nursing clinicals and glorified cna work

allnurses Guide · May 24, 2013

Im in clinical rotation and it seems like all I do is glorified cna work...I dont pay thousands of dollars for school to do cna work (Ive been a cna for over 6 years now) ...I want to learn core nursing skills so my question to you all is,is all clinicial rotations like this?
The nurses I work with dont do cna work so why are we the students expected to do the cna work? Cant all the ADL's be delegated to the cna? (sorry if i sound negative but I really want to know the answer so I know what to expect.
Thanks

It's very possible that you may work at a facility or in a unit with no CNAs. If you are a CNA and you are calling what you do now at clinicals "glorified" you can expect to do more complex skills as you progress. The reality is that clinical groups can't sort people according to past experience and thus treat all as if at square one. Many programs are now requiring nursing students to become CNAs prior to starting, so it really is integral to the process.

People often talk about the positive aspects of doing the ADLs, but I've seen what can happen when a patient needs those things (turning, repositioning, feeding, etc) and the nurse is the only caregiver who was never taught how to do them. It is not good.

It seems to be fairly common that students graduate without having inserted an NG tube or Foley in school, and often they panic, but in almost every case your new job will have skills you will need to do with someone else the first time. I started in peds so exactly none of my clinical skills carried over!

Esme12, ASN, BSN, RN · May 24, 2013

Im in clinical rotation and it seems like all I do is glorified cna work...I dont pay thousands of dollars for school to do cna work (Ive been a cna for over 6 years now) ...I want to learn core nursing skills so my question to you all is,is all clinicial rotations like this?
The nurses I work with dont do cna work so why are we the students expected to do the cna work? Cant all the ADL's be delegated to the cna? (sorry if i sound negative but I really want to know the answer so I know what to expect.
Thanks

Well...where you work the nurses do not do any ADL/care? That is the exception and not the rule. It is unfortunate that the nurses you work with don't do any care for it is a big part of a nurses job to perform ADLS for her patient.....and to clean them if they soil.

It is a misconception that once you become a RN that you will no longer give care...however I do hear it is that way in LTC...it is not that way in acute care.

If you work in ICU or other specialty areas you will be giving baths and cleaning behinds....doing CNA work. Much information can be obtained by spending this time with the patients. I have NEVER found "doing CNA work" beneath me.

So ....no in the real world care is not all delegated to the CNA.

MommaTy · May 24, 2013

I hear the 1st semester is a lot like "CNA work" that is the core work for any nurse. You are starting from the basics and working your way up. They aren't just going to let you run without walking first. Hang in there, more things will come. Good luck.

NurseOnAMotorcycle, ASN, RN · May 24, 2013

I agree with mommaTy.

I think that there is an element of "when can we place NG tubes or use the defibrillator?" in every student, having been one myself, but you can't go from being a newborn to a marathon runner in a day. Be patient, study hard. Everything they are teaching you is something you need to know in order to understand the next level up. Otherwise, it's all a bunch of random facts that you are trying to string together and use.

And for the record, we are too busy in the ER to take techs from what they are doing to ask them to help with ADLs, I do all of my own care from placing the Zoll pads down to wiping their noses. If a tech has the time to help, it's nice, but I don't depend on the help. Ever.

Wrench Party · May 24, 2013

I turn patient care into a detective game in my head and use it as an opportunity to gather as much information as possible. Doing a bed bath? Skin integrity, circulatory and possible incontinence issues. Ambulating down the hall? Musculoskeletal and neuro. Talking to you? Assess for HEENT/speech/swallowing. Touching the patient otherwise? Palpate for

pain/soreness/look at dressing sites. Looking at their various body fluids? sputum (respiratory infection?), stool (digestive issues? blood? constipation?) urine ? (sediment, blood, anuria/oliguria?), emesis, NG drainage, etc.

If you don't use your 5 senses in patient care, how can you take care of the patient effectively?

NutmeggeRN, BSN · May 24, 2013

"Im in clinical rotation and it seems like all I do is glorified cna work..."

I happen to value the work my LNA's do for me when I work in the LTC facility....and it is something I did all through HS and college as well.

Learning what compromised skin integrity looks like is a very valuable lesson, as well as knowing the difference between a red spot and an open bedsore.

You cannot do an effective care map if you do not know what you are speaking of.....learn everything you can and then learn some more.

You will appreciate it down the road.

Pangea Reunited, ASN, RN · May 24, 2013

Doing some CNA work in nursing school can endear you to the nurses on unit. Not only will they be more willing to teach you and allow you to participate in "higher" tasks, but they are also more likely to have the time.

avaloncar, BSN, RN · May 24, 2013

My class felt like that. And we had to do patient care mixed with our med administration, dressing changes etc. I knew of some schools who only had the students doing patient care in the first quarter/semester. To me it gave those students a sense of entitlement or made it seem like patient care wasn't a part of nursing. They even acted like they were better than us because they only did "nursing" work in clinicals. We looked at them like what do you do all day?! Lol Because not having that direct patient care doesn't help you practice your patient interaction skills and bonding. They hardly ever went into the patients rooms and seemed scared to even walk in the room. (We sometimes had other schools on the floor with us during clinical) I also think having students doing patient care helps us to learn how to refine our time management skills. That is a huge deal when you step into the real world of nursing.

Anoetos, BSN, RN · May 24, 2013

If the nurses you work with don't do CNA work, they're crappy nurses.

kbrn2002, ADN, RN · May 24, 2013

Just because you've been a CNA for six years doesn't mean the rest of your class has that experience. CNA work is core nursing, and am important step in learning observation and assessment skills. Instead of being upset with the "glorified CNA" work use it as the learning experience it is meant to be, work on your head to toe assessment skills. How does the patients general appearance/body condition relate to their diagnosis? Take the time to study the patient and with experience you will see a new patient and have a good idea of the correct plan of care to follow based on a quick body assessment that all started with your "glorified CNA" work.

springchick1, ADN, RN · May 24, 2013

It seems to bother you that the nurses you work with don't do ADLs so why would you want to be like that? You seem to have the attitude that what you consider CNA work to be beneath you. Like others have said, not everyone has had experience with patient care and doing ADLs is a great way to interact with patients and get comfortable with them.

SoldierNurse22, BSN, RN · May 25, 2013

OP, I felt the same way you did in clinicals. I had been a CNA myself and I wanted to learn the critical thinking skills everyone was talking about!

The truth of the matter is that in clinical, the focus is more often than not on skills, not necessarily critical thinking. Skills you can teach. Critical thinking is developed. They will certainly start you on the way to the "higher level" nursing skills, but if you don't have a good foundation (such as your CNA-level nursing skills) you will be lost on the sauce as an RN.

Consider yourself lucky--I was so thankful that I had CNA experience. Time management came a lot easier! :) Best of luck!