Book-smart, but not "on-the-job" smart?

Nursing Students CNA/MA

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Specializes in Geriatrics.

I just wanted some other advice from CNAs or nurses that might be the same way, and understand what I'm going through. See, I like to think that I'm relatively "book-smart." As is, I read a lot, study a lot, and pick things up really fast when it's in a strictly theoretical, book + paper form. It's when it comes to doing the actual real-life, physical, skill portion of things that I come across a problem. Basically, I'm a person that is book-smart but awkward when it comes to the real world; a stereotypical "nerd, geek, etc." if you will. When I started my CNA job, I was so slow and awkward. I felt like the worst CNA EVER at first because it took me forever just doing the basic things like turning, cleaning, changing, etc. and I remember feeling really horrible and sick to my stomach when it was my 2nd day by myself and it was 11pm and I was STILL getting residents cleaned up and changed for bed. People were literally SCREAMING at me and words cannot describe how horrible I felt, at being so slow and awkward and trying so hard yet not being able to measure up to the standards of my job.

Now, the last day I worked, I was actually getting better and faster at things. I was getting better at the actual physical skills, though I was still a bit slow, and I was able to get my residents cleaned up and changed, everything taken care of, etc. on time. But I still feel bad that it took me THAT long (about 2 1/2 weeks) to get competent at things.

I ended up quitting the job afterward, for unrelated things, and might come back but I'm not sure. Now, here's my question: WHAT do I do to get better and faster at the actual physical, real-world part of the job?? I desperately want to be good and fast at the job, but it's hard on me. I just wanted to ask, any of you that struggled at first but became good and competent after a while, what you did and how it eventually came to you. Thanks.

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Everyones has different ways of doing things, i think once u get comfortable ull have ur way of doing it alot faster.

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Specializes in Trauma Surgical ICU.

Plan and simple.. practice. You have to have the hands on training to get all the skills down. The more you do it, the better and faster you will become.. "Book smarts" is fine, I'm sure I could read a book and learn how to do a back flip but I know I will bust my butt many times until I get it right (books make everything sound easy) LOL... The book doesn't account for pts that don't understand, are stiff, demented and trying to hit you etc...That takes experience :)

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Specializes in Geriatrics.

Sunn0408: You are SO right. Like, for example, I might have been taught in the books and videos, how to do peri-care properly. However, when I get to the actual work, I have a patient whose legs are so contracted that you CAN'T both open them and do the peri-care properly, at least not without a second person present and you can't even hardly GET that second person to help half the time. So what do you do in that situation?? Just clean the person up the best you can, by yourself. It's HARD doing this job by yourself, the 3-week class you take barely prepares you for what's ahead. But as a CNA, I've just tried to make the best out of what I've been dealt. I hope things work out and get better as time goes by. :/

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Specializes in Geriatrics.

One of the things that stick out in my mind was one of the days before I quit. A fellow CNA came to me, right before it was time to clock in for my shift, and was like "OMG ___, you won't BELIEVE the things people have been saying about you!! They are like, TurtleCat, she is SO slow and nervous, she really sucks, she won't make it and I don't think she is cut out for this job!!" This made me want to quit right then and there. So I went and had a talk with the DON and ADON in their office, and the ADON was all "TurtleCat, you want to know how long I've been a nurse? 15 years. The first few weeks I started, people were all "OMG, you know that girl, ___ (name of ADON)? She is SOOO slow and incompetent! She won't make it!" The DON asked me to say, in my words, that *I* thought was my OWN problems with my performance, compared to what other people were saying and gossiping about. My answer was "Well... yes, I'm slow. BUT, I've also just started." The supervisors were basically all just egging me on to keep at it, and keep trying. I don't know.

I was talking with some of my friends and they were like "TurtleCat, you were BORN to take care of people." So I really want to keep trying at this CNA job, until I get good at it, and I hope that this second job works out. I did go back to my other job, yes, but I'm hoping I can still keep working at this nursing home job part-time and do both. I just don't know.

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Specializes in Trauma Surgical ICU.

Yes, you do the best you can. Speed comes with time. Don't let what others say bother you, people talk and you can't please everyone. As long as you are safe and do your job, let them talk. My favorite saying is "if they talking about ya, they thinking about ya". Nice huh :)

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Hi there,

I know exactly how you feel. I felt the EXACT same way. Things get much better with time, because as other posters have said - the only way to get better at this is to practice.

Some tips that have helped me with my speed was honestly to stay organized about things. I know it sounds stupid, but even organizing my scrub pockets helped me immensely. It really was the little things that made the most difference, and now I can say that I am doing much better.

I work at a hospital, and we typically take vitals every four hours. I work night shift, so basically my night is divided into three "four hour blocks." Before I go into the rooms, I really try to be as organized as I possibly can. I keep my clipboard, a roll of trash bags, a roll of linen bags and extra pairs of socks on the basket for the vitals monitor. My clipboard has the patient report sheet with my information from report, and a sheet of blank white paper folded in half with all my room numbers on it with dashes for the vitals and white space. I also organize the wires on the vitals monitor so I'm not detangling cords in the patients rooms. For my first round of vitals, I keep a pen for the white board and a regular pen in one pocket. In my other pocket I keep a pack of electrodes (for the EKG's), tape, and gauze. I make note on my white sheet of paper which rooms need what things (like what gloves need to go into which room, which incontinent patients need linens in their room, which patients I plan on bathing that need things like soap, etc). Little things like that sound stupid but it makes it go way faster.

The key for me was to stop making additional trips to my patient's room for supplies. That is really what was slowing me down. I now very rarely go into a room and do only one thing. Every time I go into a patient's room to do vitals I am doing ten other things as well. I empty foleys and other drains each time I do vitals. I do daily weights on my last round of vitals. When I enter patient's rooms do do blood sugars I carry glove boxes in with me. Linen bags get emptied gradually (I don't wait to do all of them anymore). This has really sped everything up, and I keep track of everything. Every thing gets written down, checked off when its done, crossed out when its charted. I never go from one end of the hallway to another without carrying something. When things are at their slowest at night around 2 a.m, that is when I do my morning stocking. I even label my water cups ahead of time. Its all these little tasks that really do make your shift go much smoother. I have even been known to....lets say I am waiting for another tech/nurse to help me clean a patient up. I will even put soap on the washcloths while I wait for them...don't stand around. Things like that....little things...just start them as soon as you can.

It's not perfect. There are some shifts, that no matter what you do or how organized you are, they are just going to suck because of the amount of workload. All you can do is do your best in the situation that you are given.

Also, you may not be doing a terrible job even if you think you are. Sometimes the people who are the most "efficient" are also very rough with people and don't take the time to explain what they are doing, etc. It's all about finding a balance. Remember, the best time to do something..is right now. If you think you will do it two hours later....think again lol.

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I know this is an older post but I know exactly how you feel. I started working as Care Aide (Nurse Assistant) 7 years ago. I was the worst. I know I was. I was confused and slow and overwhelmed. But I loved taking care of people, so I kept at it. I cried before my shifts cuz I was so nervous and I hated going there an screwing up (and it took me longer than I would care to admit to improve), But I did improve. I learned to organize my time, and get things done on time but MY way. I tuned out the static of other ppls chatter, and learned to only care about one opinion, the Patients.

I am in my second year in an RN program now and again I am a whiz with the book stuff and my skills take me sooooooo long to get down, but I practice and practice. I get down on myself sometimes and feel like I will always be the worst, but then I remember I love taking care of people, Nursing is my passion, and whether I have to work and work (and cry sometimes) I will get better, I will be a good nurse one day.

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