I'm scared

Nursing Students CNA/MA

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Specializes in 12 years exp in corporate healthcare.

Hi everyone,

I know this may seem like a small topic to all of the "seasoned" nurse aides or nurses, lol!..but I was offered a part-time position at a LTC facility and I start this weekend. I've had my CNA license for a year and after applying to hundreds of facilities, (maybe due to no experience) I finally found a place that really looked at my resume and decided to give me a chance. I'm scared because during my shadow evaluation, all of the CNA's told me that on my first day, I will probably get no help!...so now I can see myself running and it seems like when you're rushing, accidents are bound to happen. So any advice on a routine that help you out on making your shift run smoothly???..

Specializes in PACU, LTC, Med-Surg, Telemetry, Psych.

You probably will not get help. Fact of life in LTC. The culture of CNAs is that no one wants to do "someone else's work for them". Hospitals are a bit better as most LPNs/RNs at hospitals are more hands-on.

However, if it helps any, it is usually okay to ask for help for patients that are really, really heavy or if someone has a tendency to get agitated. If this is not acceptable, do not do anything until you get help. You can get slammed if you drop someone. I have seen it happen. Better to let that patient wait.

Just do the best you can. Keep track of when families show up and make sure no brown or yellow is present when they show up. Make sure no brown or yellow is around for shift change and you should be okay.

Use bed alarms, rails (if allowed), at all times.

Specializes in 12 years exp in corporate healthcare.

That is sooo true and that is reality as I had seen it during my shadow evaluation. I will follow your advice as to letting the patient wait. I don't want to risk a patients safety at all. The comment about not letting family memeber not seeing "brown" or "yellow" are you refering to making sure that they are dry with no urine or fece stains showing?...Thanks for your advice!!!

Specializes in LTC.

You're going to have to do the bare minimum for right now. As you get used to the residents and the routine you'll figure out how to meet most of their needs and give good care but at first, you'll just be glad you made it to the end of the shift.

Just make sure you don't leave a room without double-checking to make sure they have the call light, the bed is lowered, and alarms and floor pads are in use (if ordered). If you forget to brush someone's teeth, wash out their stockings, or put lotion on them, no big deal. You'll work that in within a few weeks. If they fall out of bed and break a hip because you didn't leave them in a safe position, then you'll feel horrible and you may get fired.

What shift are you working? I started on 3-11 and found it easier to get all my non-picky residents in bed right away. Then I could go back and wash them later but at least for the rest of the night I could do all their care myself- turning them, changing them, giving the bed pan- rather than find another CNA to help get them on an off the toilet. Plus that gave me peace of mind later when doing the more time-consuming residents. We're not supposed to use briefs at night at my facility but I would leave people briefed till last rounds so I wouldn't have to waste time doing linen changes when I *still* had people waiting to get washed up. Also, before you change someone if you put the head of the bed way down and the feet way up, by the time you're done rolling them back and forth they usually don't need to be pulled up anymore (just don't do that if they just ate/drank).

Aside from that it depends on the residents... how many of them you have, how much they can do for themselves, etc. Total care residents are a lot of work but at the same time it's easier because they don't try to manipulate you. I have one assignment at work that's all total care, except for one resident, and it's that one person who throws a wrench in the works every time because she takes a super long time with everything and has hissy fits over nothing and it's just like uggggh!!!! There is usually at least one resident like that on every assignment and you'll have to ask the other CNAs how to deal with him/her.

When I was ending my CNA class, my teacher said that "when you're in doubt about what to do, use the time-proven FHB method." After she got some dazed looks from the class, she explained it in more detail -- face, hands, butt. She said if all three of those areas are clean and presentable, then you know you've covered the basics.

Specializes in public health.

After being unemployed for a year, what more can you lose? This is your chance! Help or no help, you have to take the job and do it well. Usually CNAs and nurses will help each other out. Don't worry, just do your job. If you are not sure about something, ask! Congratulations!

Specializes in 12 years exp in corporate healthcare.

Thank u guys for the advice!..I feel alot better now...this is a part-time job just working on the weekends because I have a full-time job already. My hours will be on Saturday from 3-11 and Sundays from 7am to 330pm...wish me luck!...I like the FHB method!!!!

Specializes in Orthopaedics, Med/Surg Acute Care.

Sunflower, I am so sorry for those awful hours - Sat 3-11p and Sun 7-3p?? you aren't going to get much rest with doubling back like that. Plus no fun time with friends/family on Sat nites.

Also remember families may visit on Sundays after church so try to keep the resident looking nice after lunch time. That isn't always easy if they are a messy eater. Using towels or bibs help some.

I hope things work out for you.

Specializes in PACU, LTC, Med-Surg, Telemetry, Psych.
Thank u guys for the advice!..I feel alot better now...this is a part-time job just working on the weekends because I have a full-time job already. My hours will be on Saturday from 3-11 and Sundays from 7am to 330pm...wish me luck!...I like the FHB method!!!!

Oh my.. Sunday is really rough. The night shift on Saturday does not seem that bad. That is not much sleep fro you either.

I hate turnarounds...

Fortunately, if you are smart these combination of shifts can be an advantage. You can set yourself up for the next day easy. You may want make sure the laundry situation is with those residents families that are religious and visit the resident. Find out the get-ups.

It is nothing but a routine after a while.

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