How to Become a Certified Nursing Assistant (CNA)

Entering the field of healthcare is a big decision. The process can be challenging and so is the work. However, it can also be incredibly rewarding and fulfilling. Becoming a Certified Nursing Assistant, or CNA, is a great introduction to the world of nursing in healthcare. Keep reading for a thorough guide on how to become a Certified Nursing Assistant and what you can expect throughout the journey. 

What is a CNA?

A CNA also often referred to as a Patient Care Assistant, Nurse’s Aide, or Nursing assistant, the job entails exactly what it says: assisting. Essentially, a nursing assistant helps patients with daily tasks and non-emergency health care issues. They work under the guidance of a Registered Nurse (RN) or Licensed Practical Nurse (LPN) and offer assistance helping with healthcare activities for the patient. 

Becoming a CNA is a wonderful introduction to the rewarding life of healthcare providers, so even if you plan on becoming an RN eventually (more on that later), beginning with nursing assistant certification is a great first step to see if you’ll actually enjoy working in a healthcare environment. 

What are the duties of a CNA?

As a certified assistant, CNAs are required to have a certain level of medical knowledge and should be able to perform basic tasks to help the RNs caring for patients. These duties will not generally include more specified activities such as administering medication or working directly with a physician. Instead, the duties of a CNA are more specific to necessary daily tasks that a patient may need help with. The following is a short list of just some of the duties a CNA can be expected to perform: 

  • Toileting and Hygiene – Often, patients with a wide variety of conditions will need help going to the bathroom. The CNA is responsible for helping these patients go to the bathroom or use a bedpan, depending on the patient’s current abilities. They may also be in charge of bathing the patients as well. In addition, basic hygiene for the patient is usually taken care of by the CNA, including brushing the hair and teeth, shaving, and nail care. 
  • Food and Water – The CNA is also responsible for feeding patients and making sure they stay hydrated. Additionally, the assistant may need to carefully measure and monitor the food and water intake. They will then also need to document it for future reference. 
  • Vital Signs – One of the first things that happens with a patient when they enter a hospital is that their vital signs are taken. Blood pressure, heart rate, temperature, etc. are all signs that the CNA will need to know how to collect and document. 
  • Attending to Patient Needs – Patients usually have call lights in order to request help from a nurse or aide. These needs can be something simple that already falls withing the CNA’s duties, such as needing water or to go to the toilet. 
  • Patient Room Care – It also generally falls on the CNA to take care of the actual rooms and to make sure they are in clean, tidy, and hygienic conditions for the patient who is there, or for the next patient to arrive. This also includes managing supplies and making sure everything is stocked and stored correctly. 
  • Assisting with Procedures – Occasionally, a nurse or physician will need some extra assistance with a medical procedure. CNAs are required to have a basic understanding of a variety of procedures and treatments, so they are often needed at these times. 

Of course, this is not a comprehensive list of all the duties a CNA is responsible for. Other functions will be assigned according to the specific facility where the CNA is working. One important thing to remember is the scope of practice, meaning that a CNA should never perform a task outside of their realm of knowledge, experience, and certification, even if requested by a supervisor. 

How does a CNA differ from an RN, MA, and LPN?

You’ll notice that a lot of the responsibilities mentioned above also fall within the duties of other health care employees, like medical assistants (MA), licensed practical nurses (LPN), and even registered nurses (RN). However, there are a few key differences: 

  • Medical Assistants – These assistants differ from CNAs in that they work more closely with physicians than with nurses or other members of the healthcare community. Their main focus is assisting with assessments and evaluations of patients. They might often help these physicians with the actual treatment of the patient. Nursing assistants, on the other hand, are more involved with patient care for day-to-day tasks. Furthermore, there are stricter requirements of what a CNA can and cannot do in a given state. 
  • LPN – The LPN can be considered the next tier up in responsibility and training from being a nursing assistant. They will be familiar with all of the duties of a CNA, but the difference is that LPNs are required to pass a state licensing exam. Meanwhile, CNAs need a certification that they completed a nursing assistant course and pass a certification exam. Because of this difference, there are several procedures and activities that an LPN is allowed to perform that are within their scope of practice that a CNA would not be legally allowed to perform. 
  • RN – While the RN and CNA may be working in the same area, an RN is the highest level of nursing that doesn’t require a post-graduate degree. Registered nurses perform many of the same tasks as CNAs, but they are given more freedom to care for the patient by what they are legally allowed to do. 

What can I expect my salary to be as a CNA?

The answer to this question varies greatly, depending mostly on what state you live in. However, nationwide in the US, you can expect to make an average of $26,590 a year as a CNA. Just as your state can determine your CNA salary, so too can the facility you work at make a huge difference in pay. For example, government jobs, such as with the VA hospitals, will pay more than many other positions, while attending to patients at their homes pays the lowest among, less even than the average pay. 

