employer will tell you that you are not supposed to become friends with your patients, this is totally impossible. You are spending one-on-one time with them every day so a relationship is bound to develop. You talk to each other about your family and friends and your hopes and dreams. You learn almost everything about your patient and them about you! My patient is like part of my family now. She comes to my children’s birthday parties and to holiday events. We talk and see each other even on my off hours. For a CNA who got into this field because they love people, this is the perfect type of job and that is what it was (and is) all about for me!

This article is part of a series of  articles that talk about how work is when you’re a certified nursing assistant. The article above and the thoughts expressed therein are those of the author, Tanya Glover who is a practicing CNA. 

The Social Butterfly- This is the patient who goes to every single “event” in the home. They do bingo, arts and crafts, dances, carnivals and church every Sunday morning. She always looks her best (or tries too) and her clothes are never washed in the facility. (She has them sent out with family because the home will “mess them up”) She is sweet with a winning personality – until you do ask how high when she says jump. You must beware the social butterfly because she can take you down quicker than the prom queen back in high school. Everyone knows her and the administration will not stand for her to be upset. This is not because they adore her, but because they have already had problems with her complaints in the past and they do not want her children back in the office demanding to know why mom is not being treated like the princess that she is.

The Social Butterfly is one of the nursing home patient personalities you'll have to deal with as a CNA

The Ladies Man- We all remember this guy from high school but never think we will meet him while working in a nursing home. This patient loves the attention of all the nurses and is not afraid to ask for it. (In fact, he assumes you want to spend your entire day with him!) When you are with him you no longer have a name; you are honey or sweetie pie or sugar. He will regale you with tales from his skirt chasing days and if you are not careful, grab a handful of your skirt as well! You can get angry with him but he simply withdraws, claiming that he really meant to touch your arm or pat your knee and all of a sudden he is confused and not up to talking anymore. He is generally harmless but trouble can ensue if this Casanova messes with the wrong nurse!

Miss Total Care of the Year- This is the patient that every CNA will fight over. (The equivalent to Miss Popularity back in high school)  He or she is total care and for the most part, cannot even move a muscle. Why do they all love her? Because she is cute! She is easy to take care of and she has family who comes in everyday to sit with her and praise the staff. They bring the nurses cookies and candy and even give them money at Christmas time! If the family falls in love with you, you are golden! They will request that you are their loved ones CNA for every shift that you work and you will then be part of the élite class of nurses. There are definite perks here!

The Grouch- This is the patient, who constantly sulks, complains about everything and thinks all the nurses are out to get him. (And not in the good way like with the Ladies Man!) If he gets lime jello on his lunch tray he complains that his favorite is cherry. If you make sure to bring him cherry the next day (out of the kindness of your heart because you know it is his “favorite”) he will gripe that he would rather have lime. You can never be gentle enough while caring for him and he will be quite vocal in letting you know how rough you are being. (Of course you are actually being just right!) He may actually like you but if you find out that he does, do not let it show. He will not admit that he likes anyone and if you challenge his Oscar the Grouch approach to life things will only get worse for you.

There are many more personality types out there but these seem to be the most dominant I have encountered in my years working at nursing homes. Keep this in mind when you enter a new facility and you will surely be able to pick out which patient is which!

This article is part of a series of  articles that talk about how work is when you’re a certified nursing assistant. The article above and the thoughts expressed therein are those of the author, Tanya Glover who is a practicing CNA. 

Be prepared to invest some time and effort into writing a concise, compelling cover letter that allows your personality to show through. Put yourself for a moment in the shoes of the hiring manager. They have received an onslaught of dozens of resumes for this one position that they must fill. They need to weed through all of the applications they receive and try to pick the best person for the job.

Quick Tip: make sure you also check out our guide on how to write a compelling CNA resume.

Your job is to make the hiring manager’s job easier. Follow all of the directions in the job announcement to the letter. Just demonstrating that you are capable of following directions will separate you from those candidates that have sent in boilerplate letters and who did not follow the directions.

