Activities of Daily Living Study Guide for the CNA
The Certified Nursing Assistant (CNA) has many roles. One of the most important roles is to assist patients with activities of daily living (often referred to as ADLs). ADLs are simple activities that most of us do every day—feeding, toileting, bathing, and ambulating, among others—but for many patients these activities may present a unique challenge. The nursing assistant is responsible to know the best way to assist the patients with these tasks so they are done attentively, efficiently, and safely.
Many patients may need help with opening food packages or getting settled with their meals, but sometimes patients are unable to feed themselves at all. To assist a patient at meal time, wash your hands before you begin feeding. Sit at eye level and protect the patient’s clothing. Use a spoon to deliver bites and ensure the patient has completely chewed and swallowed the first mouthful before offering another. Offer fluid after every three to four bites of food. Try to interact with the patient while feeding him to make mealtime a more personal, interactive experience. Encourage the patient to complete their meal, but do not force them to eat if they refuse or become too full. If the patient has problems with the meal or refuses it outright, inform the nurse in charge.
Patients who have limited mobility may need to use a bedside commode or bedpan to go to the bathroom. If the patient uses a commode, ensure that it is locked and as close to the patient as possible to minimize fall risks. Have items you may need, such as toilet paper, close by before you help the patient to transfer. Allow for privacy, if possible, but leave the patient alone only if it is safe to do so. If the patient needs a bed or fracture pan, place a protective pad under the patient to protect their bed linens. If able, have the patient roll to one side, place the pan under his buttocks, and raise the head of the bed up so the patient is in a more natural “seated” position. When the patient is finished, lower the head of the bed, remove the bedpan, and cleanse and dry the perineal area. No matter how you are assisting the patient to toilet, never compromise safety and keep the patient’s dignity and privacy in mind at all times.
Immobile patients are often given daily bed baths to keep them clean. Several brands of bathing wipes and waterless shampoos, which your facility may use for cleansing immobile patients, are available, but many places still rely on regular soap and water. To give a partial bed bath, ensure that the water is of a comfortable temperature. Expose only the area of the patient you are cleaning, and dry it immediately after with a clean towel. Wash the face only with a wet washcloth. Using only the clean part of the washcloth for each eye, wipe eyes from the inner to the outer canthus. Wash the rest of the body using a small amount of soap on the washcloth. Turn the patient on his side to wash his back and the back of his extremities. When finished, apply warm lotion to the skin and offer fresh clothes and a gown. Always be on the lookout for signs of skin breakdown as you bathe your patient and report any suspicious findings to the nurse immediately.
Assisting with Ambulation
Different patients need different levels of ambulation assistance. A gait-transfer belt is a common assistive device to help safely move patients from one spot to another. To use the belt, fasten it securely around the patient’s waist and stand directly in front of the patient with your legs slightly apart. Hold the gait belt with both of your hands, and help the patient to a standing position so his feet are positioned in between yours. When the patient is steady, move one of your hands to the side of the gait belt and another to the back. Walk with the patient while holding the belt in this position, either at his side or slightly behind him. If the patient begins to fall, do not attempt to prevent the fall or catch him with your hands. Instead, bend your knees and slowly lower the patient to the floor, protecting the head from injury and allowing the patient to rest his body against your leg. Call for assistance and stay with the patient; do not attempt to move him as this may cause further injury. Another type of ambulation CNAs frequently assist with are range of motion exercises. To perform range of motion exercises, the patient should be lying comfortably supine, that is, flat on his back. Begin by smoothly rotating each shoulder joint, and then moving it toward and away from the patient’s body—adducting and abducting. Support the wrist and elbow, and flex and extend the lower arms. Rotate the wrists and flex and extend each hand, finger, and thumb. Next, support the foot and ankle and flex each leg by bending the knees. Adduct, abduct, and rotate the legs at the hip. Support the foot at the instep and rotate, flex, and extend each foot at the ankle, and then flex and extend the toes. Never force or tug on any extremity that seems stiff or does not want to move. Report any unusual findings to the patient’s nurse immediately.
