To the students

Nursing Students CNA/MA

Published

I had the pleasure of working with two students the other day and I wanted to share some insights. From one tech/CNA in a hospital to other CNA students.

1.) Don't ask me about your break. If you are to get one just tell me you are going but don't ask me when you get it. I don't know. Plus it makes me think that you are lazy if you are asking when you get your break.

2.) You will see things in real life that are not taught in the classroom. This is a big eye opener. Please don't second guess these tactics unless a patient is being put in direct harm/danger. Patient safety is always number one but getting things done in a timely manner is number 2. Safe and quick is our motto.

3.) If you find yourself waiting new instructions or assignments, keep yourself busy by answering call lights. People will love you to no end for doing this simple task. This is also a good opportunity to learn teamwork. It doesn't matter if the call light is a patient of yours or not, it is everyones responsibility to answer them, even students.

4.) Attitudes can be hard to take, especially in a stressful place like a hospital. Please don't take anything personally because 99% of the time......IT'S NOT YOU AT ALL.

5.) If you really want to learn from the person you are with......talk to them about time management and prioritization. This is one of the hardest things to learn. Ask the person you are working with questions about how they plan their day and make prioritizations. Ask them what a typical day is like for them.

6.) I said this above in a round about way but the number one thing you should do in clinicals is ASK QUESTIONS!!!!!!! Why this? Why that? Why now? Why her? Why him? Where is this? What do I do when? How do I handle_____? Should I do _____? What do you want me to do? How can I help? Why do you do this procedure this way? What are you looking for when you are doing a bath? Can I watch? If someone has a line or a drain you have not seen before.......ask what it's for.

7.) Talk to your patients and ask them questions. Especially when it comes to transfering, lifting, or turning. Most of the time they can tell you exactly what they need from you to get from the bed to the chair or anywhere else. It's so easy to focus on the tasks and forget about the person. If there are two of you there rolling someone, ask the patient how they are doing. The patient will appreciate you taking them into consideration. If the patient looks scared, reassure them. Little things like that go a long way in creating trust with your patient.

Use your time wisely and learn all you can while you are a student. This is the best time to do so because in the real world, you may not have a chance to ask or sit down and read something but for now you do have that luxury.

Good luck to all the students out there. We need more people to do this job and we do appreciate you!

This could be a great sticky. I think it would only be fair to recognize the other side of the equation - the fact that students will see things during clinicals that are not by the book.

I am currently a CNA, so I'm not trying to stir up any angst with my fellow caregivers. These are some of the things that I saw constantly during my own clinicals done by Certified Nursing Assistants:

Not drawing curtians, not using bath blankets, almost no oral care, refusal to change a resident until after break, coming back 15 minutes late from lunch, not repositioning every 2 hours for those who need it, doing 60 vitals in a row before informing the RN of abnormal BP's and respirations, there were a handful and HIPAA violations.

I'm hoping it was just this facility; our class was mortified by the level of care. Our clinical instructor never wants to go back there again.

Fair is only fair.

Oh yeah, we could not answer call lights on our own, or anything else without direct supervision; we were not yet certified by the state.

Specializes in Nursing Assistant.

I enjoy when we have the nursing students come to our floor to do their med/surg. clinical. The only thing I have to add, besides asking questions, is don't treat the aides disrespectfully. We may not be nurses, but we know a heck of alot about our patients--afterall, we are the ones who work with them on a daily basis.

Specializes in RN in LTC.
I enjoy when we have the nursing students come to our floor to do their med/surg. clinical. The only thing I have to add, besides asking questions, is don't treat the aides disrespectfully. We may not be nurses, but we know a heck of alot about our patients--afterall, we are the ones who work with them on a daily basis.

Everyone should be treated with respect. I worked as a CNA for many years before going back to school to be a nurse. I graduate in May. Believe me I will not forget the hard work of the aides. It should always be a team effort to benefit the patients. I worked under many lazy nurses. I will not be one of those nurses. In all fairness I worked with some really good ones too. Being a CNA was one of the hardest jobs I ever had. I stuck with it because I loved the interaction with the patients. I loved the stories they told. The elderly have seen so much in thier lifetime. Thank you to all who love your job and remember you are an important part of the team!