Here are five quick tips for preparing a CNA. resume cover letter:

 1. Always customize each cover letter

Find out the name of the hiring manager and address the letter to that person. Find out some interesting facts about the organization and mention them in your letter. The hiring manager wants to get the idea that you are applying for this particular job rather than any job you can get hired to do.

2. Use your cover letter to share who YOU are

Make your cover letter stand out from the stack of other resume cover letters that the hiring manager will be sifting through. Share how much you love working with babies, or the elderly, or whatever aspect of nursing you are passionate about. This is your opportunity to set yourself apart from the rest of the applicants.

3. Do not simply rewrite your resume in the form of a letter

Keep your cover letter fresh and unique. Remember your goal is to make the hiring manager want to pick up the phone and schedule an interview with you. Add relevant facts about your work history, education and experience.

4. Expand on how your experience matches the qualifications for the position

Pull all of the qualifications from the job announcement and write about how your education, skills and experience makes you a perfect match in every way.

5. Have someone objective review & proofread your cover letter

It’s challenging to proofread your own writing with 100% accuracy. Have a fresh set of eyes review your cover letter and point out any typos or areas that do not make sense.

*Bonus Tip: Work with a career counselor if your CNA training program provides one, or consider investing in hiring a career coach to help you refine your resume and cover letters, which you can then customize and refine for each specific job you apply for.

The health care field is a highly competitive one. Each year CNA training programs crank out hundreds of thousands of trainees. The job of your resume cover letter is to show how special you are, what a good fit you are for that specific job, and how the hiring manager would be foolish not to bring you in for an interview.

Due to the increased need for long-term care in America, the Department of Labor projects at 19% growth in employment opportunities for nurse’s aides through 2018.

What does this mean for you? This means that after training and passing the CNA exam, you stand a very strong chance of finding a job.

What to Expect

As a CNA, you will have direct patient contact daily. Your tasks may vary depending on what institution you work at; however, your typical duties will include helping patients eat, bathe and dress, as well as taking vital signs, helping patients to ambulate and reporting any change in the patient’s medical condition to other nursing staff.

Because patients need 24-hour care, you may be required to work a variety of different shifts. Most CNAs work full-time and as a new nurse’s aide you might have to work holidays and weekends, depending on the scheduling needs of your place of employment.

Where to Find Work

Nursing Homes/Community Care Facilities

Because Americans are living longer, the need for long-term care facilities, such as nursing homes is dramatically increasing. In fact, almost half of CNAs that are employed in America are working in some type of long-term care facility.

The multitude of opportunities to care for the elderly is valuable insurance for your future employment prospects, even in the midst of a troubled economy. Nursing homes are a great resource for CNAs that are looking to begin their careers in healthcare.

Many CNAs are also employed in community care facilities. These residential care facilities care for elderly patients and for people with special needs. The clinical setting is similar to nursing homes; however, these patients will typically require fewer needs than patients do in nursing homes.

Home Health Aide

Working as a CNA home health aide is another growing opportunity for CNAs. As a home health aide, you will be responsible for taking care of patients in their homes. Many home health aides will be responsible for a variety of patients at several different locations.

Working in this environment will require you to have a strong sense of independence. As the population in nursing homes increases, the home health aide path will continue to be an excellent career opportunity for CNAs.

Hospitals

CNAs employed in hospital settings will be exposed to a wide variety of assignments. As a CNA in a hospital, you will be responsible for several patients at the same time. A strong proficiency in multitasking is essential to be successful in this environment.

Another benefit to working in a hospital is that you may be exposed to several diverse specialties within the hospital. For example, a CNA working on a Medical/Surgical floor will observe different clinical procedures than a CNA employed on an Oncology or a Maternity unit.

CNA Wages

How much money you earn as a CNA will ultimately depend on a variety of factors such as the type of institution that you are employed at as well as in what part of the country you work. Since the cost of living varies in America, this will be factored into your pay.

