Here are comprehensive professional CNA dialogues for each of the 22 skills:
1. Hand Hygiene (Hand Washing)
CNA Sarah: “Good morning, Mrs. Johnson. I’m Sarah, your nursing assistant for today. Before I provide any care, I need to perform proper hand hygiene.”
Mrs. Johnson: “I notice you’re being very thorough with your handwashing.”
CNA Sarah: “Yes, I’m required to wash for at least 20 seconds with plenty of lather and friction. I’m rubbing palm to palm, back of hands with fingers interlaced, and cleaning under my fingernails.”
Charge Nurse: “Sarah, I noticed you kept your fingertips pointing downward throughout the process.”
CNA Sarah: “That’s correct. This ensures water runs off my fingertips and prevents contamination. I also used a clean paper towel to turn off the faucet.”
Mrs. Johnson: “I feel much safer knowing you follow such careful procedures.”
2. Applies One Knee-High Compression Stocking (TED Hose)
CNA Maria: “Mr. Davis, your doctor has ordered compression stockings to help with circulation in your legs. I’m going to apply one to your left leg this morning.”
Mr. Davis: “Will it be uncomfortable? I’ve never worn these before.”
CNA Maria: “It should feel snug but not painful. First, I need to position you lying flat and expose only the leg I’m working on for your privacy.”
Mr. Davis: “Okay, I’m lying flat now.”
CNA Maria: “Perfect. I’m turning the stocking inside out to the heel, then placing it over your toes, foot, and heel. Now I’m gently pulling it up your leg, being careful not to use force.”
Mr. Davis: “That doesn’t hurt at all.”
CNA Maria: “Good! The most important part is making sure the stocking is wrinkle-free all the way to your knee. Wrinkles can cause pressure points and reduce effectiveness.”
Nurse Supervisor: “Maria, how did the stocking application go?”
CNA Maria: “Very well. The stocking is properly positioned, wrinkle-free to the knee, and Mr. Davis reports no discomfort.”
3. Assists to Ambulate Using Transfer Belt
CNA James: “Mrs. Chen, it’s time for your morning walk as ordered by your physical therapist. First, I’m going to put these non-slip shoes on your feet.”
Mrs. Chen: “I’ve been feeling a little unsteady lately.”
CNA James: “That’s exactly why we use a gait belt for safety. I’m placing this belt around your waist and checking that I can slip my fingers between the belt and your body.”
Mrs. Chen: “It feels secure but not too tight.”
CNA James: “Perfect. Now I want you to sit on the edge of the bed and let your feet dangle for a few minutes before we stand up.”
Mrs. Chen: “Why do we wait?”
CNA James: “This helps prevent dizziness from changing positions too quickly. How do you feel right now? Any dizziness or lightheadedness?”
Mrs. Chen: “No, I feel fine.”
CNA James: “Excellent. I’m going to count to three, and I want you to push up on the bed while I assist you to stand. One, two, three.”
Physical Therapist: “How did the ambulation go?”
CNA James: “We walked ten feet successfully. I stayed slightly behind Mrs. Chen on her weak side, holding the gait belt with palms up for better control.”
4. Assists with Use of Bedpan
CNA Lisa: “Mr. Thompson, you called for assistance. I have a bedpan ready for you.”
Mr. Thompson: “I really need to use it, but I’m not sure how this works.”
CNA Lisa: “No problem at all. First, I’m going to lower the head of your bed and put on clean gloves. Then I’ll turn you slightly and place a protective pad under you.”
Mr. Thompson: “Will this be dignified?”
CNA Lisa: “Absolutely. I’ll position the bedpan correctly with the deeper portion toward your toes, and you’ll be centered on it. Then I’ll raise your head back up for comfort.”
Mr. Thompson: “Thank you for explaining everything.”
CNA Lisa: “Of course. I’m placing the call light within reach and covering you with a blanket. Take your time, and call me when you’re finished. I’ll wait nearby but give you complete privacy.”
Charge Nurse: “How did you assist Mr. Thompson with the bedpan?”
