Make sure you know about vicarious attention for your CNA skills exam, or you’ll be sorry!

What Everyone Should Know About CNA Test Taker Failures

CNA examinees received a failing grade on their Clinical Skills Test because they often neglected to demonstrate Indirect Care. What is indirect care? Emphasizes the examinee’s behaviors that are part of each skill tested on the Clinical Skills Test. The skills test is a timed test that lasts 30 to 35 minutes. In a real exam environment, time constraints add to the pressure felt by test takers. It can be a stressful experience because someone will be watching you all the time and taking note of your every move. Remember to take a deep breath and not panic. Why? Most testers aren’t overly picky about how you do things; so stay calm and focused. Testers are more concerned with their hygiene and behavior. Always keep in mind the fact that indirect attention is extremely important because:

(1) It is the nominal performance,

(2) It has separate score classifications, and

(3) It greatly affects the examinee’s overall performance during the skills test.

Pay attention to your behavior in terms of communicating with the resident, valuing resident rights, providing safety and comfort to the resident, and following proper infection control (standard precautions). It is one of the most important among the five skills required during the skills test. Remember: The Nursing Aide Evaluator will be observing and also evaluating your performance based on your behavior!

Here are the methods for performing vicarious attention: (Remember this: it will help you pass the skills test)

1. Communications. Communicate with the resident in a respectful and dignified manner:

• Greet the resident appropriately (eg, “Good morning, Mrs. Smith”).
• Introduce yourself to the resident
• Explain to the resident why you are there and what care you will provide
• Explain each step of the process to the resident prior to performing care (eg, “I’m going to turn him on his side now”).

2. Rights of residents

• Call before entering the resident’s room
• Provide privacy for the resident by lowering the shade before performing care.
• Always pay attention to your language and actions while providing care to the resident
• Ask the resident about their preferences, such as nail length, hairstyle, or food choices.
• Avoid addressing residents with nicknames like “Honey”, “Dear”, “Honey”, etc.

3.Safety and Comfort.

• Always check the resident’s bed to see if he or she is in a safe sleeping position.
• Adjust the resident’s sleeping position to a more secure one, if necessary.
• Lower the bed while performing care.
• Apply a seat belt when making a transfer
• Make sure side rails are up before dropping off resident
• Always place the call light within reach of the resident (Very important!)
• Always lock the bed casters before helping a resident into or out of a chair.

4. Infection control.

• Always wash your hands before and after care. (Highly important!)
• Wear gloves if necessary, especially during perineal care, catheter care, drainage bag care, denture and mouth care (teeth brushing), assisting with urinal use, measuring and urine output report.
• Dispose of gloves in a hazardous waste container.
• Please follow the dirty item disposal method correctly
• Avoid direct contact with the ground when making the bed
• Make sure the resident’s personal items are not dirty or contaminated.
• Offer to go to the bathroom during potty use
• Using soap and water on the resident during perineal care
• Use clean equipment when performing care

Note: Do not forget:

1. Knock on the door before entering the resident’s room.
2. Lower the curtain (if you are performing perineal care or giving the resident a bath)
3. Always put the call light within reach of the resident
4. Wash your hand before and after care.

It is important to take into account the Indirect Attention procedures. Many examinees FAILed their Clinical Skills Test because they were not well prepared and often forget to remember the Indirect Care approach to meet the needs of the resident. You don’t have to be a fast learner, but you should remember all the standard rules and precautions you’ve learned in your training classes. Evaluators allow corrections; in case you forgot something, you are free to correct it and immediately move on to the other skills. As long as you stay calm and make sure you think about skill sets, passing the CNA clinical exam should be a piece of cake.