CNA Instructor - Need Advice for Clinical

  1. Hi There! I am a relatively new CNA instructor and I'm loving (almost) every minute of it. I feel like my classroom instruction is excellent but I'm just having a hard time with clinicals!

    At my clinical site, the students are paired up with a CNA preceptor for the day. We do clinicals for 9 eight hour days. I have to check them off on at least 15 skills. I usually have 10 students in clinical. If I watched them do each skill, that would be 150 skills I'd watch! (or 17 a day) That would be possible if I could watch the skills one after another but opportunities for skills come up at different times and it just doesn't work that way.

    I've tried to have students tell me when they are about to do certain skills but then they spend much of their time trying to track me down! I've thought about following one student each day but I still wouldn't get 15 specific skills checked off (i.e. the opportunity to apply a condom cath (etc)may come up once during the entire clinical).

    I also feel like that would be pretty intrusive to the CNA preceptor. I've been told that I spend more time with my students (I make rounds throughout the day checking on them) than any other instructor. But, if that's the case, why am I having such trouble?

    I would appreciate any advice you have for me! I know that most instructors don't actually SEE the students do every skill they sign off on, so I'm not necessarily looking for that - although if there's a way to do that it would be GREAT because that's what I'd like to be possible. Thanks so much!
    Last edit by Joe V on Jul 10, '12 : Reason: spacing
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    About belabelisa

    Joined: Mar '05; Posts: 79; Likes: 6
    Clinical Trials Nurse
    Specialty: Oncology


  3. by   VickyRN
    Welcome to the Nurse Educators Forum, belabelisa What is your school's protocol for instructors signing off skills in the clinical site? Are you required to watch each one? Or, would it be OK to elicit feedback from the CNA preceptors concerning any skills your students perform and then have the preceptor sign off?
  4. by   merlee
    Wow. So much time at a site! We had a skills lab - and could check off most things in the lab.
  5. by   classicdame
    skills lab makes a lot of sense. I would not sign off anything I did not see
  6. by   SHGR
    When our MA students have clinical, the MA preceptor signs them off on skills. Same with RN preceptors on-site in places I've worked. From what I've seen, it seems like the instructor only signs off on skills in the controlled environment of a skills lab.
  7. by   ToughingItOut
    First of all, my CNA teacher was FANTASTIC. I hope to someday become half the nurse that she is. She actually would let us track her down during clinicals to check off out skills, but, we also had a couple open lab days at the end where we could check off any skills that she had not seen us perform. Thinking back, she was so very highly regarded in the nursing home where we did our clinicals that current CNA's working there sought her out to involve her students. For example, Mr. Smith needed to be changed and turned, so the CNA or charge nurse would go find our teacher, and she would round up a small group of us (maybe 3) and walk us through everything, and, if we did most of it independently, she signed us off. She also knew that Mr. Jones like to be shaved at around 1000 every Sunday by his wife, but his wife enjoyed allowing students to have the opportunity (Mr. Jones always fell asleep; he really enjoyed his Sunday shave). My advice would be to get to know the staff and residents and let them help you out. I know that in nursing school our nurse preceptors were allowed to check us off if our clinical instructor was allowed to check off some of our skills. Would your CNA preceptors be allowed to do that? And, Mrs. Stockwell, if you're reading this, THANK YOU!!
  8. by   Amber628
    I took my CNA class back in 2009 and we were a BIG group. 30 of us to ONE teacher. There were 3 clinical groups.

    My teacher did alot of easier things during skills lab, it also helped us to prepare for our state skills exam.

    our typical day consisted of

    8am-11am instruction, reading, quizzes & exams
    11am-12pm we went over questions and homeworks also reviewed after exams.
    12-1230 - lunch
    from 12:30 to 3:30 we had skills lab EVERYDAY. We worked in groups and my teacher would tell us when we are fully able to do the skill without looking at our manual to call her over. She ALWAYS demonstrated FIRST, usually once herself, then she would ask a volunteer to do in in front of the class. Then, each person in my group [usually about 5-6] would preform the skill on one another or on a "dummy" This was good for skills like nail care, denture care, PPE, Vital signs, transferring pts, making beds, handwashing; the "easier" skills.

    If you preformed them satisfactory she would check them off.

    This gave more time for us to practice incontinent care and bathing at clinicals, and have all our skills checked off. Also it was easier to do simplier things in skills lab.

    We had a dummy we did perinal care on and she watched each and everyone of us do it and sign off BEFORE we went into the nursing home and did it on an actual patient. She wanted to make sure everyone knew the proper way. She also stressed the fact of making an occupied bed, because many times as a CNA all the linens will be soiled and the pt is bedridden.

    You have no idea how many people dont know to wipe front to back until you see them do perinal care on a dummy. Lol.

    You sound like a wonderful instructor! Best of luck

  9. by   belabelisa
    Thanks, everyone, for your replies. They are very helpful. I do want to clarify - I see the students do every skill I check off on in the lab - which turns out to be about 50-60 skills. So, by the time they go to clinical, I've actually seen them do everything. It's just that once we get to clinical, they have to do 15 skills at that facility. That's where I'm having trouble coordinating the time. I know that some other instructors let the CNA preceptor sign them off but I am wondering if this is the norm - or if there are better/different ways to go about it.Thanks again!
  10. by   Glycerine82
    Totally thinking skills lab here. That's what they did for my class. Have them use each other for things like nail care, feeding ( gotta taste the stuff your feeding these people... Best lesson I learned regarding feeding). You can even have them put each other in and off the bed pan while clothed. Transfers etc. .

    "No day but today"