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In the UK, as in other countries, the CNA might also be called a Nursing Assistant (NA), Auxiliary Nurse (Aux-N), Patient Care Associate (PCA), Nursing Tech (NT), Healthcare Assistant (HCA), Heathcare Support Worker (HSW) or Clinical Support Worker.

The role is the same, no matter the title or initials: this level of worker in healthcare is one of a relatively low status but one which often holds a high level of experience and ability, but without qualification is unable to often perform to the level at which they might be capable of working because of issues of liability and legality. Attempts to regulate, control and verify education have been made in some places, and the result is the North American "CNA" (Certified Nursing Assistant), a credential gained by registering completion of the statuary level of workplace experience and academic achievement with a central body. This central certification allows an employer to verify experience and knowledge as well as to assist in preventing individuals who have been "struck off" (had registration/certification invalidated) from continuing to work in healthcare roles. In the UK, the credibility of the Healthcare Assistant and other social care workers is intended to be strengthened by their compulsory registration from 2009 with the General Social Care Council in England or its Scottish or Welsh equivalents.

Overview

In today's hospitals and extended care facilities a nurse assistant is an important part of a healthcare team that includes many personnel outside of nurses. Nurse assistants are needed to provide routine care so that nurses can provide care that only they can perform, as outlined by each state's Nurse Practice Acts, such as formulating care plans, nursing assessments, administering medication, and assisting in surgery room preparation. The nurse assistant must not only be very skilled in the actual procedures being performed but must also be able to observe a patient's condition and report that information back to the nurse. Due to other responsibilities, the nurse cannot spend large amounts of time in the room with the patient so the nurse assistant is often referred to as the nurse's "eyes and ears".

A nurse assistant is usually responsible for Activities of Daily Living, which include bathing and feeding patients.

A nurse assistant must also have a strong grasp of emergency procedures and be able to stay calm in stressful situations. They must be able to initiate a Code Blue and be well-drilled in CPR.

In March, 2007 the National Center for Health Statistics published the results of a survey. The 62 page document is titled, "An Introduction to the National Nursing Assistant Survey." http://www.cdc.gov/nchs/data/series/sr_01/sr01_044.pdf

 

Educational preparation

Federal nurse aide training regulations are mandated in the Omnibus Budget Reconciliation Act of 1987 (OBRA 1987). State-approved training programs must be a minimum of 75 hours and include 16 hours of supervised clinical training. Aides who complete the program are known as certified nurse assistants (CNAs) or State Tested Nurse Aid (STNA) and are placed on the State registry of nursing aides. To maintain certification, all nurse aides must complete 12 hours of continuing education annually.

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 Nursing assistant skills descriptions refer mostly to the care of elderly patients, but most of them would apply to any nursing assistant situation

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Licensed Practical and Licensed Vocational Nurses

Most training programs, lasting about 1 year, are offered by vocational or technical schools or community or junior colleges.
Overall job prospects are expected to be very good, but job outlook varies by industry.
Replacement needs will be a major source of job openings, as many workers leave the occupation permanently.
Nature of the Work [About this section] Back to Top

Licensed practical nurses (LPNs), or licensed vocational nurses (LVNs), care for people who are sick, injured, convalescent, or disabled under the direction of physicians and registered nurses. (The work of physicians and surgeons and of registered nurses is described elsewhere in the Handbook.) The nature of the direction and supervision required varies by State and job setting.

LPNs care for patients in many ways. Often, they provide basic bedside care. Many LPNs measure and record patients’ vital signs such as height, weight, temperature, blood pressure, pulse, and respiration. They also prepare and give injections and enemas, monitor catheters, dress wounds, and give alcohol rubs and massages. To help keep patients comfortable, they assist with bathing, dressing, and personal hygiene, moving in bed, standing, and walking. They might also feed patients who need help eating. Experienced LPNs may supervise nursing assistants and aides.

As part of their work, LPNs collect samples for testing, perform routine laboratory tests, and record food and fluid intake and output. They clean and monitor medical equipment. Sometimes, they help physicians and registered nurses perform tests and procedures. Some LPNs help to deliver, care for, and feed infants.

LPNs also monitor their patients and report adverse reactions to medications or treatments. LPNs gather information from patients, including their health history and how they are currently feeling. They may use this information to complete insurance forms, pre-authorizations, and referrals, and they share information with registered nurses and doctors to help determine the best course of care for a patient.

LPNs often teach family members how to care for a relative or teach patients about good health habits.

Most LPNs are generalists and work in all areas of health care. However, some work in a specialized setting, such as a nursing home, a doctor’s office, or in home health care. LPNs in nursing care facilities help to evaluate residents’ needs, develop care plans, and supervise the care provided by nursing aides. In doctors’ offices and clinics, they may be responsible for making appointments, keeping records, and performing other clerical duties. LPNs who work in home health care may prepare meals and teach family members simple nursing tasks.

In some States, LPNs are permitted to administer prescribed medicines, start intravenous fluids, and provide care to ventilator-dependent patients.

Work environment. Most licensed practical nurses in hospitals and nursing care facilities work a 40-hour week, but because patients need round-the-clock care, some work nights, weekends, and holidays. They often stand for long periods and help patients move in bed, stand, or walk.

LPNs may face hazards from caustic chemicals, radiation, and infectious diseases. They are subject to back injuries when moving patients. They often must deal with the stress of heavy workloads. In addition, the patients they care for may be confused, agitated, or uncooperative.

Training, Other Qualifications, and Advancement

Most training programs, lasting about 1 year, are offered by vocational or technical schools or community or junior colleges. LPNs must be licensed to practice. Successful completion of a practical nurse program and passing an examination are required to become licensed.

Education and training. All States and the District of Columbia require LPNs to pass a licensing examination, known as the NCLEX-PN, after completing a State-approved practical nursing program. A high school diploma or its equivalent usually is required for entry, although some programs accept candidates without a diploma, and some programs are part of a high school curriculum.

In 2006, there were more than 1,500 State-approved training programs in practical nursing. Most training programs are available from technical and vocational schools or community and junior colleges. Other programs are available through high schools, hospitals, and colleges and universities.

Most year-long practical nursing programs include both classroom study and supervised clinical practice (patient care). Classroom study covers basic nursing concepts and subjects related to patient care, including anatomy, physiology, medical-surgical nursing, pediatrics, obstetrics, psychiatric nursing, the administration of drugs, nutrition, and first aid. Clinical practice usually is in a hospital but sometimes includes other settings.

Licensure. The NCLEX-PN licensing exam is required in order to obtain licensure as an LPN. The exam is developed and administered by the National Council of State Boards of Nursing. The NCLEX-PN is a computer-based exam and varies in length. The exam covers four major categories: safe and effective care environment, health promotion and maintenance, psychosocial integrity, and physiological integrity.

Other qualifications. LPNs should have a caring, sympathetic nature. They should be emotionally stable because working with the sick and injured can be stressful. They also need to be observant, and to have good decision-making and communication skills. As part of a health-care team, they must be able to follow orders and work under close supervision.

Advancement. In some employment settings, such as nursing homes, LPNs can advance to become charge nurses who oversee the work of other LPNs and of nursing aides. Some LPNs also choose to become registered nurses through numerous LPN-to-RN training programs.