Necessary Observation Skills for Certified Nursing Assistants

If you were to truly break down the influence and importance of a certified nursing assistant, you would see that these professionals are nothing more than an extension of the primary nursing staff. Throughout the work of a CNA, vital information is gathered and relayed to nurses. Without the assistance of CNAs, a host of information pertaining to the physical and mental health of patients would be lost. Because of the importance CNAs have in the realm of patient care, there are several necessary observation skills all certified nursing assistants must excel at. If you’re curious about a career in this field, then it’s important to ensure you can meet and exceed the following observational skills.

The Two Primary Types of Observation Skills

While there is a host of observation skills all CNAs must master, they all fall within two primary categories: Subjective and Objective. Both of these are tested on the CNA examination. For more info about the CNA exam, visit this site.

Subjective Observations – In the most general sense, subjective observations are those that are noticed, but can’t be measured by physical equipment. For example, the patient complains of having a stomach ache or a headache. While these are very real observations, as given by the patient, they cannot be measured with the equipment you have on hand. However, it’s essential that a CNA is able to filter out pieces of information that aren’t important, yet reporting essential subjective observations that nursing staff should be aware of. Remember, the primary job of a CNA is to report statements given by patients as accurately as possible; however, you must use your judgement to determine the level of severity a patient complaint may be at.
Objective Observations – The most basic definition of objective observations is observations that are measurable through undeniable forms. For example, vital signs, blood in patient urine and open wounds are classic forms of objective observations. These observations are not based upon the “feelings” of patients, but rather on the scientifically backed observations gathered through testing or by physical examination. Objective observations cannot be biased based upon personal feelings or personal judgements as they are, do not rely on guesswork to determine the severity of the observation.

The Four Pillars of Reporting Observations

One of the most essential components of being a CNA is learning how to report your observations; both subjective and objective. Because of the importance of reporting, all CNAs must follow the four pillars of observation reporting:

  1. All reported observations must be as accurate as possible
  2. All reported observations must be detailed and delivered to nursing/physician staff in a timely manner. Unusual findings must be reported ASAP.
  3. All reported observations cannot include bias or opinions. They must solely consist of facts, even if the fact is subjective.
  4. All reported observations that come from patient testimonials (complaints) must be direct quotes. CNAs should never paraphrase what they think the patient is trying to communicate. Doing so could severely alter the level of necessary care and treatment for patients.

Practice Tests for the CNA Examination

Just like any other career that requires a passing of a certification examination, certified nursing assistants are required to pass the NNAAP examination in order to become certified. While the exact elements and topics covered within the examination will vary by state, all states require successful completion of a two part exam. This exam consists of a written and clinical/hands-on portion. If you’re interested in preparing for this examination, the first step is to obtain a copy of the Nurse Aide Candidate Handbook distributed by your State Board of Nursing. The next step is to prepare for the actual examination by completing practice examinations. In order to ensure your preparation is as effective as possible, only choose a practice examination that covers the following topics.

NNAAP Practice Exam Content

The written portion of the CNA examination (NNAAP) generally consists of 70 multiple-choice questions. However, the exact length of the exam can vary from state-to-state. Regardless, all examinations utilize the multiple choice method of answering questions. Therefore, it’s essential that your practice examination be laid out in a similar manner.

Along with being a multiple-choice exam, most states feature three primary categories within the exam according to When searching for the best practice examination, make sure that it features the following topics and topic sub-categories.

  • Psychosocial Care – One of the primary functions of a certified nursing assistant revolves around caring for the emotional and mental health of patients. Within the practice test, make sure that it covers the following psychosocial elements:
    Mental health needs of patients
    Emotional health needs of patients
    Techniques when dealing with the mental well-being of patients
    Spiritual needs of patients
    Cultural needs of patients
  • Physical Patient Care – Along with caring for the emotional, spiritual and cultural well-being of patients, certified nursing assistants must also care for the physical health of patients. The NNAAP examination generally covers three primary categories with several relatable sub-categories.
    Daily Living Care
    Hygiene Care
    Dressing and grooming patient care
    Patient nutrition and hydration requirements
    Safe waste elimination techniques
    Caring for patient rest/comfort/sleep
    Nursing Skills
    Infection control techniques
    Therapeutic techniques
    Technical techniques/procedures
    Data collection techniques
    Effective reporting techniques
    Patient health and emergency care
    Restorative Skills
    Prevention techniques and procedures
    Self-care procedures
    Promoting patient independence
  • Role of Certified Nursing Assistants – The last topic covered within the NNAAP examination involves the role of CNAs within the nursing process. This section tends to deal with the ethical and legal requirements of CNAs. Make sure your practice exams feature the following information:
    Client Rights
    Communication Skills and Techniques
    The Role of CNAs in the medical team
    Legal requirements/behavior
    Ethical requirements/behavior

For more information visit CNA Certification Scoop.