I hear you.......Will post this in my classroom. I do give my students instructions, but better coming from you directly. CNA instructor, Idaho

I understand part of the original post, but I have a lot of disagreements with it. The big one is asking the clients about their own care. I am doing my CNA clinicals at a nursing home, and we have to check the Care Cards on the inside of their closet doors every day. They change all the time. If we answer a call light to help someone to the toilet, we have to check the care card to see if they're a one-person, two-person, hoyer lift, standing lift, etc. If we asked them, they would say they could do it themselves, which would really be a disaster.

Your suggestion to ask the clients puts the facility as well as us (and our instructors) at great legal risk in this litigious society.

Just started my clinicals and I'm glad this has been posted. I would add only one note and that is that every situation is different.

I spent my first night on clinicals in the ER. Following a couple of people I would NOT trust with the care of a stray animal. Not personable, not clean. Not pleasant. In the 5 hours I was there, not once did I see them wash their hands. They brushed over cleaning tasks. It was a slow night and there was plenty of time for focus on the basics.

I felt bad for the Nurses who obviously worked quite hard. They were all brilliant and as much as I was in awe of their knowledge their ability to simply get the job done and get the patients cared for was simply incredible. They were fast, efficient and excellent teachers. Focused on me as much as the patients. It was truly a great experience. I did feel really bad that I am working to hold the same qualification as the two I was there to shadow. Yeah, their job wasn't really something you'd look up to or aspire to become. It was, nonetheless, their job and it really felt and looked like it was being performed half-assed.

When you have students, be conscious of the fact that - like you said - it's MUCH different in the real world than it is in the classroom. Also realize that as students we have NO IDEA what we are supposed to do. We are told simply that we have to perform X-hours of clinicals. We aren't told that we should be taking care of this or that. We are told to check in and we'll be given tasks. So if there's something you expect of us when we are in your care, because we are in your care as much as the patients are, be clear about what your expectations are.

We're fresh meat. We're new to you, the patients (way different than training dummies), the environment of the hospital/care center is VAST in comparison to our one tiny classroom where we use our imaginations to simulate patient responses. It's a lot take in. We will become what you make us. If you and your staff happen to have habits that border on lazy or unclean, our first impression is that it's okay to be lazy and unclean. If you're short with your patients or rude to their families, our first instinct is that the particular behavior is acceptable.

Think of your clinical students like children. You are responsible in some way for the nurses we may one day become.

Give us the tools to be our best - we'll give you our best.

Thanks! I'm starting a CNA class soon and this is really helpful! :up:

Well I had 2 preceptors the 1st one I had was awful. I watch her chart in my clinicals for about 1 hr and all she had my classmate and I do was hand out cups of ice water and we made one patient's bed. That was the whole four hours of my 1st day of clinicals.

The next day I changed preceptors due to a family matter with my 1st one. The second preceptor I had was excellent in teaching among she did showed my classmate and I everything that was done by the book and how we would do it in the real world. One thing that I can agree with is that I didnt see many bath blankets being used or reassuring that the patients had privacy when they was giving their bedbaths. As far as turning the patients every two hours I didnt really see that neither due to I never remained with one patient more than the other. I was going from room to room. Overvall though I enjoyed my clinicals very well.

I'm sure that many CNA's when training students aren't able to work to their full level though. I know how it is training a person many times you dont have time to do things the correct way or by the book. It can be very time consuming when teaching. So lets give the people who shared their everyday careers with us the up most respect. I'm thankful for my clinicals and the CNA who took the time out to share their skills with me.:yeah:

Specializes in CNA - starting LPN school January 2009!!.
I had the pleasure of working with two students the other day and I wanted to share some insights. From one tech/CNA in a hospital to other CNA students.

1.) Don't ask me about your break. If you are to get one just tell me you are going but don't ask me when you get it. I don't know. Plus it makes me think that you are lazy if you are asking when you get your break.

2.) You will see things in real life that are not taught in the classroom. This is a big eye opener. Please don't second guess these tactics unless a patient is being put in direct harm/danger. Patient safety is always number one but getting things done in a timely manner is number 2. Safe and quick is our motto.

3.) If you find yourself waiting new instructions or assignments, keep yourself busy by answering call lights. People will love you to no end for doing this simple task. This is also a good opportunity to learn teamwork. It doesn't matter if the call light is a patient of yours or not, it is everyones responsibility to answer them, even students.

4.) Attitudes can be hard to take, especially in a stressful place like a hospital. Please don't take anything personally because 99% of the time......IT'S NOT YOU AT ALL.

5.) If you really want to learn from the person you are with......talk to them about time management and prioritization. This is one of the hardest things to learn. Ask the person you are working with questions about how they plan their day and make prioritizations. Ask them what a typical day is like for them.

