Kentucky CNA (SRNA) common mistakes
Kentucky CNA (SRNA) · Understand the traps and how to avoid them.
Applies gloves and begins perineal care without washing hands first, then uses those same soiled gloves to adjust the pillow, touch the clean drawsheet, and press the call light.
Candidates memorize the order of a skill checklist but not the points where contamination actually transfers, so gloves get treated as a substitute for hand hygiene rather than a second surface to keep clean.
What to do instead
Practice the sequence as one loop every time: wash hands, glove, provide care, remove gloves, wash hands. Treat any touch of a clean surface with a soiled glove as an automatic glove change, and say the step out loud during practice until it is automatic.
Empties a urinal or emesis basin into the toilet and rinses it before measuring, then writes "voided" on the intake and output sheet.
The task is framed mentally as 'clean up the room' rather than 'collect a measurement,' and the measuring graduate is across the hall, so pouring out feels faster.
What to do instead
Before touching the container, put on gloves and set the graduated cylinder and the I&O slip on the bedside table. Measure first, record the number immediately, then empty and rinse. Report any output that is very dark, cloudy, or noticeably less than usual to the nurse.
Dresses a resident who has left-sided weakness by putting the shirt sleeve on the strong right arm first, and undresses by pulling the sleeve off the weak left arm first.
Candidates mirror what they do for themselves and reach for whichever limb is closer or more cooperative, without connecting the order to the resident's limited range of motion.
What to do instead
Use one rule: the weak side goes in first and comes out last. Dress the affected arm first, undress it last. Have the resident do as much of the motion as possible and only guide the sleeve over the hand.
Grasps a resident under the armpits to boost them up in bed or to stand them, or pushes a joint past the point where the resident says it hurts during range of motion.
Candidates are focused on getting the person moved safely and quickly and underestimate how easily the shoulder and arm can be injured, so the underarm grip feels like the most secure hold.
What to do instead
Use a gait belt for transfers and a drawsheet with a second helper for boosting. Never lift by the underarms. During range of motion, move only to the point of resistance or discomfort, stop when the resident reports pain, and let the resident perform the motion independently whenever able.
Responds to a crying or angry resident with "You'll be fine, don't worry about it," then finishes the task and leaves the room without telling anyone.
Candidates are uncomfortable with strong emotion and have been taught to keep interactions pleasant; reassurance feels kind, and reporting emotion feels like tattling.
What to do instead
Sit at eye level, name what you see ("You seem really upset this morning"), allow silence and crying without cutting it off, ask what would help right now, and pass the observation to the nurse in the same shift. Listening is the intervention, not fixing the feeling.
Sets a full meal tray in front of a resident who is fasting for a religious observance, or clears a prayer book, rosary, or religious item off the bedside table while tidying up.
Care is delivered on a schedule and trays are passed by routine, so the candidate follows the default without checking the care plan, and personal items on the table look like clutter.
What to do instead
Before meals and before tidying, read the care plan for cultural and religious preferences and ask the resident directly. Never remove a personal or religious object from the bedside; ask the resident where they want it, and report a resident who is not eating to the nurse.
Talks over the resident to the family member or roommate ("She doesn't really eat much, does she?"), or gives care without first putting on the resident's glasses or hearing aid.
Conversation feels faster with the person who answers back, and the assistive device is seen as part of morning care to be done later rather than a prerequisite for communicating.
What to do instead
Address the resident by name, face them, and speak directly to them, not about them. Put in the hearing aid and glasses before any conversation or care, reduce background noise, and use written notes or gestures if speech is hard to understand.
Leaves the door open or the curtain pulled back during a bed bath or dressing change, and continues care after the resident says "stop" or pulls away, saying "I'm almost done."
Candidates treat privacy and refusal as courtesies that can be traded for finishing the task on time, and a resident with dementia who resists may be read as uncooperative rather than as refusing.
What to do instead
Close the door and pull the curtain before undressing the resident, and keep only the area being washed exposed. If a resident refuses, stop, cover them, tell the nurse, and document the refusal. A refusal is the resident's right and is never overridden by a schedule.
Discusses a resident's diagnosis, behavior, or bowel habits with a coworker in the hallway or elevator, on a personal cell phone, or with a friend who also works in the building.
Staff talk to staff all day and the hallway feels like an internal, private space; the candidate has not internalized that anyone overhearing, including visitors, has no right to that information.
What to do instead
Move any resident-specific conversation to a private area and limit it to those who need the information to provide care. Never use a personal phone for resident information, and if someone outside the care team asks about a resident, say you cannot discuss it and refer them to the nurse.
Notices that a resident is newly confused, has a reddened area on the heel, or has refused two meals, and either says nothing or saves it for a hurried end-of-shift report because it seems minor.
Candidates do not yet see themselves as the eyes and ears of the team, worry about being wrong or causing trouble, and assume the nurse will notice anyway.
What to do instead
Report any change in condition to the nurse immediately and in person, describing exactly what you saw and when. Then document it. Reporting a change is never overstepping; waiting until the end of the shift is.