New CNA

Dranger · May 28, 2014

Listen to RN delegation and help out when they ask. It ****** me off to no end when the CNA is either no where to be found or eternally on break. I have no problem helping out when I have time but I don't many CNAs understand we have other stuff going like the responsibility of one's life so don't roll your eyes when I ask to feed a patient, get vitals or take them to the bathroom.

I would cluster your care get as much as you can in the beginning of the shift. When you take vitals ask if they need water or have to go to the bathroom etc. They WILL be calling later when you are swamped.

hookyarnandblanket · May 29, 2014

It really depends on what shift you're working. Try to have anything you need to use for patient care ready before you start giving them care. Have them do as much as they can for themselves while you are doing something else for them, i.e. have the patient brush his nor her teeth while you put socks on him or her.

shermika · May 29, 2014

Idk what shift to do but I heard the 2-10pm shift is better for a new cna I just wanted to know some routines that people might do make their work load a little easier

Rodrinka · May 29, 2014

I'm new too and I heard the same that second shift is better for a new CNA. I don't start until the 9th so I will be following this thread.

Paws2people · May 29, 2014

Don't go into an isolation room empty handed. If you see/know that room needs gloves, briefs, linens, water, etc; make a mental note of it and bring it in next time you have to go in there. It will save you time later on.

Always leave your patients clean and dry for the oncoming shift.

When you leave a room, ask the patient if they need anything from you or the nurse before you go.

Good luck.

hookyarnandblanket · May 30, 2014

It again depends. I started 2p-10p with my first CNA job. It will really hinge on whether or not your facility believes in teamwork. If it does, then it will be easy. If not, be prepared to struggle. Most of it comes with repetition and practice. Take your time. Check to make sure the patient is safely positioned, clean, dry, comfortable, and has his or her call light.

shermika · May 31, 2014

Im kinda nervous because I heard that in a nursing home you have to be fast paced and i dnt want to have to rush then mess things or forget things I just wanna know somebody's step by step routine

hookyarnandblanket · May 31, 2014

When I worked 2p to 10p, I always went around to the residents I was assigned and put pajamas, lotion, brief/pull-up, and toothbrush and toothpaste along with their denture cup and a denture tab if they wore them, in a convenient place like a drawer so that at bedtime, I knew where it was and didn't have to hunt for it. As far as routine, that comes with time.

jjmm RN,BSN · May 31, 2014

Everyone has a different way of doing things, that will come after a few months. I used to work 3-11 and something that helped me was putting my cloths, gown (if they wore ours) and a couple briefs in my residents' rooms at the beginning of the shift when it wasn't busy. Then I didn't have to run around doing it at bedtime. I also started toileting as soon as I could before dinner. You don't realize how long it takes sometimes, plus if someone has an accident it could throw you off so start as early as you can. And get the residents that need 2 assist lifts in as soon as possible and out of the way so you're not waiting around for someone to help and end up being late for dinner. Good luck!

Leonardsmom,LPN · May 31, 2014

Some of the routines that you will develop is going to be dependent on what shift you are working and certain tasks that you may need to complete. I have worked all three shifts, started off on midnights as a new cna, the work load really wasn't that bad mostly in LTC it is changing briefs, turning and repositioning patients and answering call lights. Depending on your facility you may need to get up a certain amount of people or do a shower or two. Again that really depends on how your facility is run. Afternoon shift is by far my favorite, I tend not to be a morning person (although for some reason awake early this morning). It is busy, but not as hectic as morning shift can be. You get to interact with your residents more than you would on midnights.

No matter what shift you work some of the things I would suggest is do what I call walking rounds with the aid that you are taking over from. Go to each room and have the aid tell you about them, if it is people that you are not familiar with make sure the aid gives you pertinent information, major pet peeve of mine when I don't know somebody and the aid tries to get away with just saying they are okay. What is their transfer status, are the continent or incontinent, if incontinent when where they last checked. If a particular aid has had a past history with me of leaving incontinent residents a mess, I will visually check them to see that they are good, if they need to be changed guess what that other aid is coming into that room and is going to help me change that person. Once I have done rounds with the previous shift and made sure that the people I am taking over for are good I check to see what showers are due for that day.

I always have a piece of paper or keep a notepad with me in which I keep track of things that need to be done. I write out the list of my room numbers, I don't write names down on it because than you need to be even more careful of where you leave that paper because of HIPPA. Where I am currently working now we do daily vitals on all of our patients once in the early morning during midnight shift and in the afternoon before dinner. I start locating my patients and taking their vitals. Once I have the vitals information charted for a particular person in my notebook I place a check mark. This is my visual sign that I completed that task for a particular person. Before I leave the person that I was taking the vitals for I ask them if there is anything that they need. If someone puts their call light on while I am doing vitals I take the vital machine with me and will get their vitals while answering their call light. Also while doing vitals I will let those who are scheduled for a shower that day that it is their shower day. Sometimes I will find out that they had already taken their shower earlier that day, if so I can mark them off my list. If not I find out when they would like to take their shower.

Once vitals are done depending on how much time there is before dinner I will start completing some of the charting that needs to be done. The more you are able to do charting through out the shift the better. Depending on how many people will need my assistance in getting out of bed for dinner will determine when I start getting folks ready. Again this can really depend on where you are working, I have worked in traditional LTC where most of the people that you are taking care of is going to need your assistance, make sure you give time to check to make sure they are dry or if they need to use the bathroom, get them up in their chairs and etc. Currently I work I short term rehab, so many of the people that I work with are continent and depending on where they are at in their rehabilitation they may be able to take themselves to the bathroom, or they will call me when they need to go. When I was working LTC I would have a column on my paper for my before dinner checks and changes which I would mark off as I went. Also I would indicate who needed to get out of bed for dinner.

After dinner it is getting people ready for bed and any showers that are remaining. Have any supplies that you need ready in the rooms depending on the facility you may or may not be able to bring linens into the room before hand. If so at the beginning of the shift is usually a good time to bring in gowns, wash cloths and towels and bed chucks if they are used in your facility. If someone is able to take off their own shirt and put on their gown or night clothes of choice have them do it. Even in long term care one of the things that we should be promoting with the people that we take care of is for them to do everything that they are able to do for themselves. Once they are in bed I mark them off on my list. Finish any charting that you may need to do still and keep track of your check and changes and 2 hour repositionings. As you are in the rooms getting people ready for bed check to see what supplies the room may need, if they are running low on gloves, briefs, wipes, soap or other such things restock the rooms. It is the courteous thing to do for the next shift coming on, and if everyone on each shift did the same it would cut down on a lot of running or finding that you are with out the needed supplies when you are elbow deep in you know what.

One more additional thought for your residents that are two assists, make sure that you have them ready for transferring before going to get someone else to help you. Have their top half done, have any equipment that you need for the transfer available ex sit to stand lift or hoyer lift. If you have things ready to go when you ask someone to assist you for a transfer it will make things easier on the whole team. When I have needed basically someone to be in the room to supervise during a lift, if the person is ready to go I have usually had no problems getting a nurse that I am working with to step in the room for a moment to be in their during the transferring process. One of my biggest pet peeves is when someone asks me to help them with a transfer or moving someone in bed and I walk in to find that they have done nothing to get that person ready.