Here are a few examples of typical hourly rates:

• Nursing homes -                   $10-$13
• Community care facilities -  $9-$12
• Hospitals -                             $11-$14
• Home health aides -              $8-$10

It’s up to you to be familiar with local, state and federal laws relevant to your scope of duty as a CNA. Failure to abide by these laws can result in a civil suit against you, possible loss of certification and in extreme cases may result in fines or imprisonment.

Now that I have your attention, let’s explore some basic guidelines that will help you stay out of the legal hot seat.

Patients Right to Privacy

In 1996, the Health Insurance Portability and Accountability Act was enacted to protect the confidentiality of patients. As a nursing assistant, you are responsible for safeguarding the privacy of patients. Medical issues should only be discussed with the patient’s doctor, nursing staff, other members of the medical team and close relatives.

Know Your Facility’s Policies

It’s essential that you perform your duties by following the correct procedures of your place of employment and within the scope of your training. If you are unsure about a certain policy or procedure, always check with your immediate supervisor.

Continuing Education

Keep up to date on continuing education requirements to provide the highest level of care to your patients. This will also allow you to stay informed about any new or changing medical procedure.

Legal Issues

In addition to the previously mentioned guidelines, there are a variety of legal terms that every CNA should be acquainted with. Be aware of the following legal issues and know how to avoid them during your career.

Malpractice

This involves negligent conduct that results in harm to the patient. Examples include practicing outside the scope of your duties, not providing care as previously trained and failing to follow your facility’s policies.

Negligence

This consists of the lack of reasonable care due to carelessness and often results in injury or harm to the patient. Negligence usually occurs when a CNA is in a hurry.

Types of Patient Abuse

There are four types of abuse that have been identified within the medical community. They consist of physical, sexual, psychological and verbal abuse.

Physical

Examples include hitting, kicking and roughhousing with patients. Another form of physical abuse involves providing the incorrect treatment to patients.

Sexual

This can involve any type of seductive or sexual harassing behavior directed toward the patient. Another form of sexual abuse is forcing a patient to do a sexual act against their will.

Psychological

This type of abuse includes patient intimidation through threats or any other harassing behavior that would cause emotional harm to the patient.

Verbal

This includes the inappropriate use of tone and language as well as any unpleasant gestures or names directed toward patients.

Property Rights

All patients have the right to have their personal items safeguarded during their stay in any healthcare facility. Theft of a patient’s property is nothing less than a crime.

Assault and Battery

Assault is defined as intentionally attempting to harm someone; battery involves actually committing the offense. In a medical environment, these terms don’t always involve attacking someone. Simply performing a treatment against the patient’s will could cause significant legal problems.

To avoid this situation, always inform patients of what treatment you plan to perform, and immediately stop if the patient refuses.

This is known as informed consent. Conversely, forcing the patient to do something against their will is defined as coercion. If the patient refuses treatment at any time, notify your supervising nurse.

False Imprisonment and Involuntary Seclusion

Patients have the right to come and go as they please. You must obtain proper authorization before restricting any movement. Additionally, the use of physical restraints must be specifically ordered by a doctor prior to being utilized on any patient.

When a patient is held against their will, it’s known as involuntary seclusion. Sometimes patients become unruly and can cause problems in common areas that are shared by other patients. Check with your supervisor before removing these patients.

Considerations

Your goal as a CNA is to provide the highest level of care to your patients. By following these guidelines and the proper legal standards, you are ensuring that you’re doing both you and your patients justice throughout your career.

The required hours vary by state. Some states may require 12 hours a year, while others set the standards at 24 hours. Check with your state’s nursing board regarding their CE requirements.

CE courses are offered through a variety of options such as: your current employer, local community colleges, your state’s nursing board and through numerous private vendors. When choosing a private company, make sure that they are accredited with your state.

The topics for CE courses are offered in subjects that are relevant to your duties as a CNA, such as:

• Current clinical methods
• Emotional support for the elderly and chronically ill
• Medical record documentation
• HIV/AIDS training
• Medical error prevention
• Communication with cognitively impaired patients
• Resident rights

This is just a small sample of some of the available courses for CNAs. Continuing education courses will help you maintain a high standard quality of care and can help keep you updated on current trends in healthcare.

