A Day In the Life of a Rehab CNA

I've always wanted to write an article, but never knew what to do it on. I worked as a CNA on an Acute Rehab unit. We had patients of all acuities, but mostly they were max assists. CVAs, paraplegics, amputees, etc. I usually had 9 patients, which doesn't sound like a lot, but it was exhausting. I miss it terribly, as insane as that sounds. So, for those of you who are interested, here is a day in the life of a Rehab CNA.

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A Day In the Life of a Rehab CNA

0630 Leave the house, stop for coffee sing along to the radio praying today is going to be a good day.

0645 Punch in, put stuff in locker, pick up my list with 9 patients on it, put a phone in my pocket and start making rounds.

0646 The overnight Charge nurse spots me, "Oh! Good, you're here! I just put 213 on the commode, can you make sure you get them off when they ring"? The aid from nights asks for help getting 216 out of bed. (MAX x2, CVA, flaccid on the right).

0647 The patient in 216 also needs their pants put on, and has soiled their brief. We change the patient, put his pants on and get him up to the side of the bed. While we're transferring him, my phone rings, but I can't answer it.

0653 I Leave 216, and 213 is ringing, the secretary is yelling down the hall to tell me she's trying to call me to tell me 213 needs to get off the commode. The nurse for 212 spots me, and informs me the pt needs to have a bowl movement. I head to 213, a one person transfer. I get her off the commode and set her up at the sink to get washed up.

0658 The CNA from nights has report for me, she got two patients up and dressed, one of them is the patient from 216. 217 fell during the night, he is banged up but nothing is broken.

0700 I head into 214, to let him know breakfast is in an hour. "This is rehab, Mr. Smith. It's part of your therapy to get up and eat at a table", I say when he tells me he thinks he will sleep in today. He has PT at 0900, anyways. I look at the board in his room, it tells me that he is a max x2, and he needs help with all of his basic needs. He weighs about 250 lbs, and has no sitting balance. I start getting him washed, and give him the cloth so he can do his face while I check on 213.

0710 The pt in 213 is really angry that she's been sitting at the sink for 30 minutes. (I'm not allowed to correct her, I just have to say I'm sorry) I help her with the rest of her washing and dressing and set her up in front of the TV until it's time to take her to the dining room at 0800. By the time we're through, she's smiling again and wondering what's for breakfast.

0725 I go back to 214 and finish getting him washed and dressed in the bed. He needs a lot of help, and it hurts my back to help him roll over, but we get it done. I try to find someone to help me get him into the wheelchair, but there isn't anyone. I help him sit up, using my weight to keep him upright, while I put the gait belt around his waist. He knows the drill. "OK, ready Mr. Smith? ON the count of three, 1...2...3...., I hoist him up and scoot him over to his chair. Get him set up, he's grinning at me because he knows he gets to try mechanical soft today, which means real scrambled eggs.

0738 I finally make it to 212, who already put herself on the commode. Thank god, she didn't fall. I hate doing this, but I hand her a washcloth and tell her to wash up a bit while she's on the commode. I pick clothes out for her and get her dressed while she's pooping, poor lady. When I transfer her to her wheelchair, all I have to do is pull up her pants and she's dressed. I set her up in front of the mirror to do her makeup and promise to come back to help her with her hair.

0745 I'm sweating now, and my feet already ache from yesterday. 215 is a min assist, but needs a lot of cuing. I'm not allowed to leave her while shes on the toilet, so we do the same routine I did with 212.

0754 I fly back to 212 and help her fix her hair before scooting her to the dining room. She complains that she's early, breakfast isn't until 0800!

0755 I run to 214 and take him to the dining room for breakfast, followed by 215 and 213. The nurse took 217 for me, and 216 is in the hallway wheeling himself, except with only one working arm, he isn't getting very far. I scoot him along and park him at his table.

