How to become a nursing assistant (or) Orderly?

Nursing assistants, once known as the Volunteer Nurses’ Aide Service, date back to World War I where ‘The American Red Cross’ trained individuals to aid the nurses with the casualties of war. It was only in 1987 that the Congress passed the Omnibus Reconciliation which declared that trained assistants nurses could be hired to work alongside with nurses.

Indeed, nowadays the role of  nursing assistants who are found in the majority of the health care field, called CNAs (Certified Nurse Assistants) for short, is to help the patients by providing them not only with their day-to-day needs, but also monitor their vital signs such as temperature, blood pressure and sugar level, dietary restrictions and so on.

Step 1 – Do you have what it takes to become a nursing assistant?

What qualities should one have in order to be able to become a nursing assistant? First of all, CNAs must be compassionate, sympathetic and kind-hearted since they need to support their patients through difficult times, where they may be experiencing both physical and mental pain. Furthermore, nursing assistants should have a natural desire to help other people in need; in fact it could turn out to be unbearable if it is done only as a source of profit.

Additionally, they need be decision makers, not passive persons because they may come face to face with an instance where they must act fast and take quick decisions, otherwise the life of the patient may be threatened. They must also have a positive attitude to cheer up the patients when things are getting hectic or they are feeling depressed. Indeed they can be among the few who can make a difference in the lives of patients of all ages!

Since CNAs are responsible for assisting the patients with their daily routines, such as bathing them, moving them from a sitting position to a standing position, they must be physically strong; otherwise they would be unable to carry out such tasks! Working under the supervision of licensed nurses, nursing assistants must be able to treat the patients with dignity and the respect that they deserve! If you lack these qualities, I am I sorry to have to break it to you but this career is not the one you should be pursuing…

Step 2 – Enroll in a training course

In order to become a CNA, a college degree is not required since the credentials are issued by the state itself. As matter of fact, those who wish to become nursing assistants just have to enroll in a state-sanctioned training program. This specific training is of vital importance since as they will be responsible for other individuals, it is essential for them to familiarize themselves with the proper procedures and the correct protocols.

The average cost of the tuition fees is approximately that of one thousand and two hundred dollars. These training programs, which are quite challenging, are offered by many institutions; including the American Red Cross, local health care providers (example hospitals), community colleges, and vocational/technical schools. Training problems may also be provided online, however if this is the case, the majority of these online courses require the students to be present on the campus for the clinical part.

Nonetheless, due to the fact that CNA training requirements vary according to the state, those who wish to enroll in this course should check the regulations beforehand so as to make sure that the training course is recognized by their state, especially if you are considering to enroll in an online course since those which do not provide hands-on experience are not approved by most states. As a matter of fact, choosing a course that is not recognized in your state is useless and a big waste of time and money! Some of these institutions, after accepting them as new students, they may be asked to sit for a fitness test and may even carry out a background check to make sure they have a clean record!

What do the training courses focus on?

cna trainingIf you never paid any attention back in school, do not worry! Training courses offered by vocational/technical schools usually last between four to twelve weeks and, focusing mainly on both theoretical and practical training. The student gets to learn the fundamental nursing skills, about the infection control protocol, anatomy, and nutrition; preparing him to for the job market as a competitive applicant. On the other hand, those offered by community colleges lasting between six and sixteen weeks, aim to teach the students the value of compassionate and professional communication, apart from working as part of a team which enables them to become excellent team players. Whereas the training provided by hospitals, lasting between four and eight weeks, is quite fast-paced when considered to those offered by other institutions; students start working with patients from the very start. This enables the prospective nursing assistants to have a first-hand experience in the career they’re pursuing. Lastly, the four to eight weeks training course offered by the Red Cross, which is among the most well-known institutions, emphasizes on the art of care giving; including positioning, bathing and dressing the patients – in other words helping them complete their day-to-day needs.

If you have already obtained an associate’s or a bachelor’s degree in the nursing area or gained a Registered nurse certificate even though graduating from college is NOT a requirement, it will be advantageous to you! Once you start looking for a job as a nursing assistant you will be a more competitive applicant, and once employed it is most probable that you will start off with a relevantly higher salary when compared to that of your fellow CNAs who haven’t completed their college education.

Step 3 – Become a fully certified nursing assistant

certificationEven though the training course has been completed successfully, you are still not eligible to start working! To start working, you must be fully certified! In order to become a fully certified nursing assistant, you must sit for the CNA State Competency Test. This mandatory exam varies according to the state you wish to work in once you are fully certified. The aim of the competency test is to fully test your knowledge and proficiency in nursing skills. In some states you can start working while waiting to take your exams for up to four months! However, for legal reasons, this is not allowed in all the states which prohibit work until acquiring this certification.

