Here are professional CNA dialogues for each of the 22 skills:
1. Hand Hygiene (Hand Washing)
CNA: “Good morning, Mrs. Johnson. I’m Sarah, your nursing assistant today. Before I help you with your morning care, I’m going to wash my hands thoroughly. This helps prevent the spread of germs and keeps you safe.”
Patient: “I appreciate that you’re being so careful.”
CNA: “Absolutely. I’ll be washing for at least 20 seconds with plenty of soap and friction. You’ll notice I keep my fingertips pointing down so the water runs off properly.”
2. Applies One Knee-High Compression Stocking (TED Hose)
CNA: “Mr. Davis, the doctor ordered compression stockings to help improve your circulation. I’m going to put one on your left leg now. Let me explain what I’m doing as we go.”
Patient: “Will it be uncomfortable?”
CNA: “It should feel snug but not painful. I’ll make sure it’s smooth and wrinkle-free up to your knee. Please let me know if you feel any discomfort.”
3. Assists to Ambulate Using Transfer Belt
CNA: “Mrs. Chen, it’s time for your walk. I’m going to put this gait belt around your waist for safety. First, let’s get your non-slip shoes on.”
Patient: “I feel a little dizzy today.”
CNA: “That’s why we’ll sit on the edge of the bed first and let you get your balance. Take your time. If you feel dizzy or lightheaded at any point, please tell me immediately.”
4. Assists with Use of Bedpan
CNA: “Mr. Thompson, I have your bedpan ready. I’m going to position you correctly with the deeper part toward your toes. I’ll give you privacy and leave the call light within reach.”
Patient: “Thank you for explaining that.”
CNA: “Of course. Take your time, and when you’re finished, press the call button. I’ll help you with hand hygiene after we’re done.”
5. Cleans Upper or Lower Denture with Patient
CNA: “Good morning, Mrs. Garcia. Time for your denture care. I’ve lined the sink with a towel to prevent damage if we accidentally drop them.”
Patient: “I’m glad you know how to handle them properly.”
CNA: “I’ll be very careful. I’m using the denture brush with just a little toothpaste to clean all surfaces thoroughly. The water is nice and cool for rinsing.”
6. Counts and Records Radial Pulse
CNA: “Mr. Williams, I need to check your pulse now. I’m going to place my fingers on your wrist and count for a full 60 seconds.”
Nurse: “What did you get for his pulse rate?”
CNA: “I counted 76 beats per minute. It felt strong and regular. I’ll document this in his chart right away.”
7. Counts and Records Respirations
CNA: “I’m going to count your breathing now, Mrs. Lee. Just breathe normally – don’t try to change anything.”
Supervisor: “How was her respiratory rate?”
CNA: “I counted 18 respirations per minute. Her breathing appeared even and unlabored. I’ll record this on her vital signs sheet.”
8. Donning and Removing PPE (Gown and Gloves)
CNA: “I’m caring for a patient in isolation, so I need to put on this gown and gloves before entering the room.”
Colleague: “Remember the proper sequence for removal.”
CNA: “Right – gloves off first, then hand hygiene, then the gown from the shoulders turning it inside out. Hand hygiene again when I’m done.”
9. Dresses Patient with Affected (Weak) Right Arm
CNA: “Mr. Rodriguez, I’m going to help you put on your shirt. Since your right arm is weaker, we’ll start with that side first.”
Patient: “Why do we start with the weak side?”
CNA: “It’s easier and safer this way. I’ll guide your hand through the sleeve, then we’ll do your stronger left arm. This prevents unnecessary strain.”
10. Feeds Patient Who Cannot Feed Self
CNA: “Mrs. Park, it’s lunchtime. I have your pureed diet here as ordered. Let me raise your bed to at least 45 degrees first.”
Patient: “What are we having today?”
CNA: “You have chicken with vegetables and mashed potatoes. I’ll offer small bites and give you plenty of time to chew and swallow. Would you like some water between bites?”
11. Performs Modified Bed Bath to Face and One Arm, Hand, and Underarm
CNA: “Mr. Jackson, time for your bath. I’ve checked the water temperature – it should feel comfortable. I’ll start with your eyes using just water, no soap.”
Patient: “The water feels good.”
CNA: “Perfect. I’m using different parts of the washcloth for your eyes and face to prevent spreading any bacteria. Now I’ll move to your arm with soap and water.”
