In order to obtain certification or licensure as a CNA, one must attend an approved course for certification and pass a certification exam. The State Board of Nursing has lists of programs approved for certification (which you can also find here on our website.)

Why attend Approved CNA Training Program?

There are times when those seeking CNA certification already have clinical experience and knowledge, and they may find it difficult to understand why they have to undergo a basic course in something of which they already have knowledge and practice. Because State Boards require very specific procedural steps and knowledge for licensure, the Boards have found that the exam failure rate of those who are not program trained tends to be much higher than those who are trained in approved programs. Approved training not only means a higher rate of success in passing the exam, but is also an excellent indicator of who will be more successful in their work as a CNA. Greater success on the job means greater safety for the patients being served.

The Process

When one has completed (or shortly before completion of) an approved course, the trainee will then apply for certification to the State Board of Nursing. The certification process involves passing a two part test, a written and a practical examination, and also passing a background check and being fingerprinted. When all of these components are successfully completed and the State fees are paid (either by the facility training the individual, or by the individual themselves), the Board of Nursing will issue the license.

CNA Recertification and Renewal

In order to maintain one’s license from year to year, one must be employed or have been steadily employed as a CNA. This shows the Board that the CNA is practicing and keeping up with their licensed skills. If these conditions are met, the CNA must pay the renewal fee on or before the recertification date, and the Board will issue the renewed license. There are allowable periods of unemployment before the CNA must take a refresher course and/or retake the examination. These periods differ from state to state, and should be checked on the state website.

If the certification is allowed to lapse by not renewing on time, it is often necessary for the CNA to present themselves in person at the State Board in order to renew the license.

Infractions of policy or protocol, operating outside one’s scope of practice, or disciplinary action can result in suspension of the certification. In the case of suspension, the CNA must request a waiver or hearing in order to reinstate the license. There may be other penalties associated with reinstating the license, varying according to state law.

The average approved, certifying CNA course is 120 hours long. The CNA learns the basic skills of care, comfort, and communication. A basic CNA course is divided into classroom learning and clinical experience.

Classroom Learning

In the classroom one learns the principles of patient care including but not limited to: patient rights and privacy, documentation and reporting, infection control, anatomy, healthcare team responsibilities, scope of practice, procedures and protocols, and least restrictive environments (LRE).

Patient Rights and Privacy

The guarding of patient information is critical wherever one works, so a nursing assistant will be carefully trained in this matter. The laws governing patient rights and privacy were established under the second incarnation of the Health Insurance and Portability and Accountability Act, known by all health care workers as HIPAA. Facilities take HIPAA very seriously, as they are tested annually on their compliance with HIPAA. If the facility is not in HIPAA compliance, it can lose its accreditation and can be shut down. Therefore, as a facility employee, one must be completely familiar with HIPAA guidelines and practices which include privacy of all written, verbal, and documented communication regarding the patient and/or his treatment. Ignorance of HIPAA can result in a complaint against the CNA by patient or staff members which could result in suspension or loss of license. Even a casual remark in an inappropriate setting can result in a complaint or investigation. Part of the annual compliance test is observing the CNAs at work as to their personal compliance with the act.

Documentation and Reporting

In addition to safeguarding information, the trainee will be taught proper observation, documentation, and recording methods. Increasingly, these documents and reports are recorded and generated by computer, so computer skills will likely be an important part of one’s training, especially in a school setting.

Infection control

Infection control procedures are a critical part of the CNA’s training, as the spread of infection impacts the entire facility, not only the patient, but all staff and visitors as well. The CNA will be carefully trained how to prevent the spread of infectious disease through cleanliness, isolation, and the use of personal protective equipment (PPE).

Anatomy

Basic anatomy will be covered in the CNA coursework in order to understand the disease process, and how the CNA’s handling of the patient and routine care are best approached.

