To practice as a nurse assistant in the United States, an individual must be certified to work as a CNA (Certified Nursing Assistant) in the state where they are employed.
Unlike LPNs (Licensed Practical Nurses) and RNs (Registered Nurses), nursing assistants do not need to acquire a license –once they have completed the state certification process and enrolled in the state nurse aid registry they are free to practice their trade.
The prerequisites a candidate must fulfill to become certified as a CNA are outlined below.
Educational Prerequisites for Nursing
These will vary from state to state but generally consist of the following:
1) High school diploma or equivalent such as a General Education Development Test (GED).
2) Completion of a CNA training program; either at a licensed educational institution such as a community college or vocational school, or an approved on-the-job program offered by a medical facility such as a hospital, nursing home, or similar establishment.
a) Training programs will typically include from 75-150 hours of instruction.
b) Training must include both a classroom instruction segment, which is designed to provide an aspiring CNA with a thorough knowledge of the theory and practice of nursing, and a clinical segment, in which he or she will receive hands-on instruction in how to put that knowledge into practice.
c) The instructional portion of the training may be completed online.
State Prerequisites for Nursing
While exact prerequisites will vary from state to state, the following are typically found in most states, in one form or another.
1) Proof of completion of an approved training program.
2) Most states require that CNA applicants be at least 16-18 years of age to become certified.
3) Completion of a state certification exam. This exam will test both the knowledge of a candidate in the form of written questions, as well as practical skills by asking a candidate to demonstrate his or her ability to perform nursing functions in a clinical setting.
The written portion of the test will generally consist of 70 or so multiple choice questions. You can read more about the certification exam here.
The clinical segment of the test is performed in the presence of an evaluator, and requires a candidate to demonstrate his or her ability to perform 5 selected nursing tasks.
The tasks to be performed will not be disclosed beforehand to the certification candidate. State nursing acts typically require that nurses be able to perform the following functions, among others:
a) Helping bedridden patients.
b) Checking for vital signs.
c) Transportation of patients and providing ambulatory assistance when needed.
d) Feeding patients intravenously.
e) Cleaning and disinfecting patient rooms.
f) Responding to patient distress signs.
g) Documenting patient records
h) Dietary care. Making sure patients are following a prescribed dietary regiment when necessary.
i) Surgery assistance. Helping nurses ready a patient for an operation.
j) Operation and cleaning of equipment used in various medical procedures.
k) Patient personal and oral hygiene. Including bathing and brushing teeth and other such tasks as necessary.
4) Criminal background check. This will look for any criminal behavior on the part of the candidate. Some states will also require drug tests of candidates, as well as physicals.
5) Sign up for the state nurse aid registry. Once a candidate has successfully completed the state certification examination they are eligible to place their name in the state list of certified nursing assistants and to seek work as a CNA.
Some states may allow nurse’s aids who are listed on the registries of other states to apply for listing on their registry by reciprocity, subject to certain qualifications