Free Sources for CEs

Many members of the healthcare community pay fees to obtain CEs and simply consider it the cost of doing business; however, there are other options. If you know where to look, there are several low-cost and even free opportunities for continuing education. Before you read this you should read our previous article on free CNA inservices

Institution Education Departments

Many hospitals and nursing homes will develop CE courses through their education department. These CEs are usually free to employees. Check with your institution’s educational department to see what type of program they may offer.

Education Funds

Some employers make contributions to education funds. These funds frequently offer free continuing education courses for CNAs. An example available for CNAs who work in Los Angeles is the Service Employees International Union (SEIU) UHW-West & Joint Employer Education Fund. You must be employed by one of the companies affiliated with this union to qualify.

These free courses are specifically designed for CNAs. Examples of recent courses include a class on safe patient care and stress/end-of-life care. Each one of these courses provided eight contact hours.

Centers for Disease Control and Prevention

The U.S. Centers for Disease Control and Prevention’s (CDC) mission is to develop sound public health policies, promote healthy behavior as well as provide leadership and training. As part of this goal the CDC offers free continuing education for members of the medical community.

Courses in HIV education/treatment and other CEs are available on the website: http://www2a.cdc.gov/ce/availableactivities.asp. Take a look at the site to see if any available courses might fit your needs.

Armed Forces Service

If you are a working CNA and a member of the military on active duty for at least six months, some states will not require you to take in-service CEs that year. This exemption also applies to CNAs that are spouses of military members who were caused to be absent due to their spouse’s military duties. Check with your state’s board of nursing to see if you qualify.

Promotional Arrangements

Some companies, such as Johnson & Johnson as well as certain colleges will offer free CE courses. The majority of courses provide one hour; however, these units add up quickly. Here is a list of colleges that currently offer free courses:

• UCLA Health System
• Georgetown School of Nursing
• Kaplan University School of Nursing
• Walden University
• Chamberlain College of Nursing

To find out more information and to obtain a list of current Novell courses go to: http://ce.nurse.com/FreeCE.aspx. It’s up to you to investigate your options for free continuing education courses. These examples provide a starting point; check with the websites frequently for updated information.

This high demand for CNAs is also fueling the need for qualified CNA instructors. Before entering the workforce, certified nursing assistants receive hands-on training regarding procedures that will be later applied in medical settings, such as long-term facilities, hospitals, nursing homes, clinics and other health care facilities.

It’s up to the CNA instructor to arm CNA students with the necessary tools that will help them succeed in the healthcare environment. CNA instructors must have the proper experience, aptitude and knowledge in order to prepare future CNAs for the demands and requirements of the job.

CNA Instructor Qualifications

What does it take to become a CNA instructor? First and foremost, any qualified teacher needs to understand what characteristics are needed to educate and motivate students. Effective instructors utilize the following personal traits daily:

• Patience
• Knowledge
• Experience
• Compassion

In addition to these fundamental character traits, potential CNA instructors must be aware of the licensing requirements that are needed in the state where they want to teach. Contact your state’s nursing board to determine their specific licensing process.

Experience

Most states require two years of on-the-job experience working with elderly or chronically ill patients. Experience and familiarity in nursing homes and long-term care facilities will meet these requirements.

Prospective CNA instructors must not have any active administrative actions pending on their record at the time of application. Additionally, you must obtain your registered nursing (RN) license to become a CNA instructor. This will require you to take and pass the National Council License Examination (NCLEX – RN), and successfully graduate from an accredited nursing program. Most states also require two years of work experience as an RN before becoming an instructor.

Education

Prospective CNA instructors must pass a state-approved instructor training course. This course is available through technical schools, community college and nursing facilities. Your states nursing board can provide you with the specific requirements of your particular state.

Most states require 15 to 20 hours of instruction that will provide you with the necessary duties as a CNA instructor. Here is an example of an actual current instructor training program. This class is offered through Lincoln Land Community College in the state of Illinois:

Course Description

This five-day course qualifies RNs to teach the basic nursing assistant training program. The class includes a four hour lecture on Alzheimer’s disease and a clinical workshop.