Healthcare Team Responsibilities and Scope Of Practice

Learning ones role in the healthcare team, and the limitations of ones practice are essential in providing full, knowledgeable care for the patient. The CNA’s scope of practice refers to the tasks within his or her certified skill set. It is important to know one’s scope of practice as defined by one’s State Board of Nursing in order to protect him or herself, the patient, and the nurse.

Procedures And Protocols

A large portion of the CNA’s training will be devoted to learning specific care procedures and protocols (the order in which things are done).

Least Restrictive Environments (LREs)

Learning about LREs teaches the CNA to remain within facility and legal guidelines governing the patient’s environment. This will include such things as learning when bed rails must, can, and cannot be used; learning the best practices for handling difficult or combative patients which will allow them the greatest amount of freedom with the least amount of injury to themselves and others.

Clinical Experience

In the clinical portion of the training, the trainee will learn body mechanics; patient movement, including transfer, transportation, and range of motion; comfort and care procedures such as peritoneal care, changing an occupied bed; safety and preventive care, such as preventing skin breakdown, fall prevention, hazard avoidance; personal protective equipment; handling laboratory specimens within the CNAs scope of practice; activities of daily living (ADL) assistance, and other procedures as necessary.

The training time for CNAs varies from state to state, but the average training requirement is 120 hours. In these 120 hours, the CNA learns critical skills of care and communication. There are also opportunities for advanced training. Actual hours and approved programs are available through one’s State Board of Nursing. Links to school sites are also available through this website.

Basic CNA training is divided into classroom learning and clinicals, followed by taking the State Board Examination.

Classroom learning: In the classroom one learns the principles of patient care including but not limited to: patient rights and privacy, documentation and reporting, infection control, anatomy, healthcare team responsibilities, scope of practice, procedures and protocols, and least restrictive environments (LRE).

Clinicals: In the clinical portion of the training, the trainee will learn body mechanics; patient movement, including transfer, transportation, and range of motion; comfort and care procedures such as peritoneal care, changing an occupied bed; safety and preventive care, such as preventing skin breakdown, fall prevention, hazard avoidance; personal protective equipment; handling laboratory specimens within the CNAs scope of practice; activities of daily living (ADL) assistance, and other procedures as necessary.

State Board Examination: The exam consists of a written portion which tests your knowledge of principles, and a clinical portion which tests your ability to actually perform procedures. A list of what is required for the test is available from the State Board. The exam is not given through the school or facility where one is trained, but in a controlled environment, usually at the State Board office.

Continuing Education: When working for a facility, especially in acute care, there will always be continuing education opportunities, some which may be mandatory if the CNA is moving among various departments. These opportunities may include telemetry, behavioral health, advanced infection control, critical care, rehabilitation, Alzheimer’s and Hospice care, etc.

There are professional organizations that the CNA can join, such as the National Network for Career Nursing Assistants, http://www.cna-network.org/, which will also offer many opportunities for continuing education.

If the CNA wishes to advance in training and career, there are always opportunities to learn specialty skills such as telemetry monitoring, phlebotomy, Health Unit Coordination, or medical terminology among other skills.

Phlebotomy skills are generally beyond the scope of practice of the CNA; however, they can be extremely useful if the CNA wishes to advance into such positions as Medical Assistant or Nursing.

CNA certification and training is also a valuable step toward a nursing career. Many hospitals offer the CNA free schooling as an RN in return for a specified term of future employment as a nurse.

Nursing aide or commonly known as CNA is a title given for nursing professionals who provide day- to-day bed side care for patients or elderly people. CNAs work under supervision of licensed nurses such as: LPN or RN.  Common working places for CNA are hospitals, nursing homes and long term care centers. Even though nurse aides commonly referred as CNA, they also have the following titles: nursing assistants, geriatric aides, unlicensed assistive personnel, orderlies, or hospital attendants. So don’t get confused by these titles, they all mean almost the same thing.

