Clincial Advice?

[brivsac]

I have just recently started clinical for my CNA class. I enjoy most of it so far, the residents are angels but I feel like a burden on the CNAs and nurses. Whenever the CNA I'm partnered with goes on lunch or break, I'm left alone and told to answer call lights. The problem is we're still new and I don't know how to do/am not allowed to do most of the things the residents want.

Some examples: one woman I responded too had dementia and couldn't speak. I tried but I could not figure out what she wanted. I got a nurse and within 15 seconds of talking to the resident she figured out that she just wanted to know the time! Another time I responded to a call light, a man wanted to be transferred from his wheelchair to his bed. Students are not allowed to transfer alone, so I went to look for a CNA. I found one, told him what the man needed, and he told me to wait. Once he was able to help me we went into the residents room...and the resident could pretty much get into bed himself, he just had to have someone with him. I felt so stupid! I made the resident wait and I bothered a busy CNA to pretty much help me with nothing!

Another time when my CNA was on lunch one of my classmates told me a resident in a isolated room(I'm not allowed to go in that room) that my CNA was assigned to needed to be changed. I told her I cant go in there and we had to find an RNA to tell her. That same time when my partner was on lunch I was responding to call lights and a woman wanted to be turned. I couldn't do it alone and didn't feel comfotable attempting it by myself because I didn't want to hurt the resident. Once again, I had to hunt down a different CNA for help. She was busy and said the resident would have to wait until my partner got back from lunch. Later, a nurse asked me to help her change a dressing on the same resident. Right as we were about to turn her, a CNA came to help. The resident said she'd rather have the CNA turn her instead of me (completely understandable) I stepped aside to help/observe when the CNA told me to take my lunch. I asked if Incould stay and observe real quick then take my lunch and she said "no, you need to go".

I understand that the CNAs are probably going to be annoyed no matter what with all us students running around with them, but I don't want to make it worse for them by always asking for help! My instructor is always nowhere to be found and even if I scour the entire facility I still can't find her. When I'm left alone I try to ask other CNAs if they need help so I'm not just standing aroun and they always seem annoyed, and if I get call lights I can't even help the resident half of the time and have to get someone else! I don't need my hand held when I'm left alone, and I wish I could just do things myself but I'm not even allowed to do most of it alone. What can I do to not bother the CNAs so much? I want tto he a help to them, not an annoyance. Also any tips on what I could do when left alone? I try to do nail care, brush hair, or just tak to the residents but most of them are asleep. This is kind of making me anxious for clinical every morning and I'd rather be able to actually focus on learning skills and not constntly runnig around trying to find an already busy person to bother.

[Possum_RN]

I've been there: both as a student, and then as a busy CNA with students on the floor.

Take a deep breath. Cut yourself some slack. IT'S OK.

Bottom line? DO NOT PUT YOUR LICENSE AT RISK. Do not feel bad for getting a CNA to help transfer a patient who can mostly transfer alone. Standby assists to transfer's are still transfers. What if he was on a new blood pressure medication, and got dizzy upon standing? What if he fell back and hit his head on the rails? You can't take that risk as an unlicensed student - the rules are there for a reason.

Same with the isolation room: the CNA's have training on what PPE (personal protective equipment) is needed, where to obtain it, and how to apply it. YOU DONT. So do not take that risk.

Don't feel bad about having trouble understanding a patient. Many times, you will become familiar with a resident after you have spent time with them - certain gestures, certain sounds, the fact that they are fixated on one or two things.

As for the "no, you need to go" comment: as I said, I've been there as a busy CNA. Sometimes, residents become agitated, and you have to remove the trigger - you can't reason with the resident. Sometimes, I was short with the student CNA's - shooting off orders without explaining the reasoning behind it. I always tried to follow back up with them and assure them they were just fine, but it didn't always happen, and not all health care workers will bother to do so. From what you've said, it sounds like that may be the case here.

When I was a student CNA, I always had nail files and lotion in my pockets. I'd find a resident who was lonely and wanted to talk, and do nail care. Other times, when the patient's were napping, I would fill up the water pitchers and go around placing them in the rooms, taking out trash (even when it wasn't the scheduled time to do so), or go around and straighten up the rooms (not touching resident's belongings, just clearing empty cups, taking out unused linens that pile up, replacing crusty urinals and denture cups, etc) - anything to be out of the hallway standing around. Peeking into denture cups was a big one for me....I could always find dentures that had just been plopped in there without being cleaned, and could at least check off denture care for the day! I would often walk in on a CNA alone doing a bed change or some other task I could assist with for a check-off....the CNA's tended to be more receptive when I magically appeared to help when they needed it, rather than asking them to find me something

Sometimes, I got props from my instructor, because I would find bedrails down, bed alarms off, or trip hazards. Got a special mention for that in my evaluation they used when companies called them for references.

Sounds like you have that mindset already - you just need to pinpoint some tasks to do. It takes time to get to know the "flow" of a unit.

Best of luck to you....remember, you are a student, and this is a new and strange situation. Cut yourself some slack and keep up the good work. Also....when you are a busy CNA with students, remember to smile at them :) .

[Here.I.Stand, BSN, RN]

I remember my CNA clinicals, 20 yrs ago. I remember feeling so awkward, wanting to help but unsure what to do.

My first thought was "where is the instructor in all of this?" Then you addressed that. I would say something; maybe "If I have questions, where can I find you?" I would also take your lunch break at the same time as the staff you are working with; that way you don't have to be on the floor with no guidance.

Keep in mind that the staff isn't so much assisting you as they are doing their jobs. So you need a staff member present for a transfer; if you were not there, they would be doing that transfer anyway.

Also keep in mind that the nurse who understood the resident knows him very well. When you are regularly work with a person, you become accustomed to their unique speech patterns. I'd probably have trouble myself meeting him for the first timec, even having been in healthcare more than half my life.