Alabama CNA common mistakes
Alabama CNA · Understand the traps and how to avoid them.
Putting on gloves before performing hand hygiene when answering a procedure question or starting a skill.
Candidates memorize 'wear gloves' as the first infection-control step and skip hand washing, even though gloves do not replace hand hygiene.
What to do instead
Always perform hand hygiene first, then don gloves; remove gloves and perform hand hygiene immediately after removal and between residents. When a question asks for sequence, choose hand hygiene as the first and last step.
Pulling a resident up by the arm or shoulder during a transfer, or twisting the torso while boosting.
Candidates focus on moving the resident quickly and underestimate the injury risk to both the resident and the aide.
What to do instead
Use a gait belt when indicated, lock bed and wheelchair wheels, lower the bed, stand close, bend the knees, keep the back straight, pivot the feet, and get help. Never pull on the resident's arm or shoulder.
Responding to a crying or angry resident with 'You're fine' or 'Don't worry' and then leaving.
Candidates feel uncomfortable with strong emotions and try to shut them down instead of listening.
What to do instead
Acknowledge the feeling, stay calm, listen, offer presence or a simple choice, and report persistent distress to the nurse. Avoid arguing with or minimizing the resident's feelings.
Following a rigid task schedule and refusing a resident's preferred routine, such as choosing clothing or when to bathe, when the care plan allows choice.
Candidates prioritize completing tasks efficiently and may see personal preferences as unimportant.
What to do instead
Offer choices within the care plan, respect dignity and independence, explain what you are doing, and negotiate timing safely. Document refusals and preferences and report them to the nurse.
Correcting or arguing with a resident who has dementia when they say a deceased spouse is coming to visit.
Candidates believe they must reorient the resident to reality and do not realize that confrontation can increase agitation.
What to do instead
Respond to the emotion, validate feelings, redirect to a safe activity, and avoid arguing. Report new or worsening distress to the nurse.
Using a bed rail, lap belt, or locked door as a quick way to stop a wandering resident.
Candidates panic about safety and choose restraint instead of supervised nonrestraint strategies.
What to do instead
Use nonrestraint measures such as a safe wandering path, supervision, alarms per facility policy, activities, and a toileting schedule; report to the nurse. Restraints require a provider order and are not first-line.
Completing all ADLs for a resident who can still feed, groom, or dress themselves.
Candidates think faster care equals better care and may not see the value of restorative independence.
What to do instead
Set up items, encourage the resident to do what they can, allow time, give cues, and follow the care plan. Document what the resident achieved and what assistance was needed.
Skipping range-of-motion exercises or not encouraging use of the affected side because the resident says it hurts or it is slower.
Candidates avoid discomfort or time pressure and may not connect inactivity to contractures and loss of function.
What to do instead
Follow the restorative plan, support the limb, stop if there is new pain and report it, and encourage self-care and use of the affected side within orders.
Talking about a resident's diagnosis or behavior in the hallway, elevator, or with friends or family who are not authorized.
Candidates forget that casual conversation is a confidentiality breach and may seek advice or support.
What to do instead
Discuss resident information only with the care team, in private, on a need-to-know basis. Do not confirm or deny information to unauthorized callers, and report breaches.
Writing 'resident seems depressed' or 'resident is fine' in the record instead of objective observations.
Candidates want to summarize or interpret, but documentation must be factual and measurable.
What to do instead
Record what the resident said or did, the time, intake and output, vital signs, and that the nurse was notified. Avoid diagnoses and opinions, and report changes promptly.