Utah CNA common mistakes
Utah CNA · Understand the traps and how to avoid them.
Walking into a resident's room without knocking, or knocking and then entering before the resident answers, and opening closed curtains or drawers without asking.
Candidates train on a task checklist and treat the room as a workspace rather than the resident's home; time pressure makes the door feel like a formality.
What to do instead
Knock, state your name and purpose, and wait for an answer before entering; if the door is closed or the resident is undressed or receiving care, ask permission again before entering. Ask before opening curtains, closets, or drawers, and pull a privacy screen for any care involving exposure.
Talking about a resident's diagnosis, behaviors, or body in the hallway, elevator, dining room, or at the nurses' station within earshot of visitors or other residents, or answering a family member's questions about another resident's condition.
Casual staff chatter and the habit of thinking out loud normalizes discussing residents as topics instead of people; candidates also want to be helpful to a worried family member.
What to do instead
Hold all resident-specific discussion behind a closed door or in a private area with only staff who need the information. If a family member or visitor asks about a resident, say you cannot discuss it and direct them to the nurse or social worker.
Finishing care and leaving the bed at working height with wheels unlocked, the call light on the floor or over the side rail, and the overbed table or personal items out of the resident's reach.
Attention is on the task just completed (bath, transfer, dressing) rather than on the 'after' state of the room, and the closing steps are not part of the memorized procedure.
What to do instead
Build a fixed end-of-care sequence that you run every single time: bed lowered to lowest position, wheels locked, side rails per the care plan, call light in the resident's hand and tested, personal items and water within reach, and tell the resident where the call light is.
Starting abdominal thrusts on a choking resident who is still coughing forcefully or can speak, or conversely standing by and watching a resident whose cough is silent and who cannot breathe.
Panic creates a reflex to 'do something' the moment food goes down wrong, and candidates have not practiced distinguishing an effective cough from an ineffective one.
What to do instead
Ask 'Are you choking?' If the resident can speak or cough forcefully, encourage coughing and stay with them. Intervene only when the cough is silent or ineffective, the resident cannot speak, or breathing stops; then activate the emergency response and begin thrusts.
Using elderspeak with residents: calling them 'honey,' 'sweetie,' or 'dear' instead of their name, speaking loudly and slowly in a sing-song voice, or discussing the resident in the third person while they are sitting right there.
Candidates copy what experienced staff do and use a soothing tone to manage their own discomfort; the resident's actual hearing and cognition are never assessed, so impairment is assumed.
What to do instead
Use the resident's preferred name, speak in a normal adult tone at a normal rate, and address the resident directly ('Mrs. Lee, are you ready for your bath?'). If the resident does not respond, check for hearing loss, background noise, or a hearing aid before raising your voice, and speak to the resident, not about them.
Wearing the same pair of gloves from one resident to the next, or removing gloves and moving on to the next task without performing hand hygiene, treating gloves as a substitute for washing hands.
Gloves create a feeling of being protected and clean, and hand hygiene between every resident contact feels redundant when hands never 'touched' anything directly.
What to do instead
Perform hand hygiene immediately before donning gloves and immediately after removing them, and always between residents. Change gloves when torn or heavily soiled and between dirty and clean tasks on the same resident, and remove PPE before leaving the room, never carrying it into the hallway.
Taking over the whole task for a resident who can do part of it - washing the face, buttoning the shirt, or bringing the cup to the mouth - because it is faster, without asking what the resident wants to do themselves.
Efficiency pressure and a genuine wish to help make 'doing it for them' feel kind, and candidates underestimate how much function a resident retains.
What to do instead
Ask the resident what they would like to do themselves, set up the supplies within reach, and allow extra time. Provide cues or partial assistance only for the steps they cannot complete, and document what they did independently so the next shift does not take it back.
Taking a blood pressure or starting an IV-site check on whichever arm is nearest, including an arm with a dialysis fistula, on the side of a mastectomy with lymph node removal, or an arm with an IV line or lymphedema.
Candidates focus on getting the cuff on correctly and treat both arms as interchangeable; restrictions are noted in the chart but not connected to the procedure in front of them.
What to do instead
Before applying a cuff, check the care plan and ask the nurse which arm to use, and look at the arm for a fistula, IV, or swelling. Use the unaffected arm and report to the nurse if neither arm is safe.
Feeding a resident who is slumped or lying flat, loading the spoon with a large bite, and not checking the mouth for pocketed food after swallowing.
Feeding is treated as a speed task during a busy meal tray, and an upright position or a mouth check does not feel like part of 'feeding.'
What to do instead
Sit the resident upright (at least 45 degrees, ideally 90) before the first bite, sit at eye level, offer small bites at a slow pace with fluids as allowed, and look inside the cheek after each few bites for pocketing. Stop and report to the nurse if the resident coughs, gurgles, or voice sounds wet.
Correcting or arguing with a resident who has dementia about a false belief - insisting a deceased spouse is dead, arguing that it is not time to go home, or quizzing the resident on the date or their room number.
Candidates use ordinary logic and honesty, which feels respectful, but reality orientation escalates distress when the resident cannot update their memory.
What to do instead
Respond to the feeling, not the fact: acknowledge ('You miss your husband'), then redirect to a safe activity or topic. Do not quiz or argue; if the resident insists on leaving, use distraction and notify the nurse rather than physically blocking or reasoning at length.