CNA Lisa: “I followed proper positioning procedures, ensured his privacy and dignity, and will help him with hand hygiene when he signals he’s finished.”
5. Cleans Upper or Lower Denture with Patient
CNA Patricia: “Good morning, Mrs. Garcia. It’s time to clean your dentures after breakfast.”
Mrs. Garcia: “I worry about them getting damaged during cleaning.”
CNA Patricia: “I understand your concern. I’ve lined the sink with a washcloth to cushion them if they’re accidentally dropped. I also have all our supplies organized on this barrier.”
Mrs. Garcia: “That makes me feel better. Should I remove them?”
CNA Patricia: “Yes, please place them in this cup. I’m going to handle them very carefully to avoid any damage or contamination.”
Mrs. Garcia: “What kind of cleaner are you using?”
CNA Patricia: “I’m using denture toothpaste with this special denture brush. I’m thoroughly brushing the inner, outer, and chewing surfaces of each denture.”
Mrs. Garcia: “The water isn’t too hot, is it?”
CNA Patricia: “No, I’m using cool water for rinsing, which is safest for dentures. Now I’m placing them in this clean cup with fresh water.”
Dental Hygienist: “How was the denture cleaning process?”
CNA Patricia: “Very thorough. I cleaned all surfaces, used appropriate water temperature, and Mrs. Garcia was comfortable throughout the process.”
6. Counts and Records Radial Pulse
CNA David: “Mr. Williams, I need to check your pulse as part of your vital signs assessment.”
Mr. Williams: “Where exactly do you check it?”
CNA David: “I’m placing the tips of my fingers on the thumb side of your wrist, right over the radial artery. I need you to relax your arm.”
Mr. Williams: “How long does this take?”
CNA David: “I’ll count for a full 60 seconds to get the most accurate reading. Please try not to talk during this time so I can concentrate.”
Mr. Williams: “Okay, I’ll be quiet.”
Charge Nurse: “David, what was Mr. Williams’ pulse rate?”
CNA David: “I counted 78 beats per minute. The rhythm was regular and the pulse felt strong. I’ll document this in his chart immediately.”
Charge Nurse: “That’s within normal range. Good work on getting an accurate count.”
7. Counts and Records Respirations
CNA Angela: “Mrs. Lee, I’m going to count your breathing rate now. This is the last part of your vital signs.”
Mrs. Lee: “Should I breathe differently?”
CNA Angela: “No, please breathe naturally. I’m going to count each time your chest rises for a full 60 seconds.”
Mrs. Lee: “Will you tell me what you’re counting?”
CNA Angela: “I’ll count silently so I don’t distract you or change your natural breathing pattern. Just relax and breathe normally.”
Nursing Student: “How do you make sure you get an accurate respiratory count?”
CNA Angela: “I watch the chest rise and fall, count for the full 60 seconds, and observe for any irregularities in the breathing pattern. Mrs. Lee’s rate was 16 respirations per minute, which is normal.”
Charge Nurse: “Any concerns with her breathing?”
CNA Angela: “None at all. Her breathing was even, unlabored, and within the normal range.”
8. Donning and Removing PPE (Gown and Gloves)
CNA Robert: “I’m about to enter Mr. Foster’s room. He’s in contact isolation, so I need to put on protective equipment.”
Nursing Student: “Can you walk me through the process?”
CNA Robert: “First, I’m facing away from the gown opening. I unfold it, put my arms in the sleeves, and secure it at the neck and waist, making sure the back flaps overlap completely.”
Nursing Student: “What about the gloves?”
CNA Robert: “I put on gloves after the gown, making sure they overlap the gown sleeves at my wrists. Now I can safely enter the room.”
Infection Control Nurse: “Robert, show the student proper removal technique.”
CNA Robert: “The key is removing gloves first, turning them inside out, then performing hand hygiene before removing the gown. I remove the gown from the shoulders, turning it inside out and folding soiled areas together.”
Nursing Student: “Why hand hygiene between removal steps?”