Basic Nursing Skills Study Guide for the CNA
A Certified Nursing Assistant (CNA) should be familiar with many basic nursing skills. This study guide covers the basics of infection control, technical procedures, and patient safety.
Preventing the Spread of Infection
In every healthcare setting, knowing how to prevent the spread of infection is crucial to keep outbreaks to a minimum and to prevent getting sick yourself. Hand washing is the single most important thing you can do to prevent the spread of infection. Hand washing should be performed before and after providing direct patient care, after going to the bathroom, before eating, and whenever your hands are visibly soiled. Use plenty of friction when you wash, and scrub your hands, wrists, and the area under the nails for at least 15 seconds. Many facilities also allow the use of a waterless hand antiseptic, such as Avagard, if your hands are not visibly soiled. Always wear gloves if you expect to come into contact with mucous membranes, blood, or other infectious substances. Remove the gloves immediately after caring for the patient.
Technical procedures such as obtaining vital signs, providing mouth and nail care, and helping a patient dress are all part of the everyday job of the CNA—and also something you will likely be asked to demonstrate on the clinical skills portion of the test. Before beginning any procedure, greet the patient and explain what it is you intend to do. Always allow the patient as much privacy as possible and ensure you stay with them throughout the procedure to prevent injury. Vital signs may be taken a number of ways depending on the facility where you work. Know the difference between—as well as the techniques of obtaining—oral, rectal, axillary, and tympanic temperatures, and which findings need to be reported for each type. Blood pressures may be taken manually or with a machine depending on the facility, but for either method a normal reading is usually around 120/80 or slightly less. Many vitals machines come equipped with a “pulse ox” that tells how much oxygen is in the patient’s blood and gives his current pulse rate. A normal pulse rate is between 60 and 100 beats per minute. Anything higher or lower than this range could be indicative of a problem and should be reported to the nurse assigned to your patient. When providing nail care, soak the nails in comfortably warm water for 10–20 minutes. Dry and trim them straight across with nail clippers. For those who may have problems with hands or feet, such as diabetics, check for special orders before performing nail care. When assisting patients with toothbrushing, allow them as much independence as possible while still maintaining their safety. If you are caring for dentures, transport them in a cup or basin, and fill the sink with water or pad it with a washcloth while cleaning to prevent accidental breakage. When dressing a patient, have all their fresh clothing ready to go before removing their soiled clothing to prevent prolonged periods of nakedness. Allow patients to choose their clothes, if possible, and allow them as much independence as safety permits. If one side of their body is weak or paralyzed due to stroke, ensure the affected arm/leg is supported while you assist them in dressing.
Knowing how to keep both yourself and your patient safe is critical to providing safe care and to passing your CNA exam. Be familiar with the personal protective equipment available in your facility such as masks, gloves, eye shields, and gowns, and know when it is appropriate to wear each. Be careful when changing patient sheets because they are a common location for discarded needles, especially in the hospital setting. Change sheets that are soiled immediately, and fold the soiled portion inward and away from your body. Dispose of the linen in an appropriate plastic bag, and put it in the designated soiled linen area to prevent it from becoming a fall hazard for yourself or the patient.
Falls are the most common accident for patients. They can have devastating consequences, especially for older patients. To help prevent a fall, put back equipment and supplies in their proper location, clean up any spills, and always ensure that patients have glasses, ambulation devices, and a call light nearby so they can get quick assistance. When safety is compromised and a patient is injured, report to the nurse on duty or a supervisor.
Client Rights Study Guide for the CNA
Client rights can be difficult to understand and even more difficult to swallow when they have been employed. To do your job as a CNA effectively, you must know about patient rights, from the most basic of human rights to the more involved rights as a patient in a healthcare facility.
Basic rights awarded to patients include the right to both respect and dignity. This is demonstrated in numerous ways, including treating all patients with kindness and patience, giving them your full attention, and treating adults like functioning, mature men and women. If a patient is being difficult, for instance, inflicting punishments such as limiting television time or other “if you do this, then this” scenarios would be robbing them of their dignity. Treating an adult like a troublesome child is not treating them with respect.