• Date- August 8-12
• Time- 8:30 AM- 5:00 PM
• Cost- $480.00 per student

Obtaining Your License

Now that you have the necessary experience and have completed your education requirements, it’s time to obtain your CNA instructor license. To obtain your license, you will have to submit an application along with the required fee to your state’s nursing board. Some states will also require you to pass a background check.

After you have successfully navigated through the educational and licensing process, you can begin a rewarding career as a CNA instructor. Whether you choose to teach in a community college, technical school, or trade school, you can rest assured that your hard work has paid off.

Instructor Duties

As an instructor, you will be responsible for teaching courses in nursing theory and clinical practice. You will also train students to take patients vital signs as well as to observe and record patient health changes. In addition to the technical skills, you will also instruct CNA students to spot and clear safety hazards from the patient’s room.

On a daily basis you will supervise students as they practice clinical skills such as:

• Mobility
• Feeding
• Toileting
• Hygiene

Along with supervising these skills, you will review the student’s progress with the ultimate goal of preparing them to successfully pass the CNA exam.

Unfortunately, not everyone passes the test on their first attempt. If you find yourself in this unfortunate circumstance, don’t worry you will have another chance to shine. Most states will allow you to retake the exam up to three times within two years of completing your CNA training.

You only need to retake the section that you didn’t pass. If you fail both the written and skills sections, you will be allowed to retake both areas. If you are unsuccessful after three attempts, you will need to retrain at a state approved CNA program and then restart the testing process after training.

While it’s always good to have a backup plan just in case you don’t pass, there are several steps you can take that will help you ace the test.

How to Pass the Skills Section

Most people that don’t pass the exam usually have trouble in the skills section of the test. Since you are tested randomly on five skills from a list of 25 potential nursing functions, you need to be proficient in all 25 skills.

The best way to perform well in this section is to practice each set with a classmate or partner. Take the time to review your training notes and rehearse all possible scenarios until you can put them to memory.

Another potential resource is to investigate your study options online. Download a skills section study guide or take the time to watch hands-on CNA training videos that are available online. Many times these videos are performed by people who have gone through the CNA testing process.

Additionally, don’t forget that during the actual test, you will be evaluated by an instructor. Most people fail the test because they don’t remember to do the simple steps. It doesn’t matter how good you are at a particular skill, if you forget to do the crucial steps, such as wash your hands or knock on a patient’s door.

How to Pass the Written Section

There are practice written tests that you can acquaint yourself with online. This is a very effective way of scoring and measuring your progress. The written tests will provide you with sample questions and a chance to grade your score at the conclusion of the exam. Take as many practice tests as you need until you feel confident that you are ready to take the actual CNA exam.

Here are a few additional tips that will help you study and take the written portion of the exam:

Study Tips

• Don’t cram all the information in right before the test. Space out your study. Use a CNA Practice Study Guide
• Take detailed notes during training.
• Take breaks during studying sessions. Your memory retains information at the start and end of studying better than what you study in the middle of the session.
• Test yourself frequently with flashcards.

Test-Taking Tips

• Read the entire question carefully before answering. Don’t make assumptions.
• If you don’t know the answer to a question, skip it and go back later.
• Budget your time carefully and don’t forget to bring a watch.
• If you have time, read over your completed test and make sure you answer all the questions.

A certified nursing assistant plays a crucial role as a vital member of the healthcare team. CNAs are directly responsible for ensuring basic healthcare needs in a variety of settings such as: hospitals, nursing homes, community health care facilities, clinics, and in private homes.

After training and successful completion of the CNA exam, you will need to determine what type of facility that you want to work at. Keep in mind some of the following options when choosing your preferences:

• Choose your environment – Do you want to work in a large or small facility?
• Choose your location – Do want to work in the city you live in now or would you rather relocate?
• Type of facility – What type of facility are you best suited for? Talk to CNAs in a variety of settings; this will help you clarify your preferences.

