Working as a CNA / Certified Nursing assistant

Bumping Heart

In today's difficult economy situation I constantly see adds for CNA crash classes, that attract many unemployed people of different ages, due to their short duration - two weeks or so, and the greatest demand for certified nursing assistants nation-wide. But, as in many other fields, nearly 100% of the applicants have little or zero idea what the real CNA work is.
And as a result of this, many of the newly certified nursing assistants quit shortly after they are hired and thus wasting money and efforts in acquiring a new profession.

The purpose of this publication is to give some insights on the real CNA work and help you make up your mind whether of not this job is for you.

Certified Nursing Assistant / CNA job is one of the most extreme jobs in the USA

Yes! This statement is absolutely right and is based on 8+ years experience in more than 50 different health care facilities including nursing homes, rehabilitation centers, assisting living facilities, large hospitals and private houses.

In the text below I will elaborate on the work in the nursing homes as the most common place for a CNA to find a job, but will also point at other possibilities to work as a CNA.

Nursing homes are the single most regulated places in the USA, before ANY OTHER PLACE you may think about.

This simply means that they are closely watched by different institutions as well as many law firms, whose main motivation is just to make profit out of them.

I highly recommend to anybody, who is going to enter this field, to take their time and visit some nursing homes, look around and talk to the staff members ( nursing assistants ) or just observe / listen to them, pay attention to their emotions as they work.

The work environment

1. Residents.

There are people of all ages living in the nursing homes: elderly, who have lost ability to take care of themselves; handicapped; people with severe illnesses, bound in bed for the remainder of their lives; humans artificially maintained to stay alive, just because they failed to take control of their lives and put someone else to take decisions on their behalf. But you can also find here individuals, purely abusing welfare system, since they are too lazy to work.
Most of these people do appreciate Nursing Assistant's work and the care given, but there also are some extremely difficult people, no one in the 'normal society' outside wants to take care of, who can turn your life in real hell. Hence, it is VERY IMPORTANT for the CNA to have full control of their personality, ego and mind, before getting in trouble.

2. Daily duties challenges.

Anybody, who has ever been in a nursing home, beyond the lobby line, has most likely faced the usual heavy smell (from urine and feces) inside the building. This is what turns back some of the beginners-CNA-s before they have even started.

The main task for the nursing assistants is to help residents with ADL-s ( activities of daily living ) and provide all the routine care, such as:

  • dressing and undressing the residents
  • turning and repositioning bedridden residents
  • feeding
  • cleaning up residents' body excretions ( urine, feces etc. )
  • bathing residents
  • changing linen and making beds
  • transferring residents from bed to wheelchairs or other chairs and vice versa
  • answering residents' calls for help
  • observing residents conditions and reporting if there are any changes
  • charting

As you can see from all of the above, the Nursing Assistant job is a very demanding, physically and emotionally, job that requires being always in higher state of body and mind to successfully complete all work and face all the challenges. There is really lots of lifting involved in CNA work and back injures are very common among them.

And the Nursing Assistant job is accompanied with constant stress due to:

  • lack of time

Remember, that you may have a dozen people ( normally for day shifts is 8-12 people ) and at certain times several could be calling you at the same time.

  • working in an infectious environment

People in the nursing homes are prone to all kind of infections and infectious diseases are something common there.

  • dealing with very difficult personalities, who are always "right" according to the law

Sometimes Nursing assistants could be exposed to extreme abuse from such patients.

  • dealing with the administration and outside visitors

Some people want to promote their own ideas on the residents direct care that might be detrimental for the ones they are concerned about. Usually these are people, who have never had their 'hands on' in this kind of work.

  • dealing with 'problem' co-workers

Many people 'bring' their life problems to their work place, which affect more or less their co-workers. There are plenty of problems in a nursing home to bring just more. Due to excessive and prolonged stress, some of the CNA-s simply burn out and become real danger for all others.