Training

There is minimal entry requirement to become CNA. Training and certification of CNA is a breath to complete and usually doesn’t cost much as well. In fact there are a lot of options one can get the training for free.  A typical CNA training program last for two weeks (it may even take less than that and some course may last as long as 12 weeks) and the cost may vary from school to school but the most expensive training will not cost more than $1000. The training is usually offered in high schools, vocational or technical schools, some nursing care centers may also provide the course, and some community colleges also provide the training.

There isn’t much to learn in CNA programs as it is a true entry level profession. A typical CNA training program curriculum may include the following courses:

• Body mechanics
• Nutrition
• Anatomy and physiology,
• Infection control,
• Communication skills, and
• Personal care skills (these set of skills include: how to help patients bathe, eat, and groom themselves, etc)

Prerequisite

Candidates must be physically capable of handling the job. Usually a weight lifting capacity of 5olb is required. In addition to that you must also be free from the following disease: TB, Hepatitis B, measles, mumps, rubella, tetanus, and varicella. You need to produce proof of Immunizations as well.

In addition to the health related requirements, you also need to meet the following educational requirements:

• you should have high school diploma or GED,
• pass any reading & writing competency test you may be asked to take by the training facility,
• you should have clean criminal record.

Certification

After successful completion of the state approved training program, you need to take the cna certification exam admitted by your State’s board of nursing. Upon passing the exam, your name will be entered into registry of nursing aides and you can start work right away. There is some fee associated with the certification process but the exact number varies from state to state. You can get that information from our state board of nursing directory. All CNAs need to renew their certification every two years and there is some fee associated with the renewal as well. Unlike other licensed nurses, CNAs don’t need to complete continuing education to get their certificate renewed; however, you should work a specific number of hours during the two year period as a paid nurse aide in one of the healthcare facilities as stated by state BON.

Job Description

• Answers patient call lights
• Bathes, dresses and undresses patients
• Tidies patients’ room, changes soiled linen
• Assists with personal hygiene
• Serves meals, water and snacks
• Feeds patients who need help
• Transports patients, helps patients walk
• Takes and records temperature, pulse, respiration and blood pressure
• Records food and liquid intake and output
• Collects specimens; urine, stool, sputum
• Performs procedures including Heimlich maneuver, isolation, Universal Precautions, gait belt, post mortem care
• Observes and reports unusual conditions
• Measures height and weight using bed, chair and balance scales

If you are in need of job and if you are a caring and compassionate person, CNA can be a great job for you. As mentioned above, it is an entry level job and career advancing options are in abundant. The pay may not be that great at the start but CNA is a godsend, if you need a job with minimal entry requirements and low investment in money and time.

The difference between a Geriatric Aide and a nursing aide is simple: the specialty of Geriatrics is working with the elderly population while a nursing aide is trained to provide direct care to all ages of patients.

The Geriatric Aide is trained in basic comfort and care methods as is the nursing aide, but the Geriatric Aide will also receive training in the specific handling of geriatric patients. Since geriatric patients often have different needs and need different precautions taken, the Geriatric Aide will be more specifically trained. These elements will be covered in basic nurse aide training, but with less concentration.

Geriatric Aides usually choose that particular specialty because they specifically want to work with elderly patients. Such training as fall prevention, skin care/breakdown/tears, dementia, Least Restrictive Environments (LREs), and even how medications can affect an aging person differently than the average patient are all things covered in the specialty training more in depth than in basic nurse aide training.

The primary differences between a Certified Nursing Assistant (CNA) and a Licensed Practical Nurse (LPN) are training and responsibility. The LPN has a wider scope of practice and can do more things independently than a CNA. Also, the LPN earns a greater salary, often beginning where the CNA salary ends.

An LPN completes a nine month to one year training course, where the CNA course is on average 120 hours long and can be completed in a few short weeks. Becoming a CNA first makes it possible for the aspiring LPN to begin working in a clinical setting gaining employment and experience.

The basic differences in the scope of practice of an LPN and a CNA are that an LPN can administer medication or IV meds previously chosen from a protocol by an RN or MD while a CNA cannot. An LPN can also start and/or activate an IV. An RN can delegate specific tasks to an LPN that would not normally be performed by an LPN if the RN believes the LPN is capable of such, but an LPN cannot delegate tasks to another LPN or to an aide.