Basic rights also extend to patient cleanliness and comfort. Patients who are unable to evacuate their bowels alone, for instance, should not under any circumstances be left for an extended period of time in their own urine or feces. All questions of hygiene and comfort should be resolved as quickly as possible, ranging from regular baths to something as small as clipping fingernails. Patients who are unable to care for themselves require your consideration and kindness. This includes affording patients their modesty during and after wash times, as well as ensuring patients are covered adequately during rest and recovery.
While basic rights are incredibly important, complex rights that require more consideration and discretion among healthcare practitioners also exist. These rights include patient privacy, patient confidentiality, freedom from abuse, monetary control, being informed, personal decisions, and freedom from fear when reporting complaints or difficulties.
Patient Privacy and Confidentiality
Because highly sensitive, personal information is frequently exchanged in a medical care setting, patients are awarded the right to both privacy and confidentiality. This means that healthcare practitioners should not discuss client issues and concerns outside of work, with other patients, or in any way not related to the case at hand. You should never disclose patient information without their consent or you could risk serious legal repercussions for doing so. Patients expect doctors and healthcare professionals to be trustworthy and discreet with their information, allowing them to speak freely with past mistakes, illnesses, or concerns. Without confidentiality, patients cannot trust their healthcare practitioners and will not offer necessary information freely.
Freedom from Abuse
Patients have the right to freedom from abuse. Abuse comes in many forms, including neglect, physical abuse, and verbal or mental abuse. While patients can be frustrating at times, and work can be grueling, a CNA should not, under any circumstances, lay a hand upon a patient, or in any way belittle a client. As discussed, clients should not be ignored or neglected. If a patient is in need of any kind of care, you are responsible to perform the care in question in a timely manner.
Because patients/clients are to be treated as adults, their money should be handled by them alone. Though it may be tempting to advise patients to use their money in a certain way, or abstain from some purchases while under your care, your position simply requires that you provide physical, mental, and emotional care. You are not intended to function as a caretaker or personal care provider.
Being Informed/Making Personal Decisions
Being in a hospital, nursing home, or other healthcare facility can be frightening for patients. For this reason, patients have the right to be informed of their progress (or lack of progress), their overall care, and their prognosis. Though it may be tempting to keep some information from patients—particularly bad information—the patients deserve to know what is happening in their health and treatment, and should be informed immediately upon asking.
Freedom from Fear
Finally, patients should be able to have freedom from fear regarding any punishment or negative repercussions if dissatisfaction is expressed. Many dynamics are involved in the relationships between patients and their healthcare providers, and sometimes patients and providers will not see eye to eye. Because of this, many patients will lodge complaints regarding their care or hospital procedures. While this is unfortunate, patients have the right to express their opinion (or displeasure) freely, and should not be treated poorly or intimidated into keeping any displeasure or dissatisfaction quiet.
While being a CNA is a rewarding career, many facets of the work require your attention. Client’s rights are no exception; all clients should be treated with respect and dignity, including protected privacy, confidentiality, and freedom from intimidation, poor treatment, and judgment.
Communication Study Guide for the CNA
Training to be a Certified Nursing Assistant (CNA) may be a long and grueling process for some, as it involves learning a wide array of skills. One of the most important skills in CNA training (or any medical profession) is communication. Communication is a vital aspect of working in the medical field; patients must communicate their distress to a nurse or doctor, who must then communicate the possible treatment options or the possible cause of patients’ distress. This may be done in writing or verbally—either way, CNAs are required to develop keen communication skills, both in speaking and in writing.
One aspect of communication that is key to working as a CNA is patient interaction. This includes (but is certainly not limited to) active listening, appropriate conversation, and relaying information.
Because many patients are hesitant to discuss personal matters with medical professionals, you must be careful when listening to patients and catch what is said as well as what is implied. A patient with a series of STD symptoms, for instance, may not divulge all necessary information when asked. Listen carefully, ask the right questions, and pay attention to subtext.
Appropriate conversation is important when speaking casually with your patients. This may include simple small talk or more in-depth questions about your medical background or qualifications. Be open and friendly in communication, but do not overindulge or slip into extremely personal conversations.