12. Measures and Records Urinary Output
CNA: “I need to measure your urine output, Mrs. Foster. I’ll pour this into a measuring container and read it at eye level.”
Nurse: “What was her output for this shift?”
CNA: “I measured 240 mL this time. That brings her total output for the shift to 890 mL. I’ll document this in her intake and output record.”
13. Measures and Records Weight of Ambulatory Patient
CNA: “Time for your weekly weigh-in, Mr. Kim. I’ve balanced the scale and I see you have your non-slip shoes on.”
Patient: “Should I hold onto anything?”
CNA: “No, please keep your arms at your sides and try not to hold onto anything so we get an accurate reading. You weighed 165 pounds today – I’ll record that in your chart.”
14. Performs Modified Passive Range of Motion for One Hip and One Knee
CNA: “Mrs. Brown, I’m going to do your leg exercises now. I’ll move your leg gently away from your body first, then toward your body.”
Patient: “Will this hurt?”
CNA: “It shouldn’t. Please tell me immediately if you feel any pain. I’ll stop if there’s any resistance or if you’re uncomfortable. These exercises help maintain your joint flexibility.”
15. Performs Modified Passive Range of Motion for One Shoulder
CNA: “Mr. Taylor, time for your shoulder exercises. I’m supporting your elbow and wrist as I gently raise your arm up and over your head.”
Physical Therapist: “How did his range of motion look today?”
CNA: “He tolerated it well with no complaints of pain. I was able to complete the full flexion and extension movements as ordered in his care plan.”
16. Positions on the Side (Supine to Lateral)
CNA: “Mrs. Anderson, it’s time to turn you to prevent pressure sores. I’m going to move you closer to me first, then turn you toward the raised side rail.”
Patient: “Will I be comfortable?”
CNA: “Yes, I’ll place pillows behind your back and between your knees for support and comfort. I’ll also check that you’re not lying on your bottom arm.”
17. Provides Catheter Care for Female
CNA: “Ms. Roberts, I need to clean around your catheter to prevent infection. The water temperature should feel comfortable.”
Patient: “Is this necessary every day?”
CNA: “Yes, daily catheter care is important to prevent bacteria from traveling up the tube. I’ll clean four inches down the catheter tube, always moving away from your body.”
18. Provides Foot Care on One Foot
CNA: “Mr. Green, I’m going to soak your foot in warm water for about 15 minutes, then clean between your toes and dry thoroughly.”
Patient: “My feet have been really dry lately.”
CNA: “I can apply lotion after we’re done, but I’ll avoid putting any between your toes to prevent moisture buildup. Would you like me to put your socks back on afterward?”
19. Provides Mouth Care
CNA: “Good morning, Mrs. Wright. Time for your oral care. I’m going to brush all surfaces of your teeth – the inner, outer, and chewing surfaces.”
Patient: “My mouth feels so much better after you do this.”
CNA: “Good oral hygiene is really important for your overall health. I’ll make sure to be gentle on your tongue and give you plenty of opportunities to rinse and spit.”
20. Provides Perineal Care for Female
CNA: “Mrs. Martinez, I need to provide perineal care for you. I’ll clean from front to back to prevent any bacteria from spreading.”
Patient: “Thank you for being so gentle and respectful.”
CNA: “Of course. I’ll use a clean part of the washcloth for each area and always wipe away from the urethral area. This helps prevent urinary tract infections.”
21. Transfers from Bed to Wheelchair Using Transfer Belt
CNA: “Mr. Johnson, let’s get you up to the wheelchair. First, I’ll put on your non-slip shoes and the gait belt for safety.”
Patient: “I feel stable today.”
CNA: “That’s great, but we’ll still take our time. I’ll lock the wheelchair brakes and position it so you move toward your stronger side. Tell me if you feel dizzy at any point.”
22. Measures and Records Manual Blood Pressure
CNA: “Mrs. Phillips, I’m going to take your blood pressure now. Please sit quietly and keep both feet on the floor while I position the cuff.”
Nurse: “What did you get for her blood pressure?”
CNA: “Her blood pressure is 138 over 82. I made sure to deflate the cuff slowly and listen carefully for the Korotkoff sounds. I’ll document this in her chart and clean the equipment.”
