Brand new CNA and drowning

[Monkeyruler164]

I just recently became a CNA. I just got my first ever CNA job at a LTC/Rehab facility. I have never worked as a CNA. I was hired on a NOC 10pm to 6:30 am shift. The interview and hiring process was great. The staff made me want to work there. However, last night was my first night and it was terrible. I have never wanted to walk out so bad. My trainer was terrible. She explained absolutely nothing. I had no idea why we were doing what we were doing or really what we were doing. She didn't speak English too clearly and got a bit annoyed when I couldn't understand her. She kept trying to force me to do stuff I had never learned. I tried asking questions but got no answer. At one point, I asked her as she was changing a brief, she rolled resident on their side, away from her to wipe and change them and I asked her...what happens of the resident rolls out of the bed and onto the floor (there was no guardrails) and my trainer just ignored me. I'm no where near comfortable changing a resident by myself and she kept trying to make me. I asked her how do you know if you should use tan or blue brief and I heard crickets! In clinicals, we were banned from doing any transfers. So at 5:30am, she's dressing a resident and getting ready to do a hoyer and snapped at me for not knowing what to do. I ended up snapping back that I've never been trained and I apologized for. Another CNA showed me a trick of ripping the brief tabs off so as to not rip resident's skin but when I went back to trainer, she yelled at me for doing it that way. The RN was awesome though. She helped answer some questions. I'm supposed to have 4 days of training with the option of more if I need it (and I do). Tonight I'll have a new trainer but I'm totally dreading work. I've read on here that a lot of people hate it at first, so I'm assuming this is normal. I plan on refusing to be left on my own until I feel somewhat comfortable and I know what I'm doing but I'm doubting myself and this job. I need the experience but I cannot let them put me alone for fear of injuring these residents. 1 or 2 of them terrify me. One my trainer was changing and she was screaming for morphine and flatly told us she refused us. She refused us and to leave her alone. I always thought they had that right but my trainer ignored her. I can't stand the thought of hurting them. I was also told I had the choice between ltc and rehab but I was put in ltc and I didn't really want long-term. On other thing, is at my last job (retail) you werr required by the state to have a break for every 3 hours worked, so 2 breaks and a lunch for an 8 hour shift. My trainer refused to let me go to my last break, even though it is stated in handbook we get 2 breaks. I'm just a mess of nerves, frustration, and terror. Any advice would be wonderful! Any tips or hints to. Sorry it's so long.

[mvm2]

Sometimes you dont always get the trainer you would desire but you just have to do your best and learn what you can from them. Maybe your next trainer will be a lot better.

I will say I am surprised that you took a CNA class and was not shown how to use a hoyer. Many of these things will be a first time for you but things that you described like changing a brief, you just have to take a breath, roll up you sleeve and get in there and do it. Some things I know you are scared to be doing yourself and be unsafe. But there is a line of being cautious and being too scared to get in there and get hands on and learn by doing. Don't be so intimidated that you will not feel ready to do the job when the training is over.

You can do this... next time they ask about changing a brief tell them I'll do it but could you watch me and tell me if I am doing anything wrong. The best learning is by doing when it comes to CNA work

[Missingyou, CNA]

It's true, you will feel very overwhelmed and incapable for a few weeks. You WILL learn a routine, and tricks of the trade and things will get better. Hang in there!

~read some of the other posts here on organizing and tips, etc. There are lots here from new CNA's asking for advise and plenty given. :)

I agree 100% The best way to learn being a CNA is to DO it.

I can understand you being concerned about hurting someone but, there are resident's that hurt no matter what you do, and sometimes you have to just quickly & carefully do what needs to be done even when they are crying out.....otherwise, they will never be clean or repositioned!

Yes, they have a right to refuse care, but, if you leave them be to long or too often (even at their request) you can be in trouble for neglect.

~mouth care, hair brushing, things like that are a little different. While you will encourage it and attempt it, if they refuse, then let it be. ALWAYS tell the nurse that you made several attempts to provide care and they refused. Sometimes it's just a matter of knowing a resident and what works for them.

I have one lady who is late stages dementia. She needs total care, talks but rarely makes sense. When I change her brief, she yells and swears at me says "I"M GONNA TELL YOUR MOTHER!!!". All I have to do is say in a soft tone, "I'm sorry, I promise to be good from now on. I just want to help you get comfortable". So says "ok, that's good!" and I can do what needs to be done. :)

Just remember dignity, respect and compassion when caring for someone and you will be just fine! I could write a book about being kind and patient with someone and earning their trust. Just remember that these folks worked, had families, and to them, you are just a young kid (even if you're in your 40's). They expect and deserve to have respect and dignity!!! RESPECT YOUR ELDERS. You will get much more cooperation from them!

[Valcorie34, BSN, MSN, RN]

Ok so I have a few comments. First how can you have a CNA class and not do pericare or transfers in clinicals? That seems to leave someone so unprepared...

Anyway, Tips:

1. Pericare. Either tear off tabs (I do) or fold the velcroor sticky side over and tuck them under patient. Also make sure there is a draw sheet so when you roll someone, try to keep them in center of the bed. I have never had someone roll out of bed. Just watch thier positioning. Also dont leave them to get supplies, have everything ready BEFORE you start. New depends, spray, wipes, a bag to put dirty stuff in (I carry a small roll in my pocket so if trash bags run out in room I am fine) Don't be afraid to wipe. Make sure they are clean and then put everything away when your done.

Tips for NOC shift: keep the lights low, don't make lots of noise. Get a run down ahead of time from last aid. Who uses a urinal, who gets up to bathroom, does anyone have a bedside commode and how do you transfer them. Is anyone a fall risk (check on those frequently!) Is anyone combative? Does anyone need 2 person care for allegations sake. Also meet your hall partner. Let them know you are new and might need a hand with questions.

Make 2 hr rounds. Which means reposition people, change them if they need it every 2 hours. If their bed is wet, change it too! YOu can change a bed with someone in it if you make half, tuck it under them, roll the person and pull it out the other side. (get someone to show you because you will need it at night.)

Yes, people can refuse care. But allowing people to refuse care, and not providing it is a fine line. If they are very cognizant it is one thing. but combative dementia people may not have the true ability to refuse. Basically, if they always refuse then they would go days without care. Learn to work with people like that. Talk to them slowly, calmly, let them know, "it is time to go tot he bath room now, it is time to change your brief ect" Don't say would you like me to change your brief because you know they will refuse. Bottom line is they need care, and it is your job to provide it. Learn the tricks for individuals in your section this way.

Night shift is the HARDEST to start on as a new aid. You don't have the help available, you have double the people, and crazy things always happen at night. Dont be overwhelmed, you can do it, just error on the side of caution. Check care plans everytime you walk in a new room, ask questions, arrive early and make time for a good report from the last shift.