CNA Robert: “Because the outside of the gown may have contamination, so clean hands are essential when touching it during removal.”
9. Dresses Patient with Affected (Weak) Right Arm
CNA Michelle: “Mr. Rodriguez, let’s get you dressed in your favorite shirt. I know your right arm has some weakness from your stroke.”
Mr. Rodriguez: “It’s frustrating not being able to dress myself easily anymore.”
CNA Michelle: “I understand, but we’ll work together. The technique is to start with your weaker right side first. I’m going to insert your hand through the sleeve and gently guide it through.”
Mr. Rodriguez: “Why start with the weak side?”
CNA Michelle: “It’s much easier and safer this way. It prevents strain and gives us better control. Now I’m grasping your hand to guide it through the sleeve.”
Mr. Rodriguez: “That didn’t hurt at all.”
CNA Michelle: “Good! Now for your stronger left arm – this will be much easier. I’ll help you button the shirt when both arms are in.”
Occupational Therapist: “How did the dressing assistance go?”
CNA Michelle: “Very well. I started with the affected right side first, provided adequate support, and Mr. Rodriguez was comfortable throughout the process.”
10. Feeds Patient Who Cannot Feed Self
CNA Karen: “Mrs. Park, it’s lunchtime. I have your pureed diet here as the speech therapist ordered.”
Mrs. Park: “I miss being able to feed myself.”
CNA Karen: “I know this is difficult. Let me raise your bed to at least 45 degrees first – this is important for safe swallowing.”
Mrs. Park: “What are we having today?”
CNA Karen: “You have pureed chicken, mashed vegetables, and thickened apple juice. I’m sitting at your eye level so we can interact naturally while you eat.”
Mrs. Park: “The portions look very small.”
CNA Karen: “I’m offering small amounts at a reasonable pace to prevent choking. I’ll describe each food as I offer it and give you plenty of time to chew and swallow.”
Mrs. Park: “Could I have some juice?”
CNA Karen: “Of course. I’ll alternate between food and fluids frequently. How are you feeling? Still hungry?”
Speech Therapist: “How did feeding assistance go?”
CNA Karen: “Mrs. Park tolerated the entire meal well. I maintained proper positioning, offered appropriate portion sizes, and she showed no signs of aspiration.”
11. Performs Modified Bed Bath to Face and One Arm, Hand, and Underarm
CNA Tony: “Mr. Jackson, it’s time for your bath. I’ve prepared warm water and checked the temperature for safety.”
Mr. Jackson: “Will you be washing my whole body?”
CNA Tony: “Today I’m focusing on your face and left arm as ordered. I’m starting with your eyes using just water, no soap, and I’ll use different parts of the washcloth for each eye.”
Mr. Jackson: “The water temperature feels perfect.”
CNA Tony: “I’m glad. Now I’m washing your face with a damp washcloth, still no soap, using different sides of the cloth. I’ll pat everything dry gently.”
Mr. Jackson: “You’re very gentle.”
CNA Tony: “Thank you. Now I’m moving to your arm. I’m placing a dry towel underneath first, then using soap and water to clean your arm thoroughly.”
Mr. Jackson: “Don’t forget my hand.”
CNA Tony: “Absolutely. I’m washing your hands, fingers, and fingernails carefully, then I’ll clean your underarm area. Everything gets patted dry when I’m finished.”
Charge Nurse: “How was Mr. Jackson’s partial bath?”
CNA Tony: “He tolerated it well. I followed proper sequence from cleanest to least clean areas and maintained his comfort throughout.”
12. Measures and Records Urinary Output
CNA Rebecca: “Mrs. Foster, I need to measure your urine output from the bedpan.”
Mrs. Foster: “Is this really necessary every time?”
CNA Rebecca: “Yes, your doctor needs to monitor your fluid balance carefully. I’m pouring the urine into this measuring container and reading it at eye level for accuracy.”
Mrs. Foster: “What did you get?”
CNA Rebecca: “The measurement is 280 milliliters. I’ll record this in your intake and output chart right away.”
Charge Nurse: “Rebecca, what was Mrs. Foster’s output this shift?”