Relaying information will be a regular job for you as a CNA. You may be required to relay information regarding a patient’s care to a coworker or about caring for oneself directly to a patient. In these situations, listen carefully to ensure correct delivery of a message and clarify with coworkers and with patients alike. If any confusion is expressed, or if the possibility of misunderstanding arises, you must address these issues immediately to prevent a potentially hazardous communication breakdown.
As a CNA, you will be interacting with various medical professionals on a regular basis. While some of these interactions will not be professional in nature, many will require your rapt attention and will be highly confidential. In these situations, listen carefully, repeat back any information you are offered, and relay or write down the information exactly as presented.
Medical information is not only extremely confidential but is also potentially dangerous if a client or healthcare provider is misinformed. Because of this, adequate communication both verbally and in writing is of the utmost importance and must be accompanied by active, observant listening.
Monitoring Speech (Verbal and Nonverbal)
As a conversation with a close friend (or sworn enemy) can attest, conversation and communication is far more involved than simple words from a mouth. Gestures, tone, and body language are all indicators of a discussion’s purpose and tone. When speaking with patients, especially, CNAs must focus on delivering communication with tightly controlled nonverbal cues.
Offering a patient advice regarding a lifestyle change, for instance, will be poorly received if it is delivered with crossed arms, a creased brow, and a hard tone. A caring approach, with open arms, wide eyes, and a concerned tone will be far more effective in communicating the need for change. As you continue your training and work in the role of a CNA, be sure to monitor nonverbal speech by regulating your tone and body language.
As with any position, communication is a pivotal skill to master. While working as a CNA, you will be regarded with a plethora of emotions and concerns, including fear, hostility, hope, and distrust. To facilitate trust between you and your patients and pave the way for a positive experience, you must learn to communicate effectively, both in verbal displays and in written communication.
Emotional and Mental Health Needs Study Guide for the CNA
As a Certified Nursing Assistant (CNA), you are expected to care for all aspects of your patients’ health, including mental and emotional health. Mental health covers any mental disorders (including, but not limited to, schizophrenia and personality disorders); emotional health covers both emotional disabilities and simple emotional well-being. Because all patients are different, mental and emotional healthcare may vary from one patient to another. While some require extensive treatment and care regarding mental health, others only need emotional support and encouragement. When studying to become a CNA, and putting what you’ve learned into practice, put time and effort into the mental and emotional health of your patients. These aspects of health are pivotal in driving healing and recovery.
Mental health needs greatly vary between patients. As a healthcare practitioner, your responsibility lies with not only administering care but also paying close attention to patients to determine any changes in mental state, identifying any triggers for increased mental agitation, and ensuring that patients are being treated adequately. If a mental health patient, for instance, grows increasingly agitated at a certain time of day, part of your job is to seek out any potential causes and rectify the situation.
Performing adequately in this area of medicine requires some basic knowledge of the mental health field. While your expertise will be primarily medical in nature rather than psychological, this will be invaluable in properly assisting patients and peers. To prepare for assisting mental health patients, conduct a basic review of common mental maladies and disorders, including their common causes, onsets, symptoms, and treatments. You are expected to be an informed source for patients and peers alike. Remember your limitations in this field as well. While you are a medical professional, you should not take the role of diagnostician upon yourself, nor should you answer in-depth questions and concerns regarding treatment and medication. These questions should be accepted and referred to the patient’s physician.
Like mental health, emotional health is not typically marked by physical indicators. Ensuring patients’ emotional health requires regular observation and some amount of intuition regarding behaviors and emotions. Without careful observation, a patient’s emotional needs may not be met. Hospital stays can be frightening for anyone and particularly difficult in situations requiring extensive treatment or in cases without clear answers or causes. As a CNA, your primary purpose is to assist patients and physicians—part of this is caring for your patient’s emotional well-being and acting as a source of support and strength during a difficult time.
