Nursing Assistant

Definition

A nursing assistant is the entry level class in nursing services. Under close supervision, a nursing assistant will perform a variety of non-professional tasks in providing direct bedside care to assist patients with activities of daily living. A nursing assistant will also aid professional nursing personnel in providing patient medical care.

Description

Being a nursing assistant is a physically and emotionally demanding job that requires organizational skills, a caring bedside manner, patience, and maturity and the willingness to perform routine, repetitive tasks. A nursing assistant should have knowledge of basic patient care principles, methods, procedures, and terminology, hospital routine and equipment, standard asepsis and hygiene procedures, standard charting procedures, and standard instruments and equipment used in routine patient examinations and treatment. Nursing assistants work closely with patients to provide help with daily living tasks, including:

• dressing (according to patient's needs and may range from minimal assistance to complete dependence)
• bathing (bed and tub baths, showers)
• feeding (serving meals; physically feeding patients unable to feed themselves)
• toileting (assisting with bed pans and urinals; helping patient to the bathroom; providing care for patients who are incontinent)
• taking of vital signs, such as blood pressure, temperature, and pulse
• catheter care (emptying and record-keeping of inputs and outputs)
• assistance with walking or wheelchair transport
• assistance with physical therapy needs, such as range of motion exercises
• housekeeping of patient's rooms and organization of patient's belongings
• turning of patients, to help with comfort and to prevent bed sores
• maintenance of a safe environment for patients

Since nursing assistants work closely with patients, they can also monitor patient's physical, emotional and mental conditions and report any changes to the patient's health care team. Nursing assistants may also be required to provide postmortem care of a deceased patient. Nursing assistants must keep accurate and timely records of the care provided to each patient. Nursing assistants working in a nursing care facility are often the primary basic care givers, with more patient contact than other members of the staff.

Work settings

Nursing assistants usually work in hospitals, nursing care facilities, mental health facilities, and physician's offices. In 2006 in the United States there were 1.4 million nursing assistants; about 52 percent of the nursing assistants worked in nursing and residential care facilities while 29 percent worked in hospitals. In 2006 the median hourly wage for a nursing assistant was $10.67.

The work can be physically demanding, with many hours spent standing, walking, and moving patients. Nursing assistants are at risk for contracting infections and diseases and must take precautions to avoid these hazards. Nursing assistants also perform tasks that many consider unpleasant, such as emptying bedpans and changing soiled bed linens. Patients may be disoriented, irritable and uncooperative and difficult to work with.

Most nursing assistants work 40 hours per week, but because patients need care 24 hours a day, nursing assistants may be required to work evenings, nights, weekends, and holidays.

Usually to obtain a position in any type of health care facility, a criminal background check, drug testing, and a physical examination, including state-mandated tests such as tuberculosis testing will be required.

Care team role

Under close supervision, a nursing assistant performs a variety of non-professional tasks in providing direct bedside care to assist patients with activities of daily living. A nursing assistant also aids professional nursing personnel in providing basic patient medical care and provides information concerning the patient's physical, emotional, and mental conditions to the health care team.

Education/Training

In the United States, a nursing assistant who works in a nursing care facility that receives reimbursement from Medicare must complete a minimum of 75 hours of state-approved training and pass a state-administered competency test to become certified. A person can become a certified nursing assistant (CNA) by taking classes through a community college CNA program, through the American Red Cross, or through a health care facility, such as a hospital or nursing home. Community college and Red Cross classes may last 3 months to 6 months or more, while training in a health care facility may require only two weeks. Health care facilities may provide free or paid training classes, while classes at a community college may cost from $300 to $600. There are also online CNA training programs available.

The certification test consists of two parts, written and clinical. The candidate may be required to bring someone along to the test to serve as the model for the clinical skills portion of the test. The skills portion of the test will consist of the candidate demonstrating three to five nursing assistant skills, such as hand washing, patient transfer, providing of a bed pan, repositioning of a patient, patient grooming, temperature taking, or bedding change in an occupied bed. Nursing assistants who pass the test are placed on a state registry of CNAs.

KEY TERMS

Hospital —An institution that provides medical, surgical, or psychiatric care and treatment for the sick or the injured

Nursing care facility —A residential facility for persons with chronic illness or disability, particularly older people who have mobility and eating problems; Also called a convalescent home, long-term care facility, or nursing home.

Resources

BOOKS

Carter, Pamela J. Lippincott's Textbook for Nursing Assistants: A Humanistic Approach to Caregiving.

Hagerstown MD: Lippincott, Williams, & Wilkins, 2007. Hegner, Barbara, Acello, Barbara, and Caldwell, Esther. Nursing Assistant: A Nursing Process Approach. Clifton Park, NY: Delmar Cengage Learning, 2003.

Sorrentino, Sheila A. and Gorek, Bernie. Mosby's Essentials for Nursing Assistants. St. Louis, MO: Mosby/Elsevier, Health Sciences Division, 2005.

ORGANIZATIONS

National Network of Career Nursing Assistants, 3577 Easton Road, Norton, Ohio, 44203, (330) 825-9342, (330) 825-9378, [email protected], http://www.cna-network.org.

Direct Care Alliance, Inc., National Clearinghouse on the Direct Care Workforce, and Paraprofessional Healthcare Institute, 349 East 149th Street, 10th Floor, Bronx, New York, 10451, (718) 928-2063, (718) 585-6852, [email protected], http://www.directcarealliance.org;http://www.directcareclearinghouse.org/index.jsp;http://www.paraprofessional.org.

Judith L. Sims