Finding Nursing assistant / CNA job

1. Nursing homes.

As I previously mentioned, the most common ( and best for beginners ) place to start is a nursing home. I strongly recommend this for the simple reason that this is the place one can master most of the skills needed and, opposed to home care, there is always co-worker to help in extreme situations ( and there are plenty of such on a daily basis ).

There are two options to work in the nursing homes: being an employee there or working for a staffing agency. My preferred is the second option, but I also had periods of time as full time employee in a few nursing homes. Those were periods when I needed a stable income. There are three types of employees: full-time ( 32+ hours/week ), part-time ( certain days of the week or week-end ) and flexible ( also called "pool" or "PRN" ), as needed.

What is the difference between being an employee and working for agency?
Working for a staffing agency means, you should be able and ready:

  • to drive to different places in a wide area
  • to work any shift in order to make sufficient number of hours
  • to quickly adapt to different environment, equipment, paperwork and policies ( nursing homes policies differ from each other ).

From the above you can make the conclusion: "Why to work for agency, when it seems to be more stressful?". Yes, it is more stressful, but at the same time helps you to develop flexibility, better reaction and sense to all job related matters. The more places and people you see, the wider your horizon is and the more qualified you become. And another point, for me personally, is that working at one and same spot for months is boring.

And, with a staffing agency, your pay rates are usually higher. The normal pay rate for Nursing Assistant / CNA jobs in the nursing homes is in the range of $ 9-12 /hour depending on experience. At times, with agencies, I have gotten up to $ 16 / hour. Recently, here in Florida, the nursing homes use lesser and lesser staffing agencies, but they still remain personnel source for hospitals and mainly for home care.

2. Assisted living facilities.

Many assisted living facilities, here in Florida, still hire CNA-s, but they usually have non-certified staff to care for their residents due to specifics of the work ( no medical care involved ). The CNA working there are usually certified in administering with medications and are called "med-techs". Of course their job could be combined: passing medications and residents' direct care.

3. Hospitals.

Hospital CNA-s are rarely involved in intense physical work. Patients here come and go within short period of time and what they need is just a little help around. This kind of work includes lots of "light" tasks, walking around, taking vital signs and a lot of charting on the computer. But some hospitals have long term care units ( for example for people with tracheotomy on constant mechanical ventilation ) where the work is the same as in the nursing homes.

4. Home care.

As I previously stated, this kind of CNA work is for experienced nursing assistants ONLY ( lack of experience may have serious consequences and cause severe damages ). The shift duration may vary from 1-2 hours up to 12 hours and the work may include all CNA duties from the nursing home. And since this is "one to one" care in patient private houses, the nursing assistants should be experts in their job as no helpers could be available around. The CNA-s also need to have excellent communication skills and personalities to promote medical care and easy the clients' conditions.

Such jobs could be obtained through Home Care Agencies of privately through newspapers adds or specific websites ( Craigslist is the most common and used source ).

5. Other job sites.

These include: doctors' offices, rehabilitation centers, special care facilities ( for addicts, behavior centers, Alzheimer centers and others ). They all have specific rules and require specific skills to be deployed.

6. Hospice jobs.

Hospice care is delivered to patients in hospitals, nursing homes, assisted living facilities, patents' homes and hospice residences.

Death is the single most important event in humans' life on Earth. For this reason it should be taken care of by the most loving, with open mind and heart, caregivers. Only those, who know about God Love qualify for this kind of care. Only such caregivers can help patients in their last moments in physical body to open for God and allow God to enter their heart and soul and finally free them. The most powerful prayer to experience God's healing love is God Yoga and it could be forwarded to anybody.

A good CNA is not the one who blindly obeys all the rules and regulations, but the one who obeys the only commandment from God: "Love all!".

And the final point:

Although the CNA work is extreme and stressful, the rewards are far beyond any material gains. Working as a CNA certainly helps to open your heart for all and spiritually grow and start feeling God's presence everywhere, anytime.

Happy Hearts

May God bless you on your path filled with love

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