CNA Rebecca: “This measurement was 280 mL, bringing her total shift output to 920 mL. All measurements have been within normal limits.”
Charge Nurse: “Good documentation. Make sure the measurement is within 25 mL of accuracy as required.”
CNA Rebecca: “Absolutely. I always measure at eye level with the container on a flat surface for the most accurate reading.”
13. Measures and Records Weight of Ambulatory Patient
CNA Carlos: “Mr. Kim, it’s time for your weekly weight check. I see you’re wearing your non-slip shoes.”
Mr. Kim: “I’ve been trying to gain weight like the dietitian suggested.”
CNA Carlos: “Let’s see how you’re doing. I’ve already balanced the scale to zero. Please step onto the center of the scale.”
Mr. Kim: “Should I hold onto the rail?”
CNA Carlos: “No, please keep your arms at your sides and don’t hold onto anything. This ensures we get the most accurate reading.”
Mr. Kim: “How much do I weigh?”
CNA Carlos: “You weigh 158 pounds today. That’s up two pounds from last week, which is excellent progress.”
Dietitian: “How did Mr. Kim’s weight check go?”
CNA Carlos: “Very positive! He’s up to 158 pounds, which shows he’s responding well to the increased calorie diet plan.”
14. Performs Modified Passive Range of Motion for One Hip and One Knee
CNA Jennifer: “Mrs. Brown, it’s time for your leg exercises to maintain joint flexibility.”
Mrs. Brown: “Will this be painful? My arthritis has been bothering me.”
CNA Jennifer: “I’ll be very gentle and stop immediately if you feel any pain. Please tell me right away if anything hurts.”
Mrs. Brown: “Okay, I trust you.”
CNA Jennifer: “I’m starting with hip abduction – gently moving your leg away from your body. I’m supporting your knee and ankle properly.”
Mrs. Brown: “That feels fine so far.”
CNA Jennifer: “Good! Now I’m bringing your leg back toward your body – that’s adduction. Next, I’ll bend your knee and hip up toward your chest – this is flexion.”
Mrs. Brown: “I can feel the stretch, but it doesn’t hurt.”
CNA Jennifer: “Perfect. Now I’m straightening your knee and hip back out – that’s extension. I’m completing all movements according to your care plan.”
Physical Therapist: “How did Mrs. Brown tolerate the range of motion exercises?”
CNA Jennifer: “Excellent tolerance. She reported no pain, and I was able to complete all hip and knee movements as ordered without resistance.”
15. Performs Modified Passive Range of Motion for One Shoulder
CNA Michael: “Mr. Taylor, time for your shoulder exercises. I’m supporting your elbow and wrist with both hands.”
Mr. Taylor: “My shoulder has been stiff lately.”
CNA Michael: “These exercises will help with that stiffness. I’m keeping your arm straight and raising it up and over your head – that’s flexion.”
Mr. Taylor: “I can feel it stretching.”
CNA Michael: “Good! Now I’m bringing your arm back down to your side – that’s extension. I’m moving slowly and watching for any signs of discomfort.”
Mr. Taylor: “It actually feels good to move it.”
CNA Michael: “I’m glad to hear that. Now I’m moving your arm out away from your body – that’s abduction. Then back to your side – adduction.”
Physical Therapist: “How was Mr. Taylor’s shoulder range of motion today?”
CNA Michael: “He tolerated all movements well with no complaints of pain. He actually reported that the movements felt good and helped with his stiffness.”
16. Positions on the Side (Supine to Lateral)
CNA Susan: “Mrs. Anderson, it’s time to turn you to prevent pressure sores. I’m going to raise the side rail on your right side first for safety.”
Mrs. Anderson: “I get nervous when you move me.”
CNA Susan: “I understand. I’ll explain each step as we go. First, I’m moving you closer to me from this left side of the bed.”
Mrs. Anderson: “Why do you move me closer first?”
CNA Susan: “This ensures you’ll be in the center of the bed after we turn you. Now I’m going to count to three and turn you toward the raised side rail.”