An LPN is trained in anatomy and physiology and is trained to differentiate “abnormal” from normal in the body, and is introduced to the disease process. This is not part of CNA training.

The LPN is also trained in pharmacology whereas the CNA would only have exposure to pharmacology training if he or she was also a certified Medication Aide.

Even though the differences are great between a CNA and an LPN, it is becoming common for someone applying to nursing school to receive greater priority in the acceptance list if they are CNAs than someone who has never worked in a clinical setting. Studies have shown that first time LPNs who have not had nursing assistant training and experience are less likely to be successful due to the overwhelming nature of first time clinical exposure where more of the burden is placed on independence.

While Medical Assistants (MAs) can be employed with the same duties as a CNA, there are distinctions between the two. So, what are the basic differences between a Medical Assistant and a Certified Nursing Assistant?

The first difference is evident between the two titles – a CNA is employed most often as an assistant to the registered nurses (RNs) in direct patient care in a clinical setting while a Medical Assistant will be more often employed in a medical office to perform routine clerical and clinical tasks. While the Medical Assistant can assist nurses or doctors, the Medical Assistant should not be confused with the Physician’s Assistant who is much more highly trained in specific responsibilities, and who assists the physician directly.

The Medical Assistant is also routinely trained in phlebotomy where a Nursing Assistant is not. A CNA may attain phlebotomy training (usually at his or her own expense) in order to be more employable in varied settings. An MA will also be trained in front office procedures including medical terminology, transcription, insurance, reception, etc. Since the CNA is rarely called on to perform such duties (usually only in a case of a suddenly absent Unit Care Coordinator), and since the CNA’s focus is more on direct patient care, this is not a necessary focus of CNA training or scope of practice.

It can be more useful to be a CNA trained in other specialties or certifications such as phlebotomy, medical terminology, and medication certification which can be obtained singly over a period of time than to be trained in a single specialty. This allows the CNA many more employment opportunities inside and out of the clinical setting. Often, CNA training and experience is valued by an employer because having been exposed to the clinical setting can mean a greater depth of understanding of the needs of patients, doctors, nurses and other staff members across the board due to the broader day to day experience in a clinical setting.

There is a large difference between the scope of practice of a CNA and a Medication Assistant Certified (MA-C), but the CNA may consider adding Medication Assistant certification to his or her skills in order to be employable in a wider range of positions.

The CNA is employable in many different clinical settings, and after a period of gaining experience, may work in acute or subacute care, longterm care, or specialized care, but in order to work in assisted living homes, one will often need to be certified as a Medication Assistant as well.

The CNAs duties surround comfort, care, and communication, but preparing or administering medication is outside the scope of the CNA. In most clinical settings, medication is handled by a licensed practical nurse (LPN) or registered nurse (RN). A CNA should never handle any medication in a clinical setting, nor should they be asked to. It is a clear violation of the CNA’s scope of practice.

Because assisted living homes are often quite large, and one of the assisted tasks is ensuring the clients receive their medication at the proper time in the proper dosage, it is not always feasible for an assisted living facility to have the clients visited by an LPN or RN. Therefore a CNA who is also certified as a Medication Assistant is the most practical and economical solution for the care center.

The MA-C is licensed to prepare and administer medication, which, because the administration of such is subject to error, incurs more liability for the facility and staff. Thus it requires special training and certification. The MA-C also has a specific scope of practice, and can only prepare and administer certain types of medications, observe and report.

An MA-C is not expected to or ever given the obligation of calculating dosage, assessing the patient’s need for or reaction to the medication, nor administering parenteral medication or any medication which must be administered via a tube, such as nasogastric, gastrostomy, etc.

One can see how the certifications and scope of practice are radically different between a CNA and an MA-C, but also that they can be complimentary skills. Adding the certification as a Medication Assistant can open up non-clinical positions or possibly a clinical position within a longterm care home at a higher rate of pay.