0805 I get to 221, who is a min assist with a TBI. He never remembers me, but I've been taking care of him for 2 weeks. He keeps yelling out words in German, and I have to ask him to tell me in English. He walks pretty well, but his gait is off. He doesn't like it when I help him, but I have to because he isn't steady. It takes me 10 minutes to talk him into getting out of the bed and into the wheelchair, so I can set him up for breakfast. He doesn't go to the dining room, because he disturbs the other patients. I get his tray, and set him up to eat.

0825 I rush to 220, who is NPO for a procedure, but has to get a shower and is a max x2 and a double amputee. I get the slide board and flag down a nurse. We get her on to the wheelchair, and wheel her into the shower. Getting into the shower is harder, because we're going uphill, but we get it done. The nurse hurries out to finish her med pass and I thank her. 220 is safe to be alone once she's set up, so I get her going, make sure she has the call light and head back to 221, I have to convince him to put clothes on.

0840 I go back to 220, and hand her towels to dry off after her shower. I call the nurse to help me get her into her chair, and I help her get her top dressed. We have to get her back into the bed so her dressing can be changed, I stay and help the nurse do the dressing change and hold the patients hand, she's afraid it will hurt.

0855 I start taking patients back from the dining room who didn't go directly to PT. 212 wants to use the restroom and 215 wants to go back to bed until his therapy at 10. I comply with both requests.

0910 With 215 back in the bed, I go to get 212 off the commode. Then I start making her bed and tiding up her room.

0910-1010 I go from room to room, stripping and re-making beds. Most of my patients are in therapy.

1010 Therapy calls, why is 215 in bed, I need to get him up.

1020 I have 215 up, and 220 needs to get up and use the rest room. Her procedure is over and she can have a tray now, I help her order it.

1030 My TBI in 221 threw his coffee, I have to convince him to let me help him change his clothes. It takes me 30 minutes and I'm only able to get a new shirt on him. He decides he has to go to the bathroom though, and then I am able to change his pants. He tried to hit me a couple times, but I managed to duck. The nurse makes sure I know I shouldn't be in there alone, but there isn't always someone else to go in with me.

1100 I take the patient in 212 to the restroom, she didn't make it and is so embarrassed that she soiled her underpants. I tell her don't worry, it happens and share an embarrassing story of my own. I promise it will be our secret. It's not her fault she can't just jump up and use the bathroom when she wants, besides these nurses love to hand out the laxatives! ?

1115 I take 213 to the bathroom, and he begs me to let him lay down for 30 minutes. I give in, I know he's tired from his morning therapy session.

1130 My patient in 220 is done with her meal, and wants to go back to bed, I convince her to stay up to digest her food.

1130 Someone laid 214 down, so I get him up, lunch is in 30 minutes.

1135 I really need to pee, and I'm exhausted. I grab a quick snack and eat it while I am peeing.

1140 The nurse needs a stool sample on 213, I think I might cry. I make sure to write it down, so I can collect it next time they go.

1142 I sit down to start charting my morning events, but someone calls for the restroom.

1150 I start getting everyone into the dining room, and I stay there until 1300 helping everyone eat and making sure they have what they need.

1300 My patents all want to go back to their rooms, one by one I give them rides and promise to come back to check on them.

1315-1400 I go from room to room, laying everyone down and/or toileting them.

1400-1430 I get 30 minutes to eat and rest my feet. Hooray!

1430 The doctor is here, and wants to check someone's incision. I help get them back to bed. The nurse tells me we're getting an admission.

1445 I get the room set up for the admission, gathering everything they're going to need.

1500 The new admission is here, a new CVA with R sided weakness and aphasia. She looks so scared. I help her get settled into the bed and tell her about our routine. I take her vitals, and get a weight on her. She looks like she hasn't had a shower in weeks, so I give her a good bed bath and shes' smelling nice and fresh by the time her family arrives.

1545 I start making rounds again, more toileting and up/down from afternoon naps. My feet and back are screaming.

1630 Dinner is in 30 minutes, I make sure everyone is up, a few of them always manage to get someone to help them lay down after therapy.

