1. The Mental and Physical Demands of the Role
Being a CNA requires both mental and physical endurance. While physical strength is important, the real challenge lies in sustaining energy through long shifts in a high-stress environment. You must be prepared to handle various personalities, often from residents who are in pain, forgetful, or difficult to manage due to their circumstances.
2. Heavy Responsibility and Accountability
Every action carries significant responsibility. Even small mistakes can have serious consequences. With multiple residents to care for, it’s easy to overlook tasks — yet every missed detail, from remembering a patient’s requested PRN medication to ensuring timely hygiene care, falls back on you. Strict adherence to protocol is essential, as CNAs are often held accountable for incidents such as falls or missed care.
3. Workforce Quality/Turnover and Chronic Understaffing
The CNA field doesn’t attract the most dedicated individuals. Due to the relatively short certification process and slightly above minimum wage pay, many enter the field without a strong work ethic or long-term commitment. This leads to high turnover rates and constant call ins, making consistent teamwork difficult. On the bright side, you will come across the most amazing human beings that you can rely on and build an unbreakable bond with that may last for a lifetime. Although you may come across people who are not desirably work-friendly, you will definitely meet some rare gems that you can only find in this kind of work environment.
I also have to address the understaffing in healthcare despite it being widely discussed, experiencing it firsthand is entirely different. Unlike many jobs where your shift ends as scheduled, healthcare operates 24/7 — you can’t leave until you’re relieved. The constant need for coverage often results in mandated overtime, pushing personal boundaries without regard for staff well-being.
4. Emotional Attachments and Resident Losses
Forming bonds with residents is inevitable, and their passing can take an emotional toll. Navigating grief while maintaining professionalism is one of the most difficult aspects I found of the job. They become like family because of the time shared and the specialized care you provide them. You learn about their past, family, likes and dislikes that you eventually become someone who knows a lot about them, probably more than you intended to know. Perhaps, a side that their families will never get to see.
There will come a time you are performing post mortem care ready to have a new patient come lay in their bed. You might realize then that it becomes more than work. CNAs work closely to people who are at the end of life. We are the people at the gates of heaven right before you enter making sure that during your time here on earth, you were taken care of and that your life mattered.
5. Limited Resources
Healthcare facilities commonly operate with inadequate supplies and equipment, making it harder to deliver quality care. Of course, this will differ from facility to facility, but I have only worked in LTC nursing homes. From vital carts, lift machines, briefs, bags, and linens if any one of these was lacking it will affect the entire care system. The lack of resources adds to the daily frustrations of the role.
6. Challenging Management
Poor management is a common issue in many facilities. A lack of support, unrealistic expectations, and minimal communication often contribute to a stressful work environment. It’s also fair to note that management has their own share of problems and issues that nursing staff might not understand. Although seeing eye to eye will always be a struggle, becoming aware of this will definitely make things smoother in the workplace. Especially in staff meetings, knowing when how to communicate and speak up about ongoing flaws is essential and a great skill to have.
7. Inability to Provide Ideal Care
With so many residents assigned to each CNA, delivering the highest standard of care is often unattainable. The constant pressure to rush through tasks means some residents don’t receive the attention they deserve — whether it’s braiding their hair, brushing their teeth, or simply listening to their stories. Time constraints force difficult compromises, leaving many CNAs feeling like they’re falling short despite their best efforts. You can be stuck in a room with your hall partner doing a 10 minute bed change while the trays are arriving, or someone has fallen and you’re not aware of it. This is normal and will constantly change the way you need to tackle upcoming tasks.
8. Fulfillment
It is an incredibly fulfilling job because you are taking care of literal lives, and making a difference in someone’s day to day life. You play a vital role in their functionality, strength, mood, and so much more. I never knew what fulfillment was until I became a CNA. Not many people will ever experience the overflowing love, uncontrollable laughter and memories you gain from a place like this because people will only see the “dirty” side of it.
It takes a substantial amount of selflessness, heart and wisdom to thrive as a CNA. Becoming aware of the reality of most nursing homes will help you navigate and prepare for the obstacles you will face. Whether you are doing it short term or long term, you will find that it will probably be the most rewarding, life changing and hardest thing you do. I compare it to people who have run a marathon. Not everyone is mentally or physically equipped to do it. It will complete something in you. My experience as a CNA has been magical because I know now that I am special, strong and selfless. We are real life angels walking on earth!
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