The CNA II training enhances and broadens the scope of practice for the CNA, training the student in several specific skills beyond basic CNA preparation. CNA II skills are specifically intended for those patients with chronic, stable conditions.

A CNA II works under the direction of a registered nurse who must follow the principles of delegation as stated in Chapter 9 of the WSBN Administrative Rules and Regulations.

36 CEUs are available. Call CCHEC at 307-328-9274 to learn more.

Training and certification as a CNA II is required before the CNA may attend a Medication Aide-certified course.cna4

Admission Requirements

• Be at least 18 years of age;
• Have a high school diploma or a GED;
• Have a current unencumbered certified nursing assistant certificate;
• Have completed at least one thousand five hundred (1500) hours of documented work hours as a CNA;
• Work in an area where opportunities exist to complete the competency skills tests.


$250, includes all materials

Class Dates & Registration

Click here to view future class dates and register or call 307-328-9274 to schedule a customized class for your facility.

Course Outline

The CNA II course consists of a minimum of 30 hours, including 15 hours of classroom instruction and 15 hours of supervised clinical practice. After completing the course, the CNA must be able to test to all critical competencies, demonstrating clinical application of the skills at their base facility under the approval of a nurse before certification will be granted.

1. Identify the policies, procedures, rules and regulations that govern the CNA II in Wyoming;
2. Identify legal implications
3. Identify the principles of delegation that a registered nurse must adhere to when making the decision to delegate a task to a CNA II; and
4. Perform CNA II Skills:

 • Oxygen Therapy

Oxygen sources
Oxygen delivery devices
Safety precautions
Flow rate
Patient care required
Pulse oximeter
Normal oxygen saturation 2

Sterile Technique

Principles of sterile technique
Creates and maintains a sterile field
Maintains sterile technique while performing an activity
Keeps gloves sterile
Accurately identifies and reports “breaks” in sterile technique

Wound Care for stable wounds over 96 hours old

Irrigates wound
Cleans wound
Applies sterile or clean dressing

Oropharyngeal Suctioning

Performs procedure on conscious patient
Performs yankauer suctioning on conscious and unconscious patient

Urinary Catheter

Removes an indwelling urinary catheter
Obtains urine specimen from catheter port

Gastrostomy, and Percutaneous Gastric (P.E.G.) Feeding Tubes in a stable site:

Adds enteral feeding to intermittent tube
Instills water following feeding
Clamps enteral feeding tube

Elimination Procedures:

Ostomy; Care and irrigation of an ostomy that is stable and skin around the stoma is not excoriated
Performs stoma care
Changes an ostomy appliance
Irrigates an ostomy
Digitally removes fecal impaction
Performs bowel training program
Administers enemas

Capillary Blood Glucose Testing

Completes training according to CLIA standards
Calibrates machine and records
Obtains capillary blood sample (i.e. finger stick)
Reads and documents glucose results according to the machine used
Identifies normal blood glucose levels 3

Tracheostomy care for patients with well-established tracheostomy:

Performs skin care around stoma
Performs trach care
Changes dressing and ties
Performs suctioning

Assisting with peripheral IV fluids:

Collects IV equipment and materials
Hangs and primes tubing
Discontinues peripheral IV

Respond to Mental Health Needs

Recognize signs and symptoms of depression/anxiety
Communicate with patients appropriately


After completing the course, the CNA must be able to test to all critical competencies on the floor under the approval of a nurse before certification is final.

Information from the Wyoming State Board of Nursing

Barbara Jean James, MSN, BSN, RN

CNA Instructor
1650 Harshman
Rawlins, WY 82301


Barbara Jean James is a graduate of Rawlins High School and holds a Masters Degree in Nursing from the University of Wyoming. She has experience in Emergency Room Care, Acute Hospital Care, Home Health Care, Long Term Care and Teaching Nursing School for University of Wyoming and Kaplan University.

Barbara has been employed at Memorial Hospital of Carbon County for 15 years at every clinical and supervisory level, and currently as a Diabetic Educator. She is also employed at Carbon County Higher Education Center as a nurse educator, the University of Wyoming as a clinical Instructor, and Kaplan University. She has been teaching classes at CCHEC since 2004 in IV Therapy, CNA, CNA II, Med-Aide, It Takes Two, New Daddy and Mommy classes and Wyoming Children’s Action Alliance STARS program, and as an instructor with Western Wyoming Community College from 2004-2010.

Other activities include serving on the Boys and Girls Club Board and Downtown Development board. Barbara belongs to Soroptomist International of Rawlins as a board member, Wyoming Nurses Association as District 50 President, and Xi Kappa of Beta Sigma Phi.

Barbara has two children, and along with her husband Randy, 4 grandchildren.