The care of residents (or patients) in nursing homes is multi-faceted. The nursing care portion is made up of registered nurses (RNs), licensed professional nurses (LPNs), and nurses aides. Many nurses aides are certified, granting them the designation of CNAs.
CNAs, in some respects, are the most important people in the resident care tree, because they are responsible for nutrition intake, recording and measuring bowel movements and urine output, changing bedsheets, helping patients to the bathroom, changing diapers and clothing, bathing, and the like. According to a recent nursing home symposium, CNAs spend about 1.99 hours per day of patient care, compared with 1.25 hours for RNs and LPNs combined. CNAs provide about 60 percent of total nursing hours to residents. CNAs also represent the highest area of turnover in the nursing home industry, with turnover rates being as high as 93 percent annually in some places.
Because of job dissatisfaction, reports also indicate a shortage in available nurses aides in the marketplace. Nurses aides who have left the field of work report a number of reasons for electing to seek work in other areas, including: “(a) low unemployment and increased opportunities in the service sector, (b) low wages and benefits combined with high job demands and a lack of resources, (c) lack of respect and rewards, and (d) unappealing work environments.” Jill Quadagno, PhD and Sidney M. Stahl, PhD, Challenges in Nursing Home Care: A Research Agenda, The Gerontologist: Oxford Journals, Vol. 43, Issue Suppl 2, pp. 4-6 (Oxford Univ. Press 2016).
While the requirements vary slightly by state, in Alabama a person must have certain minimum requirements in order to qualify as a CNA. Those requirements include a high school diploma or an equivalent GED, completion of a state-approved CNA training program, and then passing of the CNA competency exam. Meeting these requirements entitles the person to have his or her name placed on the Nurse Aide Registry as a CNA.
According to the Certified Nursing Assistant License Organization, becoming a CNA is a highly desirable field. This organization reports that the popularity of this field is fueled because “the CNA certification process is extremely straightforward and simple [and] [u]nlike most other health care careers, [one does] not need a license to work as a CNA in Alabama.” All that is required is “an acceptable score” on the competency exam for someone to get his or her name on the state’s Nurse Aide Registry.
In order to confirm that a person is on the State Registry, a potential employer only needs a Social Security number. That number can be put into the Registry, which is maintained by the Alabama Department of Public Health, and the certification confirmed. Once a person is on the State Registry, they can maintain that status by working eight hours at an approved facility every 24 months. In other words, working one shift every two years is enough to continue to refer to oneself as a CNA.
While there are certainly many adequately trained and qualified CNAs, it is not a far stretch to see that many CNAs are likely not adequately qualified for the demands of the job, especially when it comes to caring for the aging population, many of whom are admitted to nursing homes each year. Because of this, it is imperative that nursing homes do a thorough background investigation and independently skill test potential CNA candidates to ensure that they are adequately trained, that they have sufficient support to do their jobs, and that they are not overburdened in patient care assignments. Doing so, in many instances, will greatly reduce and, in some cases, eliminate harm to residents of nursing homes.
If you need more information relating to the above or nursing homes in general, contact Ben Locklar, who handles Nursing Home Litigation for the firm, at 800-898-2034 or by email at Ben.Locklar@beasleyallen.com.
Sources: http://www.cnalicense.org/states/alabama/; http://gerontologist.oxfordjournals.org/content/43/suppl_2/4.full; and http://www.nursinglicensure.org/cna/alabama-nursing-assistant.html#context/api/listings/prefilter
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