The certified nursing assistant, or CNA, provides basic care to patients. Working under the supervision of a registered nurse (RN) or licensed practical nurse (LPN), the CNA assists patients who may have trouble performing activities of daily living. Depending on the facility and job description, CNAs also work with medical technology to perform administrative duties.
CNAs may take care of patients in hospitals and care for residents in long-term care facilities, otherwise known as nursing homes. They can also work in personal residences. The following 14 job duties can be expected as a Certified Nursing Assistant:
1. Making a first impression
CNAs often perform the initial steps of a patient’s visit or resident’s stay, which means nursing assistants are responsible for making a good first impression for the medical team.
2. Taking vital signs
Certified nursing assistants measure and record patient vital signs, including temperature, rates of pulse and respirations, and blood pressure. CNAs must have a solid understanding of what these vital signs mean, and notify nursing supervisors of abnormal vital signs.
3. Feeding, bathing and dressing patients
A CNA may help feed, bathe and dress patients, especially those patients who have had strokes, are frail and elderly, disabled, injured, or recovering from surgery. When helping with the activities of daily living, nursing assistants take an opportunity to examine the patient for signs of sores, rashes or bruises, assess the resident’s ability to move, and look for any signs of change in the patient’s condition.
4. Ordering and serving food
Proper nutrition is essential for good health, especially among those who are ill or injured. Doctors sometimes order special diets and dieticians come up with food options to fit those diets, but CNAs help patients navigate menus to create a delicious meal. The CNA may also recommend switching a patient to a different diet, such as soft or pureed foods, if the assistant notices that the resident or patient has trouble eating.
In some facilities, nursing assistants must deliver the correct food trays to individual patients or residents and ensure the food on the trays fits the dietary guidelines for each patient. CNAs help open packages, cut food into smaller pieces, and makes sure the patient or resident consumes the proper amount of food and liquids.
5. Monitoring intake and output
In hospitals and other facilities, CNAs monitor intake and output. Also known as I&O, intake and output is the measurement of fluids entering and leaving the body. Intake includes the liquids a patient drinks, intravenous (IV) bags, and tube feedings. Output includes the amount of urine a patient produces and any fluid produced by drainage tubes. In the course of a day, intake and output should be equal.
6. Repositioning patients
Repositioning patients, sometimes called “turning,” reduces the patients’ risk for developing bedsores. Sitting or lying in one position puts pressure on those parts of the body resting against the chair or mattress. This pressure prevents blood from flowing to those parts of the body. This increases the risk for bedsores, otherwise known as decubitus. Changing a patient’s position every two hours keeps blood flowing properly throughout the body.
CNAs identify patients who could benefit from regular repositioning, turn patients into a comfortable position, and look for signs of skin breakdown that could lead to the development of decubitus. Once a decubitus forms, CNAs help nurses care for these pressure ulcers to reduce the presence of these painful skin sores and to decrease the risk of infection.
7. Keeping rooms clean
CNAs work with housekeeping and nurses to keep patient rooms clean. Basic housekeeping protects patients and workers from hazards that could cause someone to fall, helps patients keep track of belongings. Wiping up spills and body fluids also reduces accidents and decreases the risk for spreading infectious diseases.
8. Change bed sheets
Clean bed linens are essential to keep a patient’s skin and body healthy. Wrinkled sheets press against skin to increase the risk of decubitus. Wet sheets can lead to skin breakdown, which can result in skin ulcers and bedsores. This is especially true for bedridden patients.
Changing hospital linens takes real skill, especially when a patient occupies the bed. Rolling a patient from side to side can cause pain; doing it incorrectly can compromise patient safety. Certified nursing assistants can change bed sheets quickly and safely to provide a clean, comfortable environment for patients.
9. Setting up medical equipment
Certified nursing assistants sometimes gather and set up medical equipment for procedures performed at patient bedsides. CNAs may also set up medical equipment for use in the surgical suite.
10. Observing and reporting changes in a patient’s condition or behavior
CNAs work very closely with patients and are therefore in the best position to notice changes in patient conditions or behaviors. Nursing assistants take action when they notice confusion in a patient who was previously aware, for example, or call for help when a patient’s blood pressure goes too high.
11. Preparing patients for diagnostic tests and treatments
Many diagnostic tests and treatments require special preparations for the patient, such as consuming a liquid diet or drinking a preparation within a certain period before undergoing a scheduled test. CNAs help patients prepare for these procedures and stay on schedule.
12. Assisting with procedures
CNAs assist nurses and doctors with certain beside procedures. The nursing assistant may assist a nursing in placing an IV needle or inserting a catheter, for example, or holding a patient still while a doctor inserts a chest tube.
13. Answering patient calls
CNAs answer call lights and respond to any requests or needs patients may have. Nursing assistants might respond to patient calls by relaying requests for medications, answering questions, helping patients move to the bathroom or a chair, make a phone call, or perform other patient care.
14. Listening to the healthcare concerns of patients and residents
Many patients and residents develop a personal relationship with their healthcare professionals. There is an especially close connection between CNAs and patients or residents because nursing assistants provide the most personal of all personal care tasks. Because of this close relationship, patients and residents often feel most comfortable talking to CNAs about their health. CNAs listen to the healthcare concerns of residents and patients, and provide moral support for those facing serious illness, injury, or even the end of their lives.
Because of the wide variety of important tasks they perform, certified nursing assistants have unique and interesting jobs. The job of a CNA is also fulfilling, as they improve the lives of patients and families at nearly every stage, from birth to the end of life.