This is the first in a weekly series on what the roles of the various departments are in the nursing home. My hope is that by spelling out what each department does, and how they work together, it will be easier to advocate for your loved one by clear communication to the correct department.
My opinion (not all that humble) is that the Certified Nursing Assistant is one of the single most important roles in the nursing home. These individuals are often the first ones to meet and greet a resident upon admission, as well as the last to give cares to them. The role is the single most challenging one I ever had in the nursing home, mentally, emotionally or physicially. However, as I tell my students regularly, it was undoubtedly the most satisfying. There is an incredible feeling that comes from those moments when a resident finally trusts you to share their story, or when you can provide that last bit of care to a resident who has passed on, or break through and communicate with someone suffering from severe dementia. All of those moments happen to the Certified Nursing Assistant (CNA).
The CNA is considered the frontline caregiver. This person is a high school graduate who has completed a certification course that is around 120 hours of lecture, lab and clinical experience. She or he has also had to pass a state exam- a two hour written test and a practical skills test- successfully. The average pay range for a CNA in a long term care facility is $11-15 per hour.
The CNAs work under the supervision of the Registered Nurse or Licensed Practical Nurse. They can be expected to perform non-invasive procedures, such as collecting urine or stool specimens or obtaining vital signs. They report to their supervising nurse and document the cares they give in some capacity in most facilities.
The individuals that work in this role complete many different aspects of care. They provide the brunt of the physical, hands-on care to residents, including bathing, dressing, toileting, feeding, and mobility. These are the folks who will get a person ready for their day, help them complete any task throughout the day, and help them get ready for bed at night.
The CNA also provides significant social interaction to the long term care resident. She or he interacts with the residents multiple times during the day, providing emotional support and mental stimuli. This is also the person who is likely to first notice a change in condition, due to the intimate nature of the cares given to the residents, and the frequency with which those cares are given.
For you as the family member/advocate, the CNA is an appropriate resource for how a resident has been interacting with them, or simple factual questions such as how the resident ate at breakfast today. However, complex medical/nursing questions should go to the charge nurse. The CNA is often instructed not to give out information on residents to any family members, in this day of HIPAA and stringent privacy policies. Therefore, do not be offended if a CNA refers you to the nurse with your questions.
This group of people is one that will have a significant effect on the quality of life of the residents in a nursing home. Observing their interactions with your loved one can give you a clear indicator of how they percieve their role to be. Any concerns regarding a CNA can be taken to the charge nurse, social worker, or Director of Nursing. Compliments (although best if given directly to the outstanding CNA) should also go to the charge nurse and the Director or Administrator.
Any experiences with CNA’s that you want to share?