Mrs. Anderson: “Will I fall?”
CNA Susan: “Not at all. I’m controlling the movement completely. One, two, three. Perfect! Now I’m placing a pillow behind your back so you won’t roll back.”
Mrs. Anderson: “This is more comfortable than I expected.”
CNA Susan: “I’m glad! I’m also placing pillows between your knees and supporting your top arm. This maintains proper body alignment and prevents pressure points.”
Charge Nurse: “How is Mrs. Anderson positioned?”
CNA Susan: “She’s in good lateral position with proper support pillows, centered in bed, and reports being comfortable.”
17. Provides Catheter Care for Female
CNA Rachel: “Ms. Roberts, I need to perform your daily catheter care to prevent infection.”
Ms. Roberts: “Is this really necessary every day?”
CNA Rachel: “Yes, it’s essential for preventing bacteria from entering your urinary system. I’ve checked the water temperature and put on clean gloves.”
Ms. Roberts: “What exactly are you doing?”
CNA Rachel: “I’m following the tubing from you toward the drainage bag to ensure it’s positioned lower than your bladder with no kinks that could cause backflow.”
Ms. Roberts: “I see the tubing is hanging properly.”
CNA Rachel: “Exactly. Now I’m using a soapy washcloth to clean around where the catheter exits your body. I’m holding the catheter steady with one hand.”
Ms. Roberts: “You’re being very gentle.”
CNA Rachel: “I’m cleaning four inches down the catheter tube, always moving away from your body to prevent pushing bacteria toward your bladder.”
Nurse Supervisor: “How did the catheter care go?”
CNA Rachel: “The procedure went smoothly. The tubing is properly positioned, the insertion site looks healthy, and Ms. Roberts tolerated the care well.”
18. Provides Foot Care on One Foot
CNA Brian: “Mr. Green, it’s time for your foot care. I have warm water ready for soaking.”
Mr. Green: “My feet have been really dry and itchy lately.”
CNA Brian: “The warm water soak will help with that. I’ve checked the temperature, and I’d like you to feel it too to make sure it’s comfortable.”
Mr. Green: “That feels perfect – nice and warm but not hot.”
CNA Brian: “Great! I’m removing your sock and immersing your foot for about 15 minutes. This will soften the skin and make cleaning easier.”
Mr. Green: “This feels very relaxing.”
CNA Brian: “I’m glad! Now I’m using a soapy washcloth to wash your foot and carefully clean between each toe. Good foot hygiene is especially important for people with diabetes.”
Mr. Green: “Should I use lotion?”
CNA Brian: “Yes, I’ll apply lotion to moisturize your foot, but I’ll avoid putting any between your toes to prevent fungal growth.”
Podiatrist: “How did the foot care session go?”
CNA Brian: “Very well. Mr. Green’s foot skin looks healthier after soaking, and I provided thorough cleaning and appropriate moisturizing.”
19. Provides Mouth Care
CNA Nicole: “Good morning, Mrs. Wright. Time for your oral care to keep your mouth healthy.”
Mrs. Wright: “My mouth always feels so much better after you do this.”
CNA Nicole: “Good oral hygiene prevents infections and makes eating more enjoyable. I’m elevating your head slightly and placing this towel to protect your clothing.”
Mrs. Wright: “What kind of toothpaste are you using?”
CNA Nicole: “Regular toothpaste with fluoride. I’m applying just a small amount to this soft toothbrush. I’ll be brushing all surfaces – inner, outer, and chewing surfaces of all your teeth.”
Mrs. Wright: “Please be gentle on my gums.”
CNA Nicole: “Of course. I’m being very careful, especially around your gum line. After each section, I’ll let you rinse and spit into this basin.”
Mrs. Wright: “Don’t forget my tongue.”
CNA Nicole: “I won’t. I’m gently cleaning your tongue now, being careful not to trigger your gag reflex.”
Dental Hygienist: “How was Mrs. Wright’s oral care?”