Help in finding the nearest exam center is usually given by the instructor leading you through the training course you have recently completed. I advise you to sit for this exam straight after finishing your training when all the information is still fresh in your mind. Also, in order to prepare yourself better, you can find online test prep guides (locally provided are the most convenient) and examine yourself, while increasing your confidence.

What does the exam consist of?

cna examThe competency test consists of two exams – a theoretical exam and a practical/clinical exam. The theoretical part is made up of sixty to hundred multiple choice questions. These questions are based on the theoretical notions of nursing and are mostly about the basic responsibilities of a certified nursing assistant, the newest technology and tools that are used, cautionary measures to be taken in order to safeguard to health of the patient, law and ethics, safety, mental health needs, cultural needs, client rights and so on. The following a sample of a question that may be asked during this section:

When assisting a client in learning to use a walker, it is important to:

  1. stand behind him and use a transfer belt
  2. put padding all the way around the top rim
  3. let him walk by himself so he gains independence
  4. let him practice using the walker on the day he is discharged

The clinical part is the most challenging part of the test. For the latter exam, you cannot go alone; you need to take a friend! Why’s that? The friend you will take with you for the practical test will be your patient on whom you will demonstrate your care-giving skills to the examiner! This should make you feel more at ease, a friendly face always help soften the tension…

Apart from taking along a friend, the most vital things you will need to remember to take with you are a gait belt and gloves. A gait belt is the device used for moving the patients from one position to another, for example transferring them from a standing to a sitting position or transferring the patient from the wheelchair to the bed. The examiner will most probably assess you on three to five skills such as a partial bed bath, offering a urinal or bedpan, use of a gait belt, and making an occupied bed, while keeping a close watch on whether you take the necessary procedures for infection control (for example washing your hands and wearing gloves).

If you make a mistake, do not get nervous! These things are due to happen, especially if you have the jitters. The examiner is sure to keep this in consideration and will not fail you on your first mistake. If you realize you become conscious of your error, simply inquire him whether you can re-demonstrate, he will probably allow you to do so. You will be told whether you have passed or failed the clinical part, on the spot, right after finishing the demonstration has finished.

If unfortunately, you do not manage to pass either the practical part or the theoretical part, inquire the people responsible when you can reschedule it and whether you need to retake either both parts or just the one you failed in as it depends on the state’s rules. However, if you pass both parts you can start working immediately! You are now officially a certified nursing assistant.

Step 4 – You can finally start working as a Certified Nursing Assistant

Icon-NurseSMAt last you are eligible for nursing assistant jobs. As a newly graduate, even though this will be your first job in this area, do not give up on finding a job. With nursing assistant roles expanding faster than the usual job growth rate, according to the Bureau of Labor Statistics these work opportunities will grow by twenty one percent by 2022 – an addition of around 321,200 jobs – 730 new job openings per year, you will most likely be successful in finding your first job. This rapid growth is a result of an aging population and an increase in the number of people suffering from chronic illnesses.

Also note that it is illegal to offer your services as an independent provider. According to regulations, nursing assistants can ONLY operate under the supervision of licensed nurses. Even though one should pursue this career because he likes it and sees it as a mean of helping others, income plays a major role. The annual salary, which is dependent on many determining factors, including the state, experience, additional skills and training, ranges from twenty thousand to thirty thousand. The top paying state is Alaska, with a pay rate of $14.36 per hour, followed by New York with a pay rate of $13.63 per hour, whereas the lowest paying state is Louisiana with a pay rate of $7.57 per hour, followed by Mississippi with a pay rate of $8.16 per hour.

The key for a successful job interview

successful cnaIn order to find a good job as a nursing assistant, you need to be successful in the job interview. What questions could be asked? Firstly, it is most probable that the interviewer asks you to tell him a bit about yourself. Even though it is important to mention your academic achievements, discuss some of your personal experiences that you think will make you a good nursing assistant. Make it a point that you tell him why you are choosing this job in the first place – ‘I get along with people very well. Moreover I am a highly motivated and compassionate person; the latter is what motivated me to become a nursing assistant. I want to dedicate my time to help other people, make them feel at home and make sure they are well cared for.’ Now this kind of response will probably get you the job!

Other questions you may be asked are why you left your previous job, where you see yourself in a couple of years, what qualities you possess that you think will be useful and so on. The most important thing to remember during the interview is to be honest and keep both your feet on the ground… All you need to do is to think of why you are applying and you’re sure to do fine.

The Role of a CNA

As a nursing assistant, you are unlikely to have two or more day which are exactly the same. Your responsibilities will vary depending on whether you are working a night shift or a day shift and in which facility you will be working in. For example during a night shift, your responsibilities will include answering call lights, emptying catheters, helping patients get ready for surgery, and even provide support to people who are experiencing physical or mental pain.

