nursing clinicals and glorified cna work

[kkanady]

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

[Live.&.Learn]

I felt this way for a minute...and then I put it into perspective. You can do with it what you will, and take from it what you want. Most people were not techs before nursing school and every nurse needs to know how to care for their patient, these "CNA jobs" are the very basis of caring. From here you will learn how to asses, learn all the cool skills, learn to be a nurse. As students,we are invited to help care for these patients and should be grateful for every single opportunity. Being a tech for 20 years does not make you a better nurse, that's why those skills can be taught in a six week course. You will get to do more, but please don't take for granted the opportunity you are being given today, and more importantly, please don't put yourself above your peers, weather it's our first day taking care of a patient or we have been a tech for years, we are all in this together, and if that means doing something twice...or twenty times until everyone get's a chance, well we'll only be that much better at it.

[megank5183]

This is crazy!! you wanted your students to go and sit in their patient's room all morning? i know that if I was the patient, I would have said "get out of my room"! I understand that you want your students to seize learning opportunities, but forcing them on patients who may want to be left alone is a little odd.....

I wish I could like this twenty times over.

I had a student once who was a very experienced CNA. She was one of those who was very skilled at CNA tasks and made it really clear that she "knew everything a nurse did, she was just in school to get the credential."

So one day I found her in the nurses' station at 0900 reading a magazine. A nursing magazine, but still.

me: "What are you doing here? What's going on with your patient?"

she: "Oh, he's all done up," meaning that he's been bathed and changed and breakfasted.

me: "Get back into that room and be there. Even if all you do is sit and talk, go be with your patient."

she: Shoots me a look that would etch glass but stomps off to the room. And about three hours later comes back almost in tears. Turns out her patient had recently been given a terminal diagnosis, and nobody had had the time to just sit with him and let him talk. It took about half an hour of near-silence to get up the courage to do it, but he finally started. He talked about his family, his fear, his loneliness at having to make decisions...she ended up holding his hand, and he ended up thanking her for being there for him.

And that, I told her, is why I say not to mistake what tasks nurses do for what nurses are. Naive students often complain about "glorified CNA work" but that's their ignorance and inexperience speaking. There are none so blind as those who will not see.

[carolinapooh, BSN, RN]

I would say the patient wanted her there, or he would've thrown her out.

I had a similar opportunity as a student and have never forgotten it. And when a patient asked me to leave, I left. Based on the context of GrnTea's story that's not what happened at all.

[Esme12, ASN, BSN, RN]

Don't fall into the same trap I did.

I just finished my first semester and for my clinicals that was all I thought I had to do and I too was becoming irritated. Next thing you know the clinical instructors is asking us all sorts of nursing questions and what we did for the day to actually improve the patients conditions. Also she had some people doing actual nursing procedures and really did not communicate the expectations of what we are really suppose to do. But you can't do any procedures if you don't know how to do it can explain what to do and explain the rationale why you are doing it and understand the side effects.

My advice is the get as much of the "CNA" part done early and incorporate nursing theory into it and then what you need to do is stop thinking like a CNA(task oriented) and start thinking like a nurse and doing things like a nurse(rationale oriented). A CNA does a bunch of tasks. A nurse knows the rationale behind doing those tasks. So even though they can be delegated then does not necessarily mean the CNA knows why the task is being done. Are you allowed to look at the charts? do you know all the meds on those charts and what they do, why the patient takes them? do you know why your patient is the way they are? find out, do that, see what is going on with the patient, find out if there is any basic procedures you guys are able to do with supervision. We were able to do insulin shots, IM injections tube feedings,dressing changes and a lot of basic stuff in addition to what you may call "CNA work" which is actually nursing work by the way.

I've learned that clinicals are what YOU, the student makes it to be. If you want it to be just CNA work then you won't get the full experience. Let me get you an example. A CNA knows that say an immobile elderly patient needs to be turned every 2 hours. But can you say why? ok yeah to avoid bed sores? why else? what are the stages of bed sores, how are bed sores treated? is it sterile or unsterile? with medications does a nurse use to clean bedsores? how is this all done? how often?

ok the CNA does not bother with most of those questions, but those are the questions you should be asking, finding out and expanding yourself to think critically and this is what I mean by thinking as a nurse. While you are doing your "CNA" stuff are you assessing the patient? and you observing and are you asking questions? do a full physical examination while bathing them, do anything to expand your knowledge. Are you trying to figure out what nursing interventions a registered nurse would want to do ? are you right in your deductions? are you bugging your instructors with these questions? or are you just thinking its another patient poop i gotta clean up? Are you just cleaning up poop or are you look and noting its color? observing for signs of blood? understand what medications affecting it texture?

Also if you still feeling bored, don't EVER stand around at the nursing station, look for the busiest nurse, CNA anybody, shadow her and bug her with questions. Don't take their answers as gospel...go back to your textbooks research and find the answers yourself.

If the instructor ain't giving you stuff you do, make stuff for yourself like care plans and nursing diagnosis. Be observant, take notes, watch what the nurses are doing. Trust me, there is more to clinicals than you realize.

Ok so you can't pass meds and you can't do a tracheotomy but you can, reposition your patient and see if it improves their breathing, you can get them something to drink and understand how that is going to affect their electrolyte balance. you can take vitals signs every 2 hours and understand why its done. There are many things a CNA does that is a critical part of the nursing care so start expanding yourself, you head should be spinning with ideas and overwhelmed by the clinical experience.

The only limitation in your clinicals is yourself.

Edit: In addtion to the above, based on what others say, you should be a great asset to your class. Some of your classmates probably never ever seen no one but themselves without clothes, so giving a simple bed-bath could take you 10mins and them 1 hour, so help them out, let your instructor know you are helping them out. Take the lead and the clinical instructor will put you on a pedestal.

Well said!! I think you'll be an awesome nurse!

[nurseprnRN, BSN, RN]

This is crazy!! you wanted your students to go and sit in their patient's room all morning? i know that if I was the patient, I would have said "get out of my room"! I understand that you want your students to seize learning opportunities, but forcing them on patients who may want to be left alone is a little odd.....

That was not a random assignment, and that patient clearly did NOT want to be left alone. He had had quite enough isolation and lonely fear. In answer to your assertion, yes, that day I did want that student to spend the time in her patient's room, to go see her patient as a person, not just as a piece of work to be "done up."

That student sent me cards every year for years and years. I understand she became quite a good nurse.

[megank5183]

Ohhh....I thought you just made the students go in patient's rooms if they had nothing else to do. I remember an instructor who thought we should always be in our patient's rooms during clinicals. As you said, some patients really want to talk and don't mind a student being there. But some patients just want to be left alone. I hated having patients like this because I felt like I was intruding (which I was) but was scared my instructor would think I was slacking if I wasn't in there....let's just say I don't miss nursing school clinicals AT ALL:)