6.) I said this above in a round about way but the number one thing you should do in clinicals is ASK QUESTIONS!!!!!!! Why this? Why that? Why now? Why her? Why him? Where is this? What do I do when? How do I handle_____? Should I do _____? What do you want me to do? How can I help? Why do you do this procedure this way? What are you looking for when you are doing a bath? Can I watch? If someone has a line or a drain you have not seen before.......ask what it's for.

7.) Talk to your patients and ask them questions. Especially when it comes to transfering, lifting, or turning. Most of the time they can tell you exactly what they need from you to get from the bed to the chair or anywhere else. It's so easy to focus on the tasks and forget about the person. If there are two of you there rolling someone, ask the patient how they are doing. The patient will appreciate you taking them into consideration. If the patient looks scared, reassure them. Little things like that go a long way in creating trust with your patient.

Use your time wisely and learn all you can while you are a student. This is the best time to do so because in the real world, you may not have a chance to ask or sit down and read something but for now you do have that luxury.

Good luck to all the students out there. We need more people to do this job and we do appreciate you!

Aerorunner,

Thank you for this post. As an individual who just completed a CNA class, I think a lot of my fellow classmates needed to know this, especially about the breaks.

One thing I did feel worth mentioning, however, regarding your comment that CNA students should be answering call lights. During my class, for ur first three or four clinical sessions, our instructor specifically told us that by no means were we to ever set foot in a residents room without a CNA or our instructor present. As we continued our clinicals, and got more experience, we were able to bring trays to the residents, get them water, make beds, etc. However, under NO circumstances were we to perform any ADLs without the supervision of a licensed CNA, or our instructor.

This ended up causing a lot of strife between our CNA class and the nursing home where we did our clinicals. The CNAs would try to get out of doing their work by telling us "so-and-so" needs their brief changed. Then they would get angry at us when we told them we would be happy to help them change the resident, but we needed them to accompany us. I think if my instructor had had clearer lines of communication with the ADON, and the ADON with her staff, it would have alleviated a lot of conflict between our class and the CNA staff.

So, for any CNA preceptor, please keep in mind that what might appear to be laziness or shirking responsibilities on behalf of the CNA student may actually be the student following specific instructions from their instructor to avoid legal ramifications for the student, yourself, the school and your facility.

Well I had 2 preceptors the 1st one I had was awful. I watch her chart in my clinicals for about 1 hr and all she had my classmate and I do was hand out cups of ice water and we made one patient's bed. That was the whole four hours of my 1st day of clinicals.

The next day I changed preceptors due to a family matter with my 1st one. The second preceptor I had was excellent in teaching among she did showed my classmate and I everything that was done by the book and how we would do it in the real world.

Can I just share something here? (devil's advocate) Is it possible that the reason the first preceptor didn't have you do things is this: He/she has been the CNA for these particular residents for a very long time and is "possessive" of them? By this I mean, look at it from the CNA's view...

I have worked with Mable for years, she is like my own grandma, and I don't want a student to work with her because although they need to learn, I just don't want them working with my residents...

My suggestion would be to say:

"I know you do this all the time, and because I am a student, I am sure that you may feel uncomfortable with me doing _______ for Martha... but can I step in here, have you give me step by step instructions and give your back a break?"

It isn't in doing the procedure, it is in how you ask to do it.

Wrapped up my CNA class this weekend and hope to take my certification exam in the next week or two. (I have finals at another school - in addition to working full time - so it may have to wait a week).

Having wrapped up class and clinicals my biggest piece of advice would be this... APPLY WHAT YOU HAVE LEARNED IN CLASS AND TAKE SOME INITIATIVE.

When you are there and you see a call light, ask if you can respond to it. If you can handle the request, handle it. If you are unsure of what you should do - explain to someone that you have answered a call light and don't know how to handle the request. Let the experienced folks talk you through it or walk you through it.

I had an amazing experience at the end of my clinical hours. Really enjoyed myself. Really enjoyed my patients and worked at a break neck pace for two 12 hours shifts. I never stopped sweating and I KNOW I made a difference for the patients I worked with. It was rewarding. It was very intense and this has to be the hardest and most rewarding low-paying job on the planet.

Having been through class, I know for a fact that half of the students trying to be CNA's should never have ventured out of fast food. To the other half - never stop learning. You owe it to your patients and yourself to be the very best you can be every day you are with them.

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