NEW CNA: Running behind on workload! Feel awful!

  1. Hi all,

    Brand new CNA.
    Already had 6 days of training.
    So far, have worked 6 days of being assigned my own patients, ranging from 6 - 12, but typically 10 to 12 patients.

    Problem? I am not fast enough, I work my best and prioritize.

    Here's how I prioritize:

    1. Help/clean patients who need to immediately get to the bathroom

    2. Vitals if needed

    3. Meal times

    4. Simultaneously change soiled clothes/briefs/drawsheet or pads for anyone else who I didn't get to change, especially getting FIRST to the patients who have therapy or dialysis soon.

    **MAIN PROBLEM: my guilt for failing to care for every single one of my patients, since I did prioritize who needed what first. Some of the patients I want to change, say they want to be changed then I do it later, and move on to a higher priority. Yet, when I sit down and chart, I realized, I had FORGOTTEN like 1 or 2 patients! Even though we are REQUIRED to do bed baths for every patient, there is just not enough time to do that for every single patient! However, I find in the charting, that nearly everyone SOMEHOW has the time to do it. Is this true?! I don't know how it is realistically possible! I am still learning which things I can do to take short-cuts, b/c there is just too many patients in so little time

    I honestly did my best to keep the patient safe and clean. I feel SO overwhelmed handling 10 or more patients!! The teamwork goes well, but sometiems we only have 3 CNAs for like 30 beds. Finding help can be hard, and delays my other tasks.

    Thank you for reading, I tried to make this as concise as possible.
  2. Visit panjia profile page

    About panjia

    Joined: Sep '10; Posts: 22; Likes: 11


  3. by   Jack245
    Clipboard. It will be your best friend. Get one and make out lists of your patients each shift. Turn it into a table of what you need to do and check things off as you do them. At least it worked well for me.
  4. by   panjia
    Thank you Jack245. I am surprised that nearly all the CNAs, even the ones who have only worked for 1 month, do not need any method of organization such as clipboard. They tell me there is no time to write things down. However, I should remember that not everyone is the same. But yes, literally, nobody in the nursing home carries around any clipboards or anything. Even so, I see them have time to stop and mingle! I dont know how they have time.

    At work I focus on myself, and not compare, because that will do me NO GOOD. At the end of the day however, after I am out of work, I think about how do they just do everything. haha

    When you first started out working as a CNA, did you happen to have the same situation, like forgetting 1 or 2 patients? Some of my CNA team members helped me, but I did not get to do tasks myself personally. I feel terrible.
  5. by   Jack245
    I didn't have that, but worked with those that did. Thing is, being a CNA is a team effort. No one can do it all on their own.
  6. by   mindyfromcali
    A clipboard is good if you have the time to carry one around, but I find even just writing all of their room numbers on a piece of paper and ticking off for each type of care I give is good enough. I even still do it, because I just started working at this place less than two months ago and the assignments change a lot even though it's LTC.

    As far as finding time to do everybody, that is a hard part of the job that comes with experience. I know for me, the first few months as a CNA I was wayyyy slower than I am now. I'm able to use the drawsheet to make my life easier in most cases, even with really heavy Residents. Just be patient, go as fast as you can, and try to keep in your mind how frequent they're wet. Each one will have a pattern most of the time, and you'll learn when you need to check them.
  7. by   panjia
    Thanks for your reassurance Mindy. I really don't like missing 1 or 2 patients, because I fear I will certainly get written up, even though I have only been working independently for about 1 week. And well, to be honest, I have left some of my charting blank, because I can't lie--unless I should to cover my butt.
  8. by   mindyfromcali
    Quote from panjia
    Thanks for your reassurance Mindy. I really don't like missing 1 or 2 patients, because I fear I will certainly get written up, even though I have only been working independently for about 1 week. And well, to be honest, I have left some of my charting blank, because I can't lie--unless I should to cover my butt.
    Have you tried talking to other CNAs who work with the same Residents? There may be a method to the madness. I know when I come across a new assignment, or am working someplace new I ask a lot of questions. You can even check the charts to see if they wet a lot or not.
  9. by   panjia
    I do ask questions when I can, since the other CNAs are running around tryin to do their own thing, so I can't waste my time trying to find them. In between though, I ought to check the charts more frequently. Sometimes, when I'm on my way to check the chart, I get distracted when someone else calls for urgent help. Then, I forget. Now is the time to have that clipboard lol.

    As you said, it does come with experience. It's amazing how all those things you suggested is really common sense. I just need to calm myself down, and think methodically. I can only focus on one patient at a time, and when many CNA/nurses are telling me, you have a call light on room # so and so. I tell them, I will check as soon as I'm finish. It's just very overwhelming and distracting having multiple things that I need to do, that I forget about the patients that tell me they want to be changed later. I wish that I could just tell them, let's just do that now and get it over with.

    Anyway, thank you!
  10. by   mindyfromcali
    You don't have to necessarily do everything they need right when they ask. Just check the light, see what it is, and ask them if you can come back in a few minutes. Sometimes all they need is a medication and you just have to tell the nurse real quick. A lot of it really is just knowing how to work faster. All you can do is your best. Some Residents are more patient than others. I had a situation last night where a very needy Resident who likes to use the call light a lot wanted ice water. I asked if she would give me 15 minutes, and she was cool with it. I had other Residents down the hall who still needed to have rounds done on them.

    You'll find your rhythm. Good luck.
  11. by   panjia
    Thank you again! Yeah finding my rhythm is exactly what it is. The only way I get better, is to just get more experience...figuring out what I can do better the next time around.

    I really appreciate your advice! I wish you well on your endeavors, be it nursing or whatever your career goal is.

    Take care!
  12. by   funtimes
    If you work in a hospital, you can maybe coordinate with the RNs and have them do total care on one of their patients if you have a really heavy load. You can also have them do some other tasks like taking vitals while they are in doing an assessment.

    If you are working in LTC however, you are pretty much on your own, unless you can get other CNAs to help you if the people you are assigned to are more work than the ones they have. The RNs where I worked didnt do any ADLs. You were lucky if they toileted a patient, usually they would just tell an aide so and so needs to go.
  13. by   eatmysoxRN
    I'd ask the other CNAs how they manage. My floor has 1 NA at night for a 24 bed unit. She manages well but doesn't have to do baths since days does them. The RNs help out as much as possible but I'd be pretty upset if my CNA asked me to do total care because of poor time management. I'll help as much as possible and don't mind at all, but if it is manageable but you are having problems, keep trying new things. Bundle care. Make rounds and offer assistance while you are there. It may prevent an entire bed change if they go before an accident. Good luck!
  14. by   panjia
    funtimes: yeah, i work at a nursing home. i'm pretty much on my own, and yeah the nurses are super busy with their agenda so they just alert cnas of any adl care needed. actually, i was lucky one day...i had this one nurse placed this resident on a bedpan, but i took responsibility for removing him off the bedpan and getting him cleaned up. she was a great nurse in teamwork.

    eatmysoxrn: i understand, the nurses are busy with like 25+ patients, so i try to do the best i can to do total care for the patients. yeah, you're right, it's really just about trying new things. the more days i get to work, the more i realize what works and what does not, and the closer i get to establishing a routine. i really don't like leaving my responsibilities to other people, so like one poster said, it really is all about teamwork. if i can, i try to offer help to other cnas, but most of the time, i try to focus on my patients--because for right now, i am still new. however, i think after like a month or so, i'll be able to be more efficient

    thank you guys for your advice!