Nurse assistant skills

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In the United States, certified nurse assistants (CNAs) provide personal care to residents or patients under the supervision of a registered nurse (RN) or licensed practical nurse (LPN); see Nurse: Types of nurses (and non-nurses).

The exact requirements for certification vary from state to state. This article describes in a general way the basic skills that are typically required of state-certified nurse assistants.

Among the requirements for becoming a state-certified nurse assistant is the mastery of a set of basic skills. These skills are needed to care for patients in both long-term-care facilities and in home settings. The descriptions below refer to the care of elder patients, but many of them would apply to any assistant nursing situation.

Table of contents
1 Handwashing
2 Ambulation
3 Applying antiembolic stocking
4 Bedpan use and output measurement
5 Denture/mouth care
6 Dressing
7 Feeding
8 Hair care
9 Bedmaking
10 Nail care
11 Bedbath
12 Passing fresh water
13 Positioning
14 Range-of-motion exercises
15 Vital signs
16 External link


Handwashing is the most important part of nurse assisting. It is the first step in preventing the spread of germs. Handwashing must be performed before and after doing anything with a patient. Hands that do not feel or appear soiled can spread disease.


Ambulation is a set of techniques for assisting patients in walking. One example is the use of a gait belt or transfer belt for patients who cannot stand on their own. The gait belt is put around the patient's waist and enables the assistant to lift the patient safely without straining his or her back. It can be used to help patients get in and out of bed, get up from a chair, or enter a walker.

Walkers help the elderly get exercise. Many elderly patients cannot walk on their own due to osteoporosis or other conditions. Exercise promotes movement, helps with circulation, helps the patient heal faster and be in better health, and ultimately, have a longer, happer life.

Applying antiembolic stocking

A antiembolic stocking is a device that is used on patients that under observation for circulation and vital signs. This device is like a sock except that it has a hole usually on top or bottom of the foot for comfort, and easy access to feet, so that the nurse assistant doesn't need to remove the sock every two hours.

Bedpan use and output measurement

A bedpan is a plastic device that is placed under patients who are unable to get up and use a bedside toilet or go to the restroom. It is used to catch all of the urination and bowel movements. The patient must be properly wiped and cleansed after elimination to prevent infection. The volume of urine must be measured and recorded. If a bowel movement has taken place, that should be noted along with any significant characteristics of the stool.

Denture/mouth care

Denture/mouth care is very important in providing proper hygiene for patients. Teeth must be cleaned in the morning and after each meal. This will help prevent tooth decay or gum conditions that could lead to tooth loss. Clean teeth are healthy teeth.


For the dependent patients dressing is not an easy task. In fact it is very difficult and need to be done properly. The best way to ensure that it is done right is to remember that you dress the weak side first so that the patient can help with the strong side, and to undress the stronge side first so they can help you undress the weak side as much as possable.


Patients must not be overassisted in feeding or they may stop helping themselves. Assistance should be confined only to those parts of the task they cannot accomplish for themselves. For example, a patient who cannot load a spoon, but is capable of conveying it to his mouth, should be assisted only in loading the spoon. He should convey it to his mouth himself, even if it would be faster for the assistant to do this for him.

Hair care

Providing hair care will help patients feel good about themselves. Long-term-care facilities may have a salon where residents can have their hair done once a week just they would at home. Hair must be maintained every day as well. Hair should be brushed from bottom to top, and care should be taken to avoid irritating the patient's scalp.


Bedmaking as practiced by a nurse assistant is a skilled task that must be performed precisely. The bed must be wrinkle-free to prevent bedsores, which not only cause discomfort to the patient but can cause serious health problems. Beds must be made when occupied by a patient as well as when unoccupied.

Nail care

Nail care with may not be as important as feeding but never the less it still from time to time must be done. Because many people don't realize that bateria gets in the nail bed and can cause elderly patients to get sick. Its important to remember to soak nails for at least five minutes to help loosen dirt and germs that are lodged in nail beds.


Due to lack of staff and the cost of water, patients may only get a bath once or twice a week; on other days, patients get bedbaths. This involves cleaning the underarms, body and peri areas.

Passing fresh water

Fresh ice water should be offered frequently to promote hydration. It is important to encourage drinking, because it is not unusual for elderly patients to be unaware of thirst and thus easily subject to dehydration.


Positioning refers to a set of techniques for changing the position of a bedridden person in order to avoid health problems such as bedsores. Many states required that bedridden persons be checked and repositioned at intervals of two hours or less.

Range-of-motion exercises

If not exercised, joints gradually lose their range of motion. Nurse assistants must be able to assist patients in performing a series of range-of-motion exercises that flex the joints of their arms, wrists, legs, fingers, hips, and feet. This aids circulation, prevents arthritis and stiffness, and speeds recovery from such as strokes, seizures, and falls.

Vital signs

Vital signs—temperature, respiration, blood pressure, and pulse—must be taken and recorded at least once a day. Increasing temperature can indicate a disease, increasing blood pressure may require medical treatment and special diets, irregular pulse can indicate heart problems. If a patient's vital sign seems to have changed drastically within a short period of time, a double check for accuracy may be warranted. Unusual findings should be brought to the attention of a supervising nurse or doctor.

External link

American Health Care Association guide to career options in long term care

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