Become a Certified Nursing Assistant (CNA)

CNA's are respected, valuable members of the health team.

By Clare Absher RN, BSN  

Smiling CNA looking at camera

Am I Right for the Job?

To be a nursing assistant, you must have compassion and a desire to help people. It is not an easy job, but it can be very rewarding. As an RN in long-term care for many years, I have observed the dismay that new CNAs feel when overwhelmed by the workload and fast pace. When faced with challenging situations, nursing assistants who seem to be able to manage stress best are those with true compassion for the people who they are caring for. Nursing assistants who view their occupations as "just a job that pays the bills" usually are not successful and likely to have made the wrong career choice. Patience is crucial to the job, along with self-confidence and a certain level of maturity. Good interpersonal skills with an emphasis on being a team player are especially valuable traits for all health care workers.

How do I become a Certified Nursing Assistant? (CNA)

I receive numerous inquiries regarding becoming a C.N.A. and respond accordingly that it is not as difficult as one may think. However it is important to know that every state is different in regards to amount of time required for training and testing and the type of environment you'd like to work in. For information on specifics, you can contact your State Nurse Aide Registry or State Licensing Board. I have also included a link to a state map of CNA training programs for your reference:

Find CNA training centers

Remember when researching in your area that CNAs are known by many names such as Nursing Assistants, Nurses Aides, Orderlies, Patient Care Technicians, Home Health Aides and more, depending on where you live and work. Keep in mind that if you are hired at a healthcare facility, you must prepared to submit to a background check (criminal) and a drug test as this is now a requirement.

Regardless of where you live you will need to be trained. Often, local healthcare facilities especially nursing homes will advertise free classes OR "Be paid while you learn." These classes are offered usually to those with no prior healthcare experience and can run anywhere from 2-6 weeks fulltime. Be mindful that these facilities will require that you work at their facility for a certain amount of time in exchange for this training and sometimes will also pay for the state test. Another option for training is to attend CNA classes at a local community college or become trained through the Red Cross. These classes generally last longer possibly up to 6 months and can cost anywhere from $300 to $600 for training. The main benefit is that your training is more extensive and I have observed CNAs often are more confident due to feeling better prepared. Many CNAs quickly learn that on the job training is what matters most and although this holds true for many jobs, it is especially pertinent in health care settings. After training you will then need to take the state test to become certified and it is usually done at a specific place and on a specific date pre- arranged by your trainer. Some places will allow you to work, upon completion of your CNA training, up to three or four months after classes without your certification. The test includes a written and clinical portion. The written portion is founded on good common sense principles and reviewing your class notes and handouts is always a good idea. I have included this link for taking actual practice tests in each state to further prepare.

Practice Tests

CNAs report that often it is the clinical part of the test that many find more difficult due to their nervousness. While the state examiners expect some nervousness they will focus more on observing your basic care-giving skills. While taking the practical portion of the test, you will be asked to demonstrate several nursing assistant skills. Remember safety measures such as locking the wheelchair, using a gait belt with transfers, and raising bed rails when completing patient care. Keep in mind a patient's dignity and privacy needs at all times. Knock on door before entering, close privacy curtains and cover patients as much as possible when providing care. Introduce yourself, identify your patient by name in a professional manner, and explain each step of your care prior to proceeding. Be sure you put gloves on before performing any kind of care that would require gloves including any contact with body fluids. Always remember when you are asked to demonstrate a skill, to first use proper hand washing technique prior to performing the skill requested.

How to decide on a good place to work?

One very helpful method is to check the Nursing Home Inspector section on our site. This tool will allow you to determine how a facility has performed for the last three annual inspections and any recent complaints that were registered. This is an excellent screening tool providing a baseline and means of comparing homes against each other. Another good way to learn more about a facility or agency is simply by word of mouth. Talk frankly to other CNAs as well as the families with loved ones in facilities or with Home Care Agencies. Make a visit to the facility and talk to the staff about what they do and don't like about their workplace. Learn about the orientation you will be given as well as ongoing nursing supervision and in-services provided. Most importantly, you need to sense an atmosphere of positive respect towards CNAs from all members of the health team in a particular facility or agency.

CNAs are in great demand!

Being a Nursing Assistant is not for everyone, and many care facilities have been experiencing great difficulty recruiting and retaining qualified staffing in recent years. Our country has experienced a crisis in the area of the direct care-giving field with shortages in CNAs rating among the top causes. The pay scale often does not reflect the difficult nature of the work expected of nursing assistants. All too common short staffing with resulting frustration in an effort to provide quality care contributes to this astounding turnover rate. The shortage of caregivers combined with growing long-term care needs of our elderly population is basis for the great demand for CNAs and resulting numerous job opportunities. If you decide to choose this field of work never think or say "I'm just a CNA." On the contrary, always remember that you are a respected and valuable professional member of the health team who provides vital care.

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Clare Absher RN BSN

About the Author

Clare Absher is a Registered Nurse with 44 years of experience. Most of her experience is in home health serving as a caregiver, educator, patient advocate, and liaison between families and community resources. She has also worked in acute care, assisted living, and retirement settings. She is passionate about helping families care for their elderly loved ones at home.

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