New CNA troubles/experience

CardiacDork, MSN, RN · Oct 1, 2016

I'm an experienced nurse and I hate and suck at putting on diapers and am so glad we don't allow diapers in the ICU. Lol. I think rolling those bad boys up and in the perfect angle/position just takes time. My advise may seem counterintuitive but perhaps try slowing down because you mentioned you're doing things over and over and turning the residents side to side multiple times...

Slow down and be diligent and careful. Take time to note how large the patient is and how you roll up the diaper and where you place it and just estimate how it'll end up after you turn them. This will save you so much time man. I've learned to be real attentive to detail and it's saved me tons of time.

Also, be smart about things. Let residents have a BM before you bathe them. Encourage them to use the bedpan or get them to the commode. This way the poop pipes are clear and your cleaning will be worth more.

You seem to want to provide good care and I appreciate that. Just remember that fast isn't always good and sometimes in wanting to do things fast we end up slowing down to fix the way it was done initially.

Good luck man. You've got this :)

thelittleRNwhocould · Oct 1, 2016

Yes, it is way too fast.

CNAs in nursing homes are often overworked and have a heavy patient load - and our elderly patients are the ones who suffer. Skin breakdown is an all-too common problem in longterm care simply because of age's impact on skin integrity. Add in the fact that the patients are not changed promptly, not bathed correctly, and not turned every hour and you have a recipe for disaster. Your coworkers are tired, overwhelmed, and probably apathetic as a result of working in a messed up system.

A couple of suggestions/observations:

* The fast-paced, never-ending tasks can be handled one of two ways: you can either rush through and do a shoddy job, or you can manage your time effectively (plan out your care before you begin your tasks) and consolidate your trips (eg., grab all of the supplies you need before entering rooms, combining feeding and hygiene, etc). Even so, you may still work more slowly than the others, since you will be doing things that they are (wrongfully) neglecting. The choice is yours.

* As you gain more experience, you will become more adept at changing, dressing, and turning patients - it just takes time. Don't let the first eight days stress you out - as time goes by, you will walk into work with confidence, provided you keep trying your best to improve and learn.

* Please don't lose the desire to provide quality care to the patients you are responsible for. Do not let the need to accomplish tasks quickly drain you of your human compassion - it is one of your greatest assets, and a powerful gift to your patients. A gentle, respectful touch and an extra moment of your day may be some of the only kindness that patient receives - you have the opportunity to be the brightest part of someone's day. These people are often forgotten by their families, most of their friends have died, and the staff aren't always kind or respectful. You can make such a difference, and provide dignity to individuals in this vulnerable stage of life.

You have had only seven days so far - nowhere near enough time to become truly experienced. Allow yourself time to get better and give yourself grace when things don't go as planned. In the meantime, be the CNA who cares, even if he can't accomplish everything perfectly on the first go. You can do this! Good luck and God bless you.

nursej22, MSN, RN · Oct 2, 2016

That you care is huge, and as others have written, the more times you perform tasks, the easier they get. And as you get to know your residents, you will learn their quirks and routines.

As for briefs, many have a light line that traces down the center. With the resident on their side, facing away from you, be sure to center this line or the center of the brief with their uh, crack. And align the upper back edge at the small of their back. The part that's closest to the bed needs to be slightly tucked under them. Then roll the resident back toward you, enough that you can grasp and unfold the part you tucked under them with the tape tabs. At this point you should be able to bring up the front between their thighs and affix the tapes.

Use lots of lotion after cleaning; this make the fecal matter easier to remove the next time. And shaving cream is great for removing dried poo and odor.

mindofmidwifery, ADN · Oct 2, 2016

I worked at a nursing home and this speed you're talking about sounds ridiculous. The CNA didn't even wipe the man? That's disgusting. You can't justify taking away someone's dignity in order to be faster. I have worked with SLOW CNAs and I see that their weaknesses are not being able to prioritize correctly as well as not being prepared. You don't have to yank people's clothes off to be fast. Also, this is your first week, give it some time, I promise you'll do better. I was so intimidated by everyone's speed but a lot of my coworkers cut corners and I ended up being slower but that was my choice because I wanted to give my residents the best care. good luck

supakimchee · Oct 4, 2016

You should come to our hospital. Some of our CNAs don't actually do anything. They can't even do 1:1 sitting without somehow walking out of the room and magically socializing with the unit secretary. I worked in LTC and those CNAs bust their butts compared to acute care CNAs. Most of the time in our hospital, they usually disappear or argue with one another about who needs to do work. They actually started giving our CNAs phones because of the disappearing Houdini acts.

mindofmidwifery, ADN · Oct 5, 2016

I agree, I have a problem with a lot of the techs that I work with at the hospital not working and me having to do everyone's work. While at the nursing home I worked at there was a lot more heavy teamwork.

ETA: This was a reply to the above poster.