It is possible to get trained in an approved online program as a CNA. Most of these programs have schedules which allow the trainee to continue his or her normal daily routine, whether job or childcare, while getting the needed certification training.

Most frequently such programs are available through online universities. There may also be other approved online programs designated on the appropriate State Board of Nursing site.

Such programs allow the trainee to learn appropriate skills through online study while scheduling practical, clinical experience through approved local venues.

There are also opportunities for additional training beyond basic certification online. At times, once the CNA gets into the field, he or she might become aware of an area of expertise where one feels inadequately trained or prepared. It is also possible that the CNA might find themselves requested to perform in an area (such as Alzheimer’s or Hospice) for which he or she was not specifically prepared. Often one can find refresher courses or new skill courses online for a reasonable fee, often as low as $19.95 for a specific course. These courses will be for the purpose of enhancing ones knowledge in a specific area as there will not be a clinical portion involved. It would be up to the CNA to demonstrate to his or her employer the skills gained by taking such a course.

It’s not really possible to complete the whole CNA course online as it evolves a lot of lab and clinical training. But if you are in a situation where you want to save as much time as possible, you can find a number of schools which provide the theory part of the training online and the practical at your nearby healthcare facility.

Online training is not for everyone but it’s a great option for people with little to no time to spare for classroom sitting and relatively OK computer skills. To learn CNA online, you don’t need to have special computer skills; however, you should have the basics like: browsing the internet, run any software on your PC (usually the training comes as a text book in pdf and/or series of videos).

You can find a lot of schools (usually private) that provide online CNA training in our accredited CNA training programs database. The programs are gathered from each state board of nursing websites and formatted and categorized concisely for ease of use. Please start your search from your home town and work your way up to other states if you cannot find any programs in your area.

Other alternatives to online CNA training are evening and weekend classes. It’s very common to find training faculties that provide classes this way and they are particularly designed for adults who are working other jobs and want to switch to CNA without jeopardizing their current job. I highly recommend that you try to find these kind training options first before going for the online programs.

Training as a CNA can open the door to other career opportunities with greater earning potential. With the shortage of nursing instructors, it is more difficult to get into nursing school these days. Often one of the requirements for nurse training, or an advantage that can help open the door to advancement is to have training and experience as a CNA first.

As a CNA, one experiences not only routine patient care, but also the clinical setting as a whole. Facilities are much less likely to hire a newly trained LPN who has never had actual care experience than one who has operated in a clinical setting as a CNA. According to statistics, the LPN also has a greater success rate if he or she has prior exposure as a CNA.

After several months or a year of clinical experience, the CNA has a better idea of whether or not a nursing career is desireable. The next logical step is the one year LPN program.

An LPN, in certain circumstances, might be performing the same routine as a CNA, but because he or she has a better understanding of treating a patient, and the potential of performing tasks outside the scope of the CNA’s practice, the LPN will be paid more for the same work.

LPNs are often hired as medication nurses because their training provides them with training in pharmaceutical medications. Their primary role will be ensuring the patients receive their medications on schedule.

An LPN may perform duties that an RN doesn’t have time to do, and may be outside the scope of practice of a CNA such as wound dressing, inserting catheters, and starting intravenous fluids.

Often CNAs can find online programs that will allow them to continue to work as a CNA while training as an LPN. This would consist of online courses via the Internet, and scheduled clinical training at local facilities. At the end of the studies, the CNA would take the NCLEX-PN examination in order to be licensed as a practical nurse.

LPN coursework can contain, but is not limited to, biology, chemistry, anatomy, psychology, emergency medical technology, first aid, physical education, foods and nutrition, and child growth and development. These subjects go beyond the training of a CNA, so one can see the potential for working in areas not open to the CNA.

While the CNA earning potential is between $20,000 and $30,000, the LPN salary usually begins around $31,000 and in certain settings can run as high as $58,000.