New CNA just got hired at a hospital-need advice
- 0I just got certified as a CNA in January and I have been hired at a hospital. I've been at general orientation the whole week just learning stuff about the hospitals policies and such but also about patient care somewhat. Well, I officially start on Monday working on the Med/Surg unit. I'm trying to think how I will manage my time as I am brand new and don't know the best order to do things. I know we have to do VS as soon as the shift starts (I am day shift 6:45 AM to 7:15 PM). I think my day will look like this:
Passing breakfast trays to isolation patients/feed
Rotate every 2 hours
Take VS at 11-12
clean soiled patients
Take VS at 3-4
Am I forgetting anything? As I said I am brand new and do not know how to manage my time but I'm trying to mentally prepare myself so I will have an idea. I will need to find out what time breakfast and lunch come so I can make sure they are clean and teeth are brushed before they eat. Also, while I learned how to measure intake and output in theory, we never actually did it in clinical so the teacher talked about it once and never visited the subject again. Can someone explain exactly how it works? Any advice about time management and how to be an effective CNA? I'm kind of nervous as you may be able to tell .
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- 0Mar 29, '13 by tigerlogicWhat you do will depend a lot of the specifics of the unit. Probably vital signs, showers/baths/hygiene, ambulation and toileting will be your priorities. But blood sugars, emptying drains, or doing one-on-one with high risk patients may be on your agenda. You can only really learn about your ideal routine after you start working on the unit.
Words of wisdom from a hospital float CNA:
If its your responsibility to do something by a certain time but then can't for some reason (surprise enosis clean up, someone fell, whatever) let the nurse know so they can do it on time.
Know the guidelines of when to report something to the nurse (I.e. temp above 38 etc).
Focus on patient safety--fall risks, aspiration, potential for pulling IVs, tripping risk on Foleys etc.
If you have a free moment, ask what you can do to help. It makes a big difference.
Good luck! It's a lot of fun!
- 0Mar 29, '13 by KatieP86You should have a time of orientation. Hopefully you will be paired with somebody who is willing to show you exactly what you are supposed to be doing.
Hospitals are good places to work, IMO. The nurseatient ratio is lower than LTC, so the nurses are more able to help you and explain stuff. You will learn a lot!
- 0Mar 29, '13 by funtimesLooks like a fairly accurate rough outline of what your day will be like, except you may be doing a LOT more vitals if this is on a med/surg unit. Surgical patients may require vitals every 15 minutes when they first get up on the floor. Other patients will require more vitals because of meds they are on or because of some abnormal vitals or their condition is deteriorating.
You also left out answering call lights, which has to be done continually in between all the other tasks. Emptying drains and Recording I/O as well, Helping to admit and discharge patients, which will also happen periodically throughout the shift. Other non routine tasks will pop up as well, for instance maybe a patient has to be put in restraints, and then you have to monitor them and loosen their restraints continually, or maybe someone is confused and needs more one on one care for a time.
As for recording I/O, its pretty simple. You record everything that goes in, how much they eat and drink...and everything that comes out, usually in the form of urine and stool, and occasionally emesis. If there is an NG tube or drain of some sort, that will get drained periodically, either by you or the Nurse. Make sure you know if you are the one who drains and records it and how often you are expected to do it.
If you dont know how to do something, make sure you ask. Guessing usually isnt a good idea.Last edit by funtimes on Mar 29, '13
- 0Okay so I went to IT&S Orientation today to learn how to use the computer systems and how to enter patient info, etc. There are a few things that I was not familiar with b/c my CNA class did not cover them. I've never heard of the terms sp02%, ivpb and 02 flow l/m. What are they and how do I calculate them? Please help thank youLast edit by Purple93 on Mar 29, '13
- 0Mar 29, '13 by funtimesSpo2 refers to Oxygen Saturation, which is measured using a pulse oximeter(the thing that goes on their finger). Its recorded as a percentage. Normal Spo2 for most people would be say 93% to 100%. O2 flow is how much supplemental oxygen they are receiving. Usually through a nasal cannula, O2 Mask or Non Rebreather mask. The flow rate is measured in liters per minute and is adjusted by a gauge the tubing is connected to. There is usually a little ball that floats at the level the O2 is flowing at in the guage. Dont change someones oxygen flow rate unless you have permission, and for that matter dont mess with anyones oxygen unless you know what your doing and have permission.