While you are not expected to step into the role of nurturer, friend, or family member with your patients, you should maintain some bedside manner and treat patients with kindness, respect and, perhaps above all, compassion. Offer support or encouragement when it is sought after, or consolation when it is requested. Many patients will be alone when bad news is delivered, or will not yet have relatives in the room when a positive prognosis is offered. Both circumstances require some amount of emotional support or emotional commiseration. This may be as simple as smiling and offering a word of congratulations when good news is delivered, or offering your condolences or expressing sorry when bad news is given.
All patients require a degree of support and assistance in all areas, including mental, emotional, physical, and, in some cases, spiritual. No one area should be ignored in order to provide superlative customer care and fulfill your role as a CNA.
Legal and Ethical Behavior Study Guide for the CNA
The role of Certified Nursing Assistant (CNA) brings with it certain legal and ethical responsibilities that are unique to the medical field. It is important that you know the standards of care set by the government and your facility to ensure that you are both meeting job standards and working within your scope of practice. If you do not perform your job as expected or perform duties you have not been trained to do, you may be liable (legally answerable) for your actions.
In the healthcare setting, there are many types of liabilities. Abuse is willfully physically or mentally harming a patient. Aiding and abetting can be thought of as being an “accomplice” to a crime by either participating in it or knowing about it and failing to report it. For instance, not reporting a CNA who hit a confused patient might make you liable for the crime, even though you did not hit the resident yourself. Assault and battery are legal terms that are often used together. Assault is the threat of violence and battery is the actual offensive touching or use of force on someone. False imprisonment is not allowing the patient to move freely about. An example would be applying wrist restraints to a patient who does not have a doctor’s order for such restraints. Invasion of privacy deals with the failure to keep a patient’s information confidential. The Health Insurance Portability and Accountability Act (HIPAA) is an important law to know for anyone that works in the healthcare field. Sharing “individually identifiable health information” with someone who is not directly responsible for caring for the patient may lead to job termination or legal action. Being cognizant of patient privacy laws at all times is important because, unlike willfully harmful actions such as assault or battery, HIPAA violations are not always obviously “bad.” For example, sharing with your grandmother that you took care of her friend Mary after her knee surgery and that she’s doing well may not be a maleficent act on the surface, but it would likely be considered a violation of Mary’s HIPAA rights in the court of law. Neglect and negligence can be used almost interchangeably. Being found negligent or neglectful in a healthcare context means that you either omitted care or failed to perform it correctly, and patient harm or injury was the result. Finally, theft, or stealing, is taking something that does not belong to you.
Patient’s Bill of Rights
The American Hospital Association created “A Patient’s Bill of Rights” in 1973. A “Resident’s Bill of Rights” was created soon after to include additional rights for those living in a long-term care setting. Because many CNA’s practice in such settings, it is important to know the rights found in each bill and what they mean for your job. The bill states that every resident has the right to know what they are being charged, to know about their medical condition, to participate in their own plan of care, to control their own finances and wear their own clothes, to be free of abuse and restraints, and to expect privacy and respect, among other things. While it is important to follow these rules, it is also important to remember to do so within your scope of practice. For example, the patient has the right to know about his medical condition, but as a CNA you should not be the one to answer questions about a cancer diagnosis; that is the doctor’s job. In this instance, your responsibility would be to go through the appropriate channels to ensure the patient is able to talk with his doctor about his questions.
Ethics are a trickier subject as we all have our own ideas of good and bad and right and wrong. In the healthcare field, many facilities and professional groups have a published code of ethics that can help guide one in ethical decision-making. Generally speaking, you should always operate with the principles of beneficence and nonmaleficence in mind. Beneficence is doing good for others, and nonmaleficence is doing no harm. When issues that are ethically complex or have more than one solution arise, it is best to consult with a supervisor or other health professionals to come to a good resolution.
Member of a Healthcare Team Study Guide for the CNA
The healthcare team is composed of several types of professionals, each with his or her own expertise. Regardless of role, each member of the team works together to come up with and implement a comprehensive care plan that will best serve the resident’s medical, nursing, emotional, psychosocial, and functional needs.
