4 Chapter 1 As a result, nursing assistants may be the first ones who observe changes in resident behavior and function or who become aware of residents’ specific needs. This information is then reported to the licensed nursing staff for follow-up. The role of the nursing assistant is important and includes many responsibilities. How Do You Become a Nursing Assistant? Becoming a nursing assistant requires specialized education and training and the use of knowledge and skills learned to deliver safe, quality care. Education and Training In 1987, the US Congress passed the Omnibus Budget Reconciliation Act (OBRA), which standardized the minimum requirements for certified nursing assistant training programs and evaluation. OBRA is specific to nursing assistants working in nursing homes that receive federal funding. Today, nursing assistant education and training courses that lead to certification (a credential that shows a person has completed required education and training) must meet OBRA standards. Since OBRA was passed, states have taken the responsibility of making sure nursing assistant education and training programs meet these standards. States also determine how nursing assistant certification is given, what certification competency examination will be used, and when and where the exam will occur. The minimum age required to enter a nursing assistant education and training program differs from state to state. Programs range from a minimum of 75 hours to more than 150 hours. Requirements for supervised clinical training include at least 24 hours or more in long-term care facilities. Some programs also include hospital and other related clinical experiences. The Certification Competency Examination On completion of a state-approved nursing assistant education and training program, graduates are expected to take the certification competency examination required by the state in which they live. The examination tests knowledge (in a written or oral exam) and skills (as part of a hands-on demonstration). To become certified, a graduate must pass both parts of the examination with a state- determined score. Many resources, including this textbook, provide practice questions similar to those found on the examination. When a nursing assistant becomes certified, he or she may use the legal title certified nursing assistant (CNA). Using this title means you have met the requirements to practice as a nursing assistant within the regulations, or rules, determined by your state. Registration as a Nursing Assistant Federal law requires every state to maintain a registry, or list, of nursing assistants. Individuals who successfully complete an approved nursing assistant program and pass the certification competency exam are listed on the registry. The registry also has information about nursing assistants who have been charged with abuse, neglect, and theft. To work as a nursing assistant, a person must keep an active status on the registry. This means that a person’s information is up-to-date and that he or she has no charges of abuse, neglect, or the theft or misuse of resident property. Nursing assistants must renew their registration every two years. Requirements for education or training and the certification competency exam may vary from state to state, and so will regulations for nursing assistants. Be sure to check the specific requirements for the state in which you live. What Do I Need to Know to Become a Holistic Nursing Assistant? Learning how to be a holistic nursing assistant emphasizes the caring aspect of the nursing assistant’s role and strengthens the knowledge and skills needed to provide holistic care (care that integrates the body, mind, and spirit). Understanding and using the Providing Holistic Care Framework, shown in Figure 1.2, will be a helpful guide in this learning process. THINK ABOUT THIS According to the US Bureau of Labor Statistics, employment for nursing assistants is expected to grow 11 percent in the next six years. This growth is faster than the average for all occupations. Copyright Goodheart-Willcox Co., Inc.