CNA Nicole: “Thorough and well-tolerated. I cleaned all tooth surfaces, her tongue, and she was able to rinse effectively throughout the process.”
20. Provides Perineal Care for Female
CNA Amanda: “Mrs. Martinez, I need to provide perineal care as part of your daily hygiene.”
Mrs. Martinez: “I appreciate how respectful you always are during personal care.”
CNA Amanda: “Your dignity and comfort are my priorities. I’ve prepared warm water and checked the temperature. I’ll only expose the area I’m cleaning.”
Mrs. Martinez: “The water temperature feels good.”
CNA Amanda: “Perfect. I’m using a clean washcloth with soap to clean one side of the labia from front to back, then I’ll use a clean part of the cloth for the other side.”
Mrs. Martinez: “Why always front to back?”
CNA Amanda: “This prevents bacteria from the rectal area from spreading to the urinary tract. I’m using a clean portion of washcloth for each area to maintain cleanliness.”
Mrs. Martinez: “You’re very thorough.”
CNA Amanda: “I want to prevent any infections. Now I’m helping you turn to your side so I can clean the rectal area, always wiping away from the perineal area.”
Charge Nurse: “How did the perineal care go?”
CNA Amanda: “Mrs. Martinez tolerated it well. I followed proper front-to-back technique and used clean washcloth sections for each area as required.”
21. Transfers from Bed to Wheelchair Using Transfer Belt
CNA Kevin: “Mr. Johnson, let’s get you up to the wheelchair for breakfast in the dining room.”
Mr. Johnson: “I’m ready to get up. I’ve been looking forward to eating with other residents.”
CNA Kevin: “Excellent! First, let me put on your non-slip shoes for safety, then I’ll apply the gait belt around your waist.”
Mr. Johnson: “This belt feels secure.”
CNA Kevin: “Good. I’m checking that I can slip my fingers between the belt and your body. Now I’m positioning the wheelchair so you’ll move toward your stronger left side.”
Mr. Johnson: “Why that direction?”
CNA Kevin: “It’s safer to move toward your stronger side. I’ve locked the wheelchair brakes and removed the footrests. Do you feel dizzy or lightheaded?”
Mr. Johnson: “No, I feel fine today.”
CNA Kevin: “Perfect. I’m going to count to three. Push up on the bed while I assist you to stand. One, two, three!”
Mr. Johnson: “That was easier than I expected.”
CNA Kevin: “Great job! Now I’m helping you pivot toward the chair. When you feel the back of your knees touch the seat, reach for the armrests.”
Physical Therapist: “How did the transfer go?”
CNA Kevin: “Very smooth. Mr. Johnson assisted well, showed no signs of dizziness, and the transfer was completed safely.”
22. Measures and Records Manual Blood Pressure
CNA Lisa: “Mrs. Phillips, I need to take your blood pressure now. Please sit quietly with both feet on the floor.”
Mrs. Phillips: “I’m always nervous about blood pressure checks.”
CNA Lisa: “Try to relax. Anxiety can affect the reading. I’ve cleaned the stethoscope and cuff. Which arm do you prefer?”
Mrs. Phillips: “My left arm usually works better.”
CNA Lisa: “Perfect. I’m positioning the cuff with the bladder centered over your brachial artery, about one inch above your elbow crease.”
Mrs. Phillips: “Is it tight enough?”
CNA Lisa: “Yes, it’s snug but not uncomfortable. I’m inflating it to 160-180 mmHg, then I’ll deflate it slowly while listening for the Korotkoff sounds.”
Mrs. Phillips: “What do those sounds tell you?”
CNA Lisa: “The first sound I hear indicates your systolic pressure, and when the sounds disappear completely, that’s your diastolic pressure.”
Mrs. Phillips: “What’s my reading?”
CNA Lisa: “Your blood pressure is 142 over 86. I’ll document this in your chart and clean the equipment.”
Charge Nurse: “How was Mrs. Phillips’ blood pressure?”
CNA Lisa: “142 over 86. The reading was clear and accurate. I followed proper technique with slow deflation and careful listening for the Korotkoff sounds.”