The Healthcare Team
As a Certified Nursing Assistant (CNA), you must know the role of each member of the team. Be informed of your specific roles and responsibilities and know who to communicate with if any sort of problem with the patient arises. Other healthcare team members include, but are not limited to, the physician who is in charge of treating the illness, the nursing staff (including the licensed nurse, medical aides, and CNAs), the social worker who attends to the emotional and social needs of the patient and the patient’s family members, the chaplain or spiritual counselor, and the physical therapist. The setup and size of the team depends on the type of the healthcare system, which could be a hospital, nursing home, hospice, or clinic. The type of healthcare system could be a factor in any possible additions to your list of duties.
The Role of the CNA
Your role as CNA is different from the licensed nurse in several important ways, but this does not mean that it is not important. You cannot dispense medication, handle IVs, or perform official patient assessments. But you may spend the most amount of “hands-on” time with the patient, so it is not uncommon for you to notice changes in the patient’s condition or demeanor before other members of the healthcare team do. You are also responsible for providing direct care, ensuring the patient’s comfort, safety, and welfare, and helping the patient meet various health needs and goals.
Activities of Daily Living
Directly caring for the patient largely means attending to his or her Activities of Daily Living (ADLs). ADLs are everyday physical activities such as bathing, dressing, eating, tending to hygiene and toilet activities, positioning, transferring, ambulating, and even communicating if needed. As a CNA, you are responsible in ensuring that the patients feel at ease physically and emotionally by helping them maintain a positive, neat, and approachable image and an environment reminiscent of home. Any sign of patient discomfort must not be put off for later and must be attended to immediately. For example, if the patient call light goes on, you should respond immediately to avoid any serious problem or complication.
As a hands-on member of the healthcare team, you are largely responsible for the patient’s safety. Ascertain the resident’s safety by strictly following procedure, being vigilant at all times, and reporting any minor and major changes in the patient’s condition to the appropriate source. Avoid situations that may endanger the safety of the patient, or for which you may be charged with negligence. For example, in most facilities, identifying the resident prior to administering any type of individualized care is a standard procedure in order to avoid wrongful treatment, which could be dangerous or even fatal to the patient. Ensure the environment is kept clean and hygienic by practicing proper infection control. Any form of bodily fluid must be assumed contaminated. Because you are in charge of the patient’s daily activities and may come into contact with such fluids, wash your hands before and after care and use gloves during any procedure that involves known fluid exposure, such as cleaning a urinary drainage bag.
Assessment and Assisting
Be mindful of the health needs of the patients by reporting any and all changes to their appearance, attitude, disposition, behavior, mood, energy level, and degree of complaining. Use your senses for objective observation such as seeing bruises, hearing moans of pain, or smelling fouls odors, and listen for complaints of patient discomfort or unhappiness. Report any changes, complaints, or oddities observed to the nurse in charge. Regularly report the resident’s vitals, such as pulse, temperature, blood pressure, and respiration, as well as patient’s weight, food and liquid intake, and elimination habits. This information is very important for the other members of the healthcare team to do their job properly, so make sure to use the proper tools and measurements designated by the facility where you work. During treatments or procedures in which the licensed nurse will be heading the administration, the nursing aide may be called on to assist. Again, be aware of the legal limitations of the procedures you can perform (which you cannot refuse or neglect) or cannot perform (which you have a right to refuse).
Restorative Skills Study Guide for the CNA
Restorative skills for CNAs (Certified Nursing Assistants) differ from Restorative Nursing Assistants (RNAs) in several ways. An RNA is required to have CNA training, with additional restorative training. CNAs, however, are simply required to acquire a basic competency level with restorative skills, in addition to all expected CNA duties. Because a CNA is typically involved with patients in the long term, a basic understanding of restorative and rehabilitative skills is necessary; as a CNA, you will be required to perform a multitude of duties, including assisting your patients with rehabilitation and therapy.
Understanding Restorative Skills
Restorative skills are ultimately designed to assist clients in achieving preventative care. Through therapy and rehabilitation techniques, a CNA may expect to serve as an encouragement for their patients, as well as providing direct restorative care, ranging from assistance as small as emotional support in therapy to actually assisting clients in achieving healing goals. Included in restorative care is observation. To utilize therapeutic techniques and enact preventative care effectively, a CNA must observe patients carefully to identify any problematic areas, or any potential issues with the client—physical or mental.
