top of page
Prescription Drugs

WhAt To Know About Being A CNA



You’ve decided you want to become a Certified Nursing Assistant. You’re excited and want more information about this career. Some questions you might have deserve answers, and here we will try to do that.

1) What is a CNA?
A Certified Nursing Assistant is a member of the health care team. Always working under the direction of a nurse (RN or LPN/LVN) the CNA provides hands on nursing care to patients, residents, clients and customers in a variety of health care settings. CNA’s typically provide assistance with bathing, dressing, eating, toileting and oral care to people who cannot do these tasks alone. Also, the CNA is often the person who gets the vital signs, weights and height measurements.

The CNA has a high school diploma or GED.

2) Why be a CNA?
Why not? If you’re looking at a career in nursing, being a CNA is a great way to really test yourself on this goal. Being a CNA exposes you to many members of the health care team: You get to see nurses, physical and occupational therapists, doctors, med techs and assistants in action. You’ll soon know whether you have what it takes to further yourself in nursing; perhaps you’ll decide to move to another field of work within health care.

If you’re looking for a quick job – I say becoming a CNA might not be the right choice for you. Going through the training is hard work; being charged with caring for sick people isn’t something to be taken with a grain of salt. You have to the will and desire to help people…you’ll need patience and compassion. You have to be committed to a physically demanding job, with little tolerance for poor work ethic.

Career CNA: You won’t get rich doing this for a living. But you will gather experiences not often found in any other career. You’ll have pride over many accomplishments and you’ll make friends with people you would otherwise never meet. Being a CNA is one of the few careers where one can say they truly give it all for little in return. On the downside, your body will pay you back in a bad way if you don’t take care of it. You’re apt to hurt your back. If you get sick, plan to be at work irregardless- and PLAN on getting sick more often than other people get in other careers. As stated above, the pay is not going to be rewarding- but the other rewards are priceless.

CNA’s don’t earn a high salary. You should be very aware of this. Many of who have been doing this for a long time notice new aides coming into the field, who get disillusioned over the pay. We’re paid by the hour; that rate is dependent upon several factors which include how much experience one has; what region of the country one works in and where employment is at.

In general, CNA’s who work in long term care settings (nursing homes, assisted living) earn the least; those who work for staffing agencies and hospitals earn the most. Belonging to a union also has an impact upon pay. Overall, wages for aides range from 7.00/hr for a brand new CNA at an assisted living center, to 20.00/hr for a CNA with 20 plus yrs experience, working for an agency. The most common wages, I hear of, are in the area of 10.00 to 12.00/hr in all settings. Like I said you’re not going to get wealthy doing this work.

3) Where can CNA’s work?
In any setting provided there is a nurse to oversee the CNA’s practice. This is very important to remember. Always, CNA’s work under the direction of a licensed nurse. Don’t let anyone tell you otherwise. This is per federal and state statute, and it’s to protect the public. Only a licensed nurse can delegate duties to CNA’s. Doctors and therapists cannot. Families cannot. CNA’s cannot delegate to CNA’s.

Always keep this in mind- legally a CNA cannot practice on their own. Many aides place ads in newspapers offering their services as a CNA. This is illegal in all states! It’s okay to offer care giving services. It’s okay to use your experience as a CNA; but it’s never good to claim yourself a CNA who is providing the services. When you do this, you’re delegating. And breaking the law. Be careful with this.

CNA’s are found on the payrolls at:

  • Nursing Homes

  • Home Health Care Agencies

  • Assisted Living Facilities

  • Staffing Agencies

  • Hospitals

  • Hospices

  • Doctor Offices/Practice Groups

  • Day Care Centers and Schools

  • Medical Clinics

  • Urgent Care Centers

An interesting note on potential sources of employment: The role of the CNA is mandated by the Federal government for nursing homes only. Other health care settings are not required by law to hire CNA’s…this includes hospitals, assisted living facilities, doctors offices, ect. While all of these places DO hire CNA’s, for good reason, they don’t have to.

4) How does one become a CNA?
Once you’ve decided this is the work you want, set out to locate a training program. Many nursing homes offer the training; the Red Cross does classes too- contact your local chapter. Tech colleges are another source where training is offered. Some high schools also provide classes- but mostly for students and not others. More and more, small Medical Ed schools are popping up all over the country. Offering a variety of specialty training, a CNA program is often part of this.