There is also some variety in whether you are an hourly or salaried employee. Hourly employees may be able to make more, due to the option of working overtime or on holidays. Salaried employees have much less freedom when deciding when to work. If you are willing to travel away from where you currently live, you can find higher salaries in certain cites, like San Francisco. 

What are my job options as a CNA?

Once you receive your certification to be a nursing assistant, you’ll have plenty of job options to choose from, depending on your location and preferences. Currently, there is a massive demand for CNAs as the healthcare field suffers from a nursing shortage. Here are a few of the jobs that would be open to you after becoming a CNA: 

  • Hospitals – Though the competition for a hospital job is intense, it’s usually worth it. These are considered the best type of jobs for CNA. You have more opportunity to choose your hours and you can expect some excellent job security. You’ll also generally be offered a generous benefits package along with a high salary. 
  • Skilled Nursing Facility – Because hospital jobs are in demand high demand, most CNAs start their careers in skilled nursing facilities. Like with hospitals, you’ll have good job security and a good salary and benefits package. The downside is that there are often too many patients for the nurses on staff, so you will face a bit more stress. Regardless, it’s a great place to start out and get some experience. 
  • Home Health – The duties of this kind of CNA job are similar to what you would see in other facilities; the difference is that here, you’ll be working one-on-one with patients in their home. Your workday will be far less chaotic, and you’ll be able to work at different hours. However, the most common difficulty of working in home health is the fact that you’ll need to be prepared to deal with death. Patients choosing a home nurse option for treatment are usually in their last stages of life and will most likely pass away while in your care. 
  • Assisted Living Facility – As the Baby Boomer generation ages, we’re finding a much higher need for elder care, though not many nurses choose to go this route. However, working in an assisted living facility comes with the benefits of having lower stress levels during the day. On the other hand, the work can become tedious and boring. Nevertheless, it’s a great place to start out as a certified nursing assistant. 

How do I know if it’s right for me?

If you’re considering going into nursing and want to start with getting a nursing assistant certification, you’re probably wondering if it’s the right career path for you. If that’s the case, here are a few qualities of a good CNA that can help you decide if it’s the best decision for your career: 

  • You love working with people – By the very nature of the job, nursing means interacting with a variety of people on a daily basis, from physicians to nurses to patients and more. If you struggle to work closely with others or are quite reserved or introverted, you might find the job of a CNA challenging. 
  • You’re flexible – Can you stay a couple of extra hours after your shift to help when your replacement doesn’t show up? Can you go from the ER to ICU without being thrown off your nursing game? If so, then you’re probably flexible enough to become a CNA. 
  • You have great communication skills – Because you’ll be working with people, you’ll need to be able to effectively communicate and relay messages between the patient, physician, and other nurses. You’ll need to know how to get a message across in a quick, efficient, and mannerly way. 
  • You’re reliable – Will you go out of your way to help out your coworkers and supervisors? Will you show up to work on time every day, ready to work hard? Being reliable is a crucial part of being a great CNA; with so many people relying on you, you’ll need to step up your game. 
  • You’re physically in good shape – Now, this isn’t an absolute, but you should know that being a CNA entails a lot of heavy lifting since you might need to move patients. Making sure you’re physically strong enough to do this will make your job a lot easier! 

What’s the process of becoming a CNA?

If you’ve decided that becoming a CNA is the right move for you – congratulations! So where do you begin? 

First of all, you’ll need to do some research into state-approved programs that provide training and certification. Check out your local community college, vocational school, or even your local hospital. As you look into programs, make sure that you choose one that suits your personal preferences and needs. For example, there are many options for online and in-person programs. If you need to continue working full time or taking care of your family while you study, an online program might be right for you. Whatever program you choose, make sure to do your research and talk to others who have gone through the program. 

Regardless of the type of program you choose, you’ll generally need to fulfill certain requirements before you begin the course. These might include a high school diploma/GED, a background check, and completion of a general health/physical exam and proof of updated vaccinations. 

Most courses last between 4-12 weeks, with 8 being the average. You’ll participate in class (online or in-person) and clinical courses. These hours will vary according to your state requirements. Once you finish the training program, you’ll take a competency exam where you will demonstrate your new skills and knowledge. Upon passing the exam, you’ll receive your certification! 

Final Thoughts

Becoming a CNA is a wonderful career option, especially if you want to keep working in the healthcare sector. It will open up professional doors around the country, so if you’re considering pursuing this certification, go ahead and get started! 

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Dr. Jenna Liphart Rhoads is a registered nurse and a nurse educator. She earned a BSN from Saint Francis Medical Center College of Nursing and an MS in nursing education from Northern Illinois University. Jenna earned a PhD in education with a concentration in nursing education from Capella University where she researched the moderation effects of emotional intelligence on the relationship of stress and GPA in military veteran nursing students.