Employment Resources

Now that you have picked the type of facility you want to work at, it’s time to research your opportunities for employment. As a qualified CNA, you have several options that are readily available for you during your job hunt:

Staffing Agencies

A CNA staffing agency can assist you in your search for employment. A staffing agency can help you find the ideal job in the setting of your choice.

A qualified staffing agency can offer you benefits such as:

• Flexibility in the amount of hours you work.
• Type of setting, where you work
• Location of employment
• Convenient way to find jobs

The role of the staff agency is to fill both full and part-time positions along with temporary and hard to fill vacancies in a wide variety of healthcare facilities. The agency will also consider your qualifications and match them up to the correct institution.

Networking

During your job search, don’t forget the simple, yet effective concept of networking. Talk to other prospective CNAs and find out what resources they are using for their job search.

Seek out other working CNAs. They are often equated with the needs and “inside scoop” of their places of employment. They may also know somebody in human resources that may have potential information about current or future vacancies.

Networking is also a viable resource for a new CNA to discover the pros and cons of the different types of medical settings and environments. If you decide later in your career to pursue other advanced nursing options, networking will be a valuable resource to help propel you in your search for additional training and employment opportunities.

Pound the Pavement

If you are the type of person that feels comfortable taking the job search into your own hands, this is another very viable opportunity for you to uncover that perfect job.

Visit local hospitals, nursing homes, or whatever type of setting you choose. Sometimes, a position has not been publicly advertised or is just getting ready to become available. This proactive search will help you get a leg up on the competition.

Don’t forget to visit the career centers of vocational schools. Talk to your school’s counselor about potential resources regarding the job process. Some schools have dedicated programs that help to place recent graduates in positions at local employers.

The requirements for renewing a lapsed licensed can vary from one state to another.  Many states will require you to take a CNA refresher course if your certification has lapsed.  This course is intended to provide you with a re-introduction to the certified nursing assistant field if you  have not worked in the field for awhile.  The course is needed to make certain that you still have the knowledge and skills you need to work as a nursing assistant.  The length of refresher training programs can vary depending on the state where you live and work and the facility providing the course.

Before you read about refresher courses, check the CNA classes page for training programs in each state and the Free CNA training classes page for free training.

Where and How to Attend a CNA Refresher Course

You might very well receive or be able to receive information about how to renew your certification and details on a refresher course from the Nursing Aide Registry in your state.  If you cannot find the information you need, you can try to contact the Nursing Board to find out if they have any information pertaining to the recertification of certified nursing assistants or if they could refer you to the State Department that handles these issues for certified nursing assistants.

Courses can be offered in a variety of locations.  A refresher course must be approved by the state in order for it to make you eligible to obtain certification once again.  A training program is often offered at a nursing care facility.  This could be s skilled nursing home or even a continuing care community.  Sometimes other types of healthcare facilities also offer such courses.  You will find that some colleges and institutes of higher learning will also provide C N A refresher courses.

More About the Course

A CNA Refresher course will include a classroom portion.  There should also be some type of clinical segment provided.  This will provide you with the opportunity to practice your certified nursing assistant skills once again.  This is particularly important if you have not worked as a certified nursing assistant for quite some time.  The exact topics covered by the course can vary among states and even courses themselves.

There are various topics areas that are likely to be covered.  You will probably receive an overview about the CNA career as well as an overview of the duties and responsibilities of a nursing assistant.  You will likely learn once again how to protect a patient’s privacy as well as their dignity.  Communication skills should be practiced once again.  A refresher course should include information about infection control

The refresher course will help you to once again learn the basic nursing care skills that you will be using as a nursing assistant.  You will learn the ways to help patients with activities of daily living.  It is likely that the course will include training on how to provide end of life care for patients.  You will also learn how to provide restorative care services.

A refresher course will prepare you to once again work as a certified nursing assistant.  You will practice the skills that you might not have used for awhile.  Some states will require successful completion of the course only.  There might be some states or circumstances under which you need to also sit for the nursing assistant certification exam.