I'm just telling you this to be helpful, but you need to have it all explained to you and shown to you by whoever is training you, and if something isnt clear then ask them.
- 0Mar 29, '13 by Alexandra4rmtexasQuote from Purple93The spO2 is how much Oxygen they are carrying in their blood Cells, it os measured on the finger, I forgot the mame of it. It is a clip with a little red light that os placer over the nail. O2 flow L/m Is only uf they are on a Oxygen cannula, if the Oxygen delivery is mounted on the Wall there will be a floating metal Bead in a tube on the Wall, the line crossing the middle of the bead is ur measurement in numbers. Usually patients will be placed on 2 liters of O2% , that is if the bead is floating on the measurement of 2 uf it is mounted on the wall. On the I & O intake, Intake is the percentage of food eaten in a meal and mL of fluid consumed during ur shift documented usually as cc's. one cup is 250 cc. Output is how many mL are measured when empyting a bedpan in which a patient has urinated, or empyting a foley catheter bag, or any amount of fluid the pt has excreted. The I&0 is compared by the doctors and nurses the detect ajy fluid retention indicating renal function, heart failure, or distented bladder post surgery in a patient. The I &O is very importantOkay so I went to IT&S Orientation today to learn how to use the computer systems and how to enter patient info, etc. There are a few things that I was not familiar with b/c my CNA class did not cover them. I've never heard of the terms sp02%, ivpb and 02 flow l/m. What are they and how do I calculate them? Also in my CNA book from class it says what the normal ranges are for intake and output and my teacher briefly went over it but we never actually practiced it so I have no clue how to go about that either. Please help thank you
- 0Okay thank you so much! We have to enter those things into the system and I was highly confused but when I go to my unit on Monday I will definitely ask them. I don't feel comfortable doing something I've never done without being shown how but I just wanted to at least know what they were. So you guys were very helpful thank you so much.
- 0Mar 30, '13 by rrrs444230wow! it's great that you were able to find a job at a hospital! I'm currently in a CNA course and have no previous healthcare experience and wanted to know if anyone out there was able to find a job. How long did it take you to find this job (if u don't mind me asking)? Best of luck on monday! I'm sure you'll figure out the flow of the unit in no time!
- 0Mar 30, '13 by KatieP86Quote from Purple93sp02 is the percentage of oxygen that is being carried to organs by the red blood cells. In our hospital, the range of "normal" is between 95-100%. However, it will vary by patient as to what is an acceptable range. If an oxygen saturation reading is low, it is critical.Okay so I went to IT&S Orientation today to learn how to use the computer systems and how to enter patient info, etc. There are a few things that I was not familiar with b/c my CNA class did not cover them. I've never heard of the terms sp02%, ivpb and 02 flow l/m. What are they and how do I calculate them? Please help thank you
IVPB- I know this means "IV Piggy back" but we do not use this term in my country, so I do not know. Anyway, you won't have much to do with them, as they are related to medication and the nurse will hang them and take them down.
IV flow l/m means the amount of oxygen patients are receiving Oxygen is dosed in litres per minute- for example 4 l/m. However, it can also be measured in %, so it might get a little confusing at first! You are not required (in most places) to check flow rate, that is usually the RNs job as part of their assessments.
I+O= means input and output. Input- whatever liquids the patient puts into their body. Can be oral, IV, NG etc. Output- whatever comes out (vomit, pee, diarrhea, etc). The difference between the two can indicate how hydrated a person is, or if their medication is working well or not.