New York CNA common mistakes
New York CNA · Understand the traps and how to avoid them.
Puts on gloves without washing hands first, or strips off gloves and then immediately touches the bed controls, the chart, or the door handle without washing hands again.
Under test pressure, gloves get treated as a substitute for handwashing; candidates rehearse the visible task steps but never rehearse the transition points between them, so hand hygiene silently drops out of the sequence.
What to do instead
Build hand hygiene into every skill twice: as step one and as the final step, spoken aloud ("I'm washing my hands, then applying gloves"). Practise with a checklist where hand hygiene appears at both the start and the end of each skill until it is automatic.
Washes the perineal area from back to front, uses one washcloth for several strokes, or cleans a catheter by stroking the tubing toward the body instead of away from it.
The procedure gets memorised as a list of motions rather than as one governing rule, so when the anatomy on a mannequin is unclear the candidate guesses at direction.
What to do instead
Learn the single principle behind the whole skill: always move from the cleanest area toward the dirtiest, one stroke, one cloth. For catheter care, always stroke away from the meatus and never back toward it. Say the direction out loud on every practice run.
Walks into the room and begins the procedure without knocking, giving their name and role, explaining what will be done, or pulling the curtain or closing the door.
Candidates treat communication as filler around the 'real' skill and, when nervous, start the physical task immediately to avoid running out of time.
What to do instead
Drill one fixed four-part opening for every single skill: knock, name plus role, explain and ask permission, provide privacy. Practise it as a memorised script until it comes out without thinking.
Leaves the bed wheels unlocked, leaves the bed raised at working height with the resident unattended, or lowers a side rail and never raises it again.
Raising the bed protects the caregiver's back and feels like good practice, but lowering it afterwards is treated as cleanup and forgotten under time pressure.
What to do instead
Pair every height change with its reversal: 'up to work, down to leave.' Put lowering the bed and locking the wheels as the last line on the skill checklist and physically check it before turning away from the resident.
Places the wheelchair on the resident's weak side, forgets to lock the wheels or swing the footrests out of the way, skips the gait belt, or pivots the resident before asking them to bear weight.
Transfers are memorised as a physical sequence, so the safety checks feel like optional extras, and the 'strong side' rule is often repeated without being understood.
What to do instead
Use a three-part check before touching the resident: Lock the wheels, move Armrests and footrests clear, put the Belt on. Then place the chair on the strong side and have the resident stand before pivoting. Rehearse the checks as a verbal routine every time.
Estimates intake and output instead of measuring it, records vague phrases like 'drank well', or offers water to a resident who is on thickened liquids or a fluid restriction.
Guessing habits from home care carry over, and the resident's diet order is never checked before a drink is offered.
What to do instead
Measure what goes in, measure what comes out, subtract, and record exact millilitres. Before offering any drink, read the care plan for thickened liquids or restriction and state the order aloud during practice so the check becomes routine.
Leaves the resident alone to go find the nurse when a resident is choking or has fallen, or starts abdominal thrusts on a resident who is still coughing forcefully.
The instinct to 'go get help' conflicts with the correct action, and candidates have not been taught to distinguish a good airway from a bad one.
What to do instead
Memorise the rule: activate the emergency system by calling out from the room and do not leave the resident. Encourage coughing while air is moving; give thrusts only when the resident cannot speak, cough, or breathe. Practise saying the decision aloud.
Writes 'resident was fine' or 'seemed confused' in the record, or notices a change such as refusing food, new redness, or a complaint of pain and mentions it only to the next aide rather than the nurse.
Candidates do not realise that only the licensed nurse can assess, and they write conclusions instead of observations because that is how people talk day to day.
What to do instead
Report every change to the licensed nurse promptly, then document what you actually saw, heard, and did, with numbers and direct quotes (for example 'ate 25% of lunch, said pain 6 out of 10'). Never record opinions, guesses, or blame.
Dresses, feeds, or grooms a resident completely and quickly instead of letting them do the parts they can do, and never brings out the prescribed adaptive equipment such as a plate guard, built-up handle, or walker.
Time pressure and the wish to be helpful push candidates to do everything for the resident, and restorative language is rarely emphasised in informal training.
What to do instead
Before each ADL, ask what the care plan says the resident can do and let them do it, assisting only the parts they cannot manage and in the order they prefer. Hand them the adaptive device rather than substituting your own hands.
Takes a blood pressure over the resident's sleeve with the arm unsupported, counts an irregular pulse for fifteen seconds and multiplies by four, or takes an oral temperature right after the resident has had a hot drink.
Technique is learned once and never re-checked, and under time pressure candidates shorten counts and skip positioning because the numbers still 'look' plausible.
What to do instead
Follow a fixed checklist every time: bare arm, cuff about an inch above the antecubital space, arm supported at heart level, five minutes of rest first; count pulse and respirations for a full sixty seconds; wait fifteen minutes after hot or cold liquids before an oral temperature. Say each step aloud while practising.