1700 Finished getting everyone up, and into the dining room for dinner. Pass their trays, and repeat the Lunch process.

1800 I start wheeling patients back to their rooms. Most are asking to get dressed for bed, I promise to come back when everyone is out of the dining room.

1810 I start making rounds, getting everyone into night clothes and into bed.

1910 I spot night shift, I think I might kiss them. We make rounds and I say goodnight to my patients. I'll be back in the morning, I tell them.

1925 I finally can finish my charting and punch out. See ya in 11.5 hours!

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Glycerine82

About Glycerine82, LPN

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Somehow I think you missed something;) Thanks for sharing!

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Wow. Just wow. The CNAs were my heroes when my family member was in rehab and later in LTC. They were so kind, so competent, so understanding. I don't know if everyone appreciates their work, but I certainly did.

Thanks for your article -- you communicate very well.

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Very enlightening and well written! Thank you for sharing

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Specializes in Short Term/Skilled.

? Thank-you.

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Specializes in Skilled Nursing/Rehab.

Great article! I have worked as a CNA on a Rehab and Skilled Nursing unit for 3 years now, and as soon as I pass my boards I will transition into an RN role there. This sounds EXACTLY like a typical day shift on our unit! I will admit, once I started my nursing program I went to working one weekend nights, one weekend days. After experiencing the night shift (which does not include bathing and showering unless there is an unusual circumstance, like days are short an aide), I got off of days as fast as I could! AND, we only work 8 hour shifts as CNAs. Hard to imagine doing 12s with all the lifting, etc.! Sounds like you are an awesome CNA and your unit is (was?) lucky to have you!!

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Specializes in ER, TRAUMA, MED-SURG.

Wow!

Good grief - I'm tired just reading about your days. I worked as a CNA before finishing nsg school but it wasn't that kind of pace!

Kudos to u for sure!

Anne, RNC

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Specializes in Short Term/Skilled.
Baubo516 said:
Great article! I have worked as a CNA on a Rehab and Skilled Nursing unit for 3 years now, and as soon as I pass my boards I will transition into an RN role there. This sounds EXACTLY like a typical day shift on our unit! I will admit, once I started my nursing program I went to working one weekend nights, one weekend days. After experiencing the night shift (which does not include bathing and showering unless there is an unusual circumstance, like days are short an aide), I got off of days as fast as I could! AND, we only work 8 hour shifts as CNAs. Hard to imagine doing 12s with all the lifting, etc.! Sounds like you are an awesome CNA and your unit is (was?) lucky to have you!!

Thank you! Sadly, it's was. I had surgery on my foot and there were complications so now I'm not able to work in that capacity. :(

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Specializes in Surgical, quality,management.

Wow, I can't believe that you are doing 2 assist on your own. That is so dangerous for both you and the patient. I know you are doing your very best for your patients but please remember you only have 1 back.

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Specializes in Short Term/Skilled.
K+MgSO4 said:
WOW!, I can't believe that you are doing 2 assist on your own. That is so dangerous for both you and the patient. I know you are doing your very best for your patients but please remember you only have 1 back.

Very true. God knows I wish I didn't have to, but I just worked with what I had.

It's a hard situation to be in, for sure :(

There were certainly patients I wouldn't attempt to transfer alone, and others I knew would be fine, it just depended on their physical barriers and what kind of equipment I had on hand. In this case, the wheelchair was at the same level as the bed, the sides were off of both and it was more like a hoist and scoot than a true transfer.

Just clarifying, especially if any new CNAs stumble upon this and get the wrong idea ?

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Whew I'm tired from just reading this. You are amazing !!! Those patients are blessed to have you. I have worked with cnas that don't do half of what you do.

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WaaaW,,,good job,,it takes someone with the passion and love for this job to do all what you did...gosh well done sweetheart

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