In hospitals and long-term care facilities, many patients need extensive ongoing care. Nurses can change bedpans and help patients dress but it's not a cost-effective use of their skills, so nurses' aides are often used to perform these duties. Certified Nurses Aides, or CNAs, have different job titles in some states but their duties are roughly similar. Each state has its own form of licensing or registration for CNAs, which expires if not periodically renewed.
Licensing vs. Registration
Most CNAs work with the elderly, the disabled or the chronically ill. Since these are vulnerable populations, the 1987 Omnibus Budget Reconciliation Act made it mandatory for all nursing aides to pass a recognized competency evaluation and be registered by the state. Registration is a form of oversight that confirms you've had training and filed the appropriate forms with your state's board of nursing. Licensing is a more stringent process. States that license their CNAs usually require a certification exam, a criminal background check and some form of continuing education.
Licensing is a state responsibility, so there's no national standard. In most states, licensing and registration for CNAs have a two-year cycle. Some states count from the date of your initial certification, while others -- such as Oregon -- count your birthday as the renewal date. You will usually receive a written reminder from your state's board of nursing several weeks before your renewal date. This gives you time to complete the necessary forms and submit them. Most states have a schedule of fees for renewals, though a few registry-only states, such as Idaho, do not.
Reinstatement and Reactivation
There might be times when you fail to renew your license or registration when they're due. Perhaps you're taking a few years off to start a family or hike across India, or maybe you just missed your renewal date due to a vacation. Most jurisdictions have a grace period of a month or two, and you can get your license back by submitting the appropriate forms and paying an extra fee. If you've been away from the profession for a while, reactivating your license usually requires taking refresher training and a competency exam.
In addition to expiring, your license can be suspended, withdrawn or placed under restrictions for unethical or criminal conduct. Some forms of misconduct are blatant, such as stealing from patients or abusing them physically. However, you can also leave yourself open to disciplinary action through subtler errors such as giving patients care that falls outside your legal scope of practice. Wanting to give your patients the best of care is a good thing, but it's important to understand the legal and ethical limitations of your role.
- Explore Health Careers: Nurses Aide/Nursing Assistant
- U.S. Bureau of Labor Statistics: Occupational Outlook Handbook -- Nursing Aides, Orderlies, and Attendants
- Idaho Department of Health and Welfare: Certified Nursing Assistants (CNA)
- Oregon State Board of Nursing: CNA and CMA Certification Information
- Indiana State Department of Health: Frequently Asked Questions about Certified Nurse Aides
- Illinois Department of Public Health: Certified Nursing Assistant Facts
Fred Decker is a trained chef and certified food-safety trainer. Decker wrote for the Saint John, New Brunswick Telegraph-Journal, and has been published in Canada's Hospitality and Foodservice magazine. He's held positions selling computers, insurance and mutual funds, and was educated at Memorial University of Newfoundland and the Northern Alberta Institute of Technology.