The day shift is not as quiet as it the night shift. The busy hours start as soon as the patients wake up and you have to bathe them, dress them, help them eat their breakfast, and sometimes even give them their necessary medication. You must be able to manage multiple patients concurrently, for this reason you must be organised and efficient.

Being a nurse assistant is a highly demanding job; physically, mentally and emotionally. Hence it is essential to take care of yourself and not neglect your needs. In order to prevent injury, make sure you lift the patients properly. Furthermore, eat healthy, get plenty of sleep, and exercise, even if not regularly, to maintain your high energy levels during work. You can also participate in activities that will help you keep a mental stamina and help you relax. I know it’s easier said than done but after all, if you do not put your effort in taking care of yourself, how can you take care of others?

The thing that you must NOT ever do is go to work if you are not feeling well yourself. This may be a threat to your patients, especially the older ones who are more vulnerable.

Step 5 – Certification Renewal

accreditation-iconAlthough it is true that you are a certified nursing assistant, many states require a certification renewal every two years. In order to be able to renew it, you must complete a minimum of forty eight hours of continuing education. Even though it differs from one state to another, the majority of the states oblige you to do a minimum of twelve hours in each year within the two year time frame. During this period you will be receiving training on healthcare issues that are always evolving such as medical record documentation, first aid, and domestic violence. This continuing education is usually paid by the employee itself. It may be the case that your employee provides you with this training himself! In either case, you will not need to spend a dime while furthering your knowledge!

Step 6 – Why stop now?

Once you become a certified nursing assistant you need not stop there. CNAs can further their career by furthering credentials, allowing them to specialize in their work. These specializations include becoming activity assistants, medication aides, wound care associates, and patient care technicians. Other opportunities such as physical therapy assistants, registered nurses, and even occupational therapy assistants are possible by continuing their education.

Even though sometimes the job may be a bit tedious due to many long hours and work which may be very demanding, nursing assistants generally confess that they feel satisfied and confident that they are pursuing the right career because they are helping other people, people who rely on them to help them get through the day. If you are a CNA you are rewarded in some many ways, ways you will not even think possible until you get to experience them yourself!

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Similar Occupations

There are other medical careers with job duties that closely relate to those of nursing assistants or orderlies. Some of these occupations are as explained below:

  • Personal Care Aides: They typically assist clients or patients with self-care and daily tasks. Personal care aides also provide social assistance and support that allows clients to take part in the communities. There is no formal educational credential and the average salary is about $20,980.
  • Home Health Aides: They usually help people with cognitive impairment, disabilities or chronic illnesses with tasks of daily living. Home health aides frequently assist people who need help. Some states allow home health aides to dispense medication and check if patients have any vital signs under the instruction of a health practitioner or nurse. There is no formal educational credential and the average salary is about $21,920
  • Psychiatric Technicians and Aides: They typically care for patients with developmental disabilities and mental illnesses. The main function of psychiatric technicians is to monitor the conditions of their patients and provide therapeutic care. Psychiatric aides ensure patients are safe, living in a clean environment and help them in their daily activities. The minimum requirement is an associate’s degree from a certified occupational therapy assistant program which is licensed in most states and the average salary is about $28,320
  • Medical Assistants: Their work is to complete clinical and administrative tasks in the offices of hospitals, doctors and other healthcare facilities. However, they duties usually differ with speciality, location and the size of the practice. The minimum requirement is a postsecondary non-degree award and the average salary is about $30,590.
  • Physical Therapist Assistants and Aides: Physical therapist assistants are also called PTAs and they usually work under the supervision and instructions of a physical therapist. Physical therapist aides assist patients who are on the road to recovery from illnesses or injuries to manage pain and regain movement. The minimum requirement is an associate’s degree from an accredited program and the average salary is about $42,980.
  • Licensed Practical and Vocational Nurses: The main function of licensed practical and vocational nurses is to provide fundamental nursing care. Licensed practical nurses (LPNs) and licensed vocational nurses (LVNs) work under the direction of doctors and registered nurses. The minimum requirement is a postsecondary non-degree award and the average salary is about $43,170.
  • Occupational Therapy Assistants and Aides: They typically help patients grow, improve and recover the skills and abilities needed to perform daily activities and for daily living. Occupational therapy aides usually perform support tasks while occupational therapy assistants are directly concerned with providing therapy to patients. Both of them work under the instructions and supervision of occupational therapists. The minimum requirement is an associate’s degree from a certified occupational therapy assistant program that is licensed in most states. The average salary is about $54,520.
  • Registered Nurses: They coordinate and provide patient care, educate patients and the community about various health conditions and give patients emotional support and advice to them and their family members. The minimum requirement is a bachelor’s degree from an accredited program. The average salary is about $67,490.


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