While you may not be expected to perform actual physical therapy exercises alongside your patient, you essentially serve as an emotional and physical support to your patient. This may mean encouraging your patient to complete all necessary exercises, or may mean actively assisting your patient to fulfill all therapy requirements adequately. Because restorative skills encompass many different techniques, approach patients with patience and positivity.
Restorative Care and Patient Interaction
When engaging in restorative care, you must regard your patients as adults in need of assistance. While your patients should not be treated like children or forced to undergo therapy or rehabilitation they do not want to attend, they should be strongly encouraged to attend all therapy sessions and work their hardest while there. Before and after therapy, motivate and encourage the patient, while assisting with any physical needs related to preventative care. This may include transporting the patient to the resident therapist, assisting with physical therapy techniques, and observing the patient for any signs of trouble or relapse.
Restorative skills also include basic patient care and transferable skills. Basic patient care may involve assisting with toileting and hygienic needs, and encompasses teaching patients how to care for themselves following hospitalization or significant medical treatment. As a CNA, you must be respectful, diligent, and patient with you clients, as many may resist rehabilitation efforts and may be inclined to dismiss some recommended treatment plans and follow-up care. When dealing with difficult patients, remember to treat them as adults. Patients treated with disrespect or condescension will likely not listen to your advice and may be able to pursue legal action against staff members—including any resident CNAs.
Spiritual and Cultural Issues Study Guide for the CNA
A Certified Nursing Assistant (CNA) is responsible for a number of factors regarding a patient—including physical, emotional, and mental well-being. Two pivotal aspects of mental and emotional well-being are issues of culture and religion. Culture and religion are factors entirely unique to each patient, and both may bring a series of challenges and difficulties for the patient’s care providers. As a CNA, you are expected to handle culture and religion issues with kindness, respect, and understanding.
“Culture” is defined as the arts, ideas, and behaviors of a certain ethnic or geographical group. The cultures of one portion of the United States, for example, may differ greatly from another. The most common cultural construct you may run into as a CNA is the construct of cultural ideas—especially as they relate to dealing with healthcare professionals, overall lifestyle, and child rearing.
When dealing with cultural concerns, keep an open mind and respect the potential strength of any cultural constructs. Cultural beliefs (including fears and misgivings) run deep and may have been shared over a series of generations. They are neither easily relinquished nor appreciated when these beliefs are belittled or cast aside. As a CNA, you must offer sound medical advice and care while taking cultural beliefs and concerns into account. This may be as simple as traditional dietary behaviors, or as complicated as a long-held disbelief in or mistrust of doctors and conventional medicine.
Religion is as deeply ingrained—if not more so—than culture and may be more difficult to work with. As a CNA, you must be considerate and understanding regarding religious beliefs. Do not belittle or ignore any concerns brought about by any given religion.
Religious issues may be small, such as dietary restrictions, or large, such as the refusal to accept a blood transfusion. Seek to work with religious beliefs, rather than simply working around or in spite of religious difficulties. When consulting with a patient with religious restrictions, listen to all of the patient’s concerns before proceeding. Be open to explaining any misunderstood or preconceived notions regarding medicine and healthcare to the patient. Make it clear that you, as a medical health professional, are working for the patients, not against them. Treat religious beliefs with respect regardless of any personal feelings toward a belief system, and work with the patient to achieve all health goals.
Tolerance and understanding are key aspects of both cultural and religious harmony among CNAs and patients. Though it may be tempting to dismiss immediately any false notions regarding the medical profession, an effective and successful CNA takes the time to listen to all concerns regarding religion and culture, and works to assist the patient with overcoming obstacles brought about by the thoroughly ingrained beliefs found in religion and culture. Because religious rights and cultural beliefs are protected, failure to adhere to all laws and regulations regarding religion and culture may result in legal difficulties stemming from discrimination. While treating religious and cultural diversity with deference is a pivotal aspect of being a caring, effective CNA, these beliefs are also protected legal rights, and hence should be treated as such.