Costs of training programs vary by region and by the source. College classes are the most expensive followed closely by these Medical Ed schools; typical for my area, NH- right now- the costs including books is 1500.00. One thing to remember when choosing a program is to make sure it is approved by your State board of Nursing or whatever State agency is charged with approving curriculum. This is vital to know. It does no good to take a course that isn’t approved.

Another important thing to know: Stay away from ONLINE and CORRESPONDENCE courses for Nursing Assistants. While these are great for basic knowledge most of these are not approved by most states. People who suddenly find themselves taking care of an elderly parent benefit most from these courses- not those with a serious interest in this as a career. You need clinical hours- real, hands on training in order to perform this work. You don’t get this with the online/mail order courses.

5) What Can I Expect During Training?
Plan on anywhere from 3 weeks of full time classes and clinical hours, to 8 weeks part time. You can expect to be challenged. Your knowledge will increase a lot. Some of the topics typically covered in a CNA course include:

  • Patient/Resident Rights

  • The Roles and Responsibilities of the Health Care Team

  • Legal Issues for Nursing Staff pertaining to the CNA

  • Medical Terminology

  • Infection Control

  • Medical Unit Environment- Safety and Proper Body Mechanics

  • Emergencies: Some states require CPR to be a part of this

  • Communication Skills

  • DocuMentation Skills

  • Patient Care: Vital Signs, bathing, dressing, moving patients, feeding, oral care, grooming skills

  • Patient Room Upkeep

Most CNA courses cover the typical requirements and education you will need to be successful working in nursing homes, acute and sub acute care centers, perhaps some rehab and restorative nursing instruction is covered as well. You will learn about caring for adults, children and babies. Some of this will include caring for people who are dying, and, how to provide postmortem (after death) care. Most CNA courses do not cover all the skills required for employment at hospitals. Most of these places offer their own special orientation for this purpose.

You should expect to do a lot of reading, and take many quizzes to test your new knowledge. You should know that 100% of your attendance is very critical to your success in any CNA program. Clinical hours refer to the portion of your training that takes you into the actual heath care setting- usually the nursing home. Here, you will be given an assignment of residents (not more than one in most cases). You will be expected to use your newly learned skills to show your instructor you can apply them on real people.

6)What happens after my training is completed?
Your instructor will assist you with scheduling a Competency exam administered by your state. This exam is mandatory and you must pass it. It will test your knowledge and competency with skills. Once passed, you are certified. In some states, you don’t need to wait to work however…there is a federal ruling that allows nursing assistants to work while waiting to take their exams, for up to four months. Many places won’t allow you to do this, for legal reasons.

The Exam is done in two parts: A written portion and a clinical portion. The written test is usually not too difficult- and this web site offers sample questions for you to practice. The clinical part is a bit harder. You have to bring a friend with you in order to complete this portion. The friend will serve as your patient, whom you demonstrate to the examiner, your skills. Bring a GAIT BELT with you for use during your clinical exam.

The important skills the examiner will watch for will include infection control (hand washing!; GLOVES!), patient safety privacy and dignity. Remember to close the privacy curtain. Remember to identify yourself to your “patient”, and remember to identify the patient! You will be asked to perform several tasks- usually up to five skills, but no less than three skills. These might include a full or partial bed bath; offering a urinal or bedpan; a transfer into a wheelchair; a complete or partial set of vital signs; making an occupied bed…any skill you learned in your training is apt to chosen by the examiner. Be prepared but don’t sweat and lose sleep over this. Your training should provide you with the competence you need to pass the exam.

You will be told on the spot if you pass or fail. The examiner realizes you are nervous and will expect some jitters from you. Mistakes are not the end of IT; if you realize you made a mistake ask if you can re-demonstrate. Often this is allowed. If you do fail, ask about re-scheduling another test. Each state has different rules about how often a test can be re done and whether BOTH portions need to be re-done.

NEXT, please read the following posts about other important information you will need in order to effectively work as a CNA. This info will provide you with details about aspects of this work you must take seriously.

bottom of page