Calling all CNA's. What is your typical day like at work?

Glycerine82, LPN · Feb 5, 2013

I work in a hospital setting, acute rehab. I have 7 or 8 PTs who range from strokes to quadriplegics Most of them are 2 assist or a max of one. I get to work at 0645 and start getting people up for therapy, bathe, shower, toilet... Then at 0800 everyone To the dining room to eat, then I start making beds/finish getting people up who didn't go to DR. In Between, I toilet whoever needs as well as help nurses with whatever they need dressing changes etc. (they help me too with transfers etc). Once all the beds are done and everyone's up its time to document for a few minutes then more rounding and lunch in dining room. In between all that a lot of PTs want to take a nap in between therapy. It's a lot of up down. After lunch it's toileting and or naps until next therapy session. Pass ice collect trash an do it all over for dinner. Sometimes I leave the heavy ones in bed for supper if they want to because by 1700 I am exhausted. After everyone's so e with dinner I go from room to room getting people in night clothes and putting them in bed. By this time is about 1900 and night shift gets report and I'm on my way home by 1915. :-). It's a lot of work but i love it.

I also so vitals as needed ( nurses do q shift with their am assessment). Bladder scans, take discharges out, settle in and orient new admissions etc etc. nursing home is much much different.

"No day but today"

blackvans1234 · Feb 5, 2013

CNA (or PCT) in a hospital, inpatient physical rehab setting, evening shift

The census vary's and has hi's and low's. Lately it has been lows due to trouble with nurse liasions finding patients and dealing with insurance companies. I'm per diem.

Come in at 3pm, get hand off report from previous PCT, maybe get report from nurse), Start Q shift vital signs on patients. Answer call bells as they ring. Fill new PCT names on patient boards and take down their daily therapy schedual (in room). Fill waters as needed. Get every patient into a wheelchair or chair (from bed)- this is required as a part of therapy and helps with DVT prevention. Ask RN if they need anything

Accu checks on diabetic patients at approx 430, food arrives anywhere from 445-5pm, give or take. Ask every patient if they need anything with food. Feed any stroke patients that are unable to feed self. Open packages. Take trays out of room, note intake as necessary. More people need to go to the bathroom, we ambulate them to bathroom with walker. Some patients that are impulsive due to stroke must not be left alone in bathroom.

6-8 We get patients undressed (our patients wear street clothes during the day, pj's or hospital gowns at night), and make patient do as much as possible, with supervision. Shift change for the RN's at 730, this is usually when the other PCT is on lunch and the patients start ringing for BR, vomiting, need pain med, etc.

Take lunch break (usually around 830 for me)

Put Total knee replacement patients on CPM for two hours, (6-8 then 8-10 for bil TKR)

Accuchecks at 930, fill out hourly rounding sheets and PCT flow sheets for tommorow (date and name stamp)

Remove Ted hose stockings and put on Venodynes on every patient, fill waters, fill out hourly rounding sheet, Ask RN if they need anything. Try to remember what I forgot to do during the shift. Empty dirty linens, fill linen carts. Empty any foley's

That sums it up pretty well.

The major difference between Rehab and medical units is that the staff to pt ratio is higher, however each patient requires more assistance with ADL's. Rehab patients do not get urinals or bedpans, we ambulate to the bathroom each and every time. Little old women that can't hold more than 100cc's will be ringing hourly, same goes for men with prostate issues.

Another notable thing is that the Docs and hospitalists on call do not usually intervene with small changes in patient condition (our patients are ''stable'' , even the ones on dialysis...) so Rapid responses are sometimes called.

These things are all basically PCT independent, if a nurse needs help with something, then we do that too. We turn and position stroke patients Q2 as well.

COMPLEXBeautyy · Feb 5, 2013

I work in a hospital setting, acute rehab. I have 7 or 8 PTs who range from strokes to quadriplegics Most of them are 2 assist or a max of one. I get to work at 0645 and start getting people up for therapy, bathe, shower, toilet... Then at 0800 everyone To the dining room to eat, then I start making beds/finish getting people up who didn't go to DR. In Between, I toilet whoever needs as well as help nurses with whatever they need dressing changes etc. (they help me too with transfers etc). Once all the beds are done and everyone's up its time to document for a few minutes then more rounding and lunch in dining room. In between all that a lot of PTs want to take a nap in between therapy. It's a lot of up down. After lunch it's toileting and or naps until next therapy session. Pass ice collect trash an do it all over for dinner. Sometimes I leave the heavy ones in bed for supper if they want to because by 1700 I am exhausted. After everyone's so e with dinner I go from room to room getting people in night clothes and putting them in bed. By this time is about 1900 and night shift gets report and I'm on my way home by 1915. :-). It's a lot of work but i love it.
I also so vitals as needed ( nurses do q shift with their am assessment). Bladder scans, take discharges out, settle in and orient new admissions etc etc. nursing home is much much different.
"No day but today"

Can you please describe what a day in a Nursing home is like as well?

Jaynie_Marie · Feb 5, 2013

CNA NOC shift in a nursing home

10:45 clock in.

10:45-11:00 pass fresh ice and linens for a.m. cares, if anyone is still up finish putting them to bed, answer call lights

11:00-11:20 get report from nurse, answer call lights

11:20-11:30 set up linen cart and laundry/garbage brutes to be accessible during rounds, answer call lights

11:30-12:00/12:30 first rounds, answer call lights

12:00/12:30-1:00 take turns going on 15 min breaks while your partner works on starting charting from first rounds, filling out reposition sheets on qh repos, pass thickened waters, answer call lights

1:00-1:30 chart first rounds, pass fresh water pitchers and cups, take first set of vital signs, answer call lights

1:30-2:00/2:30 second rounds, answer call lights

2:00/2:30-3:00/3:30 take turns going on 30 min breaks while partner starts charting second rounds, fill out repo sheets, usually a lot of call lights going off at this time, wash wheelchairs

3:30-4:00 finish charting second rounds, wash wheelchairs, answer call lights

4:00-4:30/5:00 third rounds, answer call lights

4:30/5:00-5:30 take turns going on a second 15 min break if desired, chart third rounds, answer call lights

5:30-6:00 take second set of vitals, finish charting for the night, usually a lot of call lights going off at this time too

6:00 check alarms with incoming shift

6:00-7:15 get our residents up (usually 2-3 residents per CNA depending on the unit assigned)

7:15 make sure off our work is done, clock out

Obviously this varies depending on staffing levels, if any emergencies or deaths occur, etc. NOC shift is not as slow as many people tend to think!

Mewsin · Feb 5, 2013

I work in LTC mostly nights, we have 45 patients, one nurse 2 evening CCAs 2 night CCAs (after 2330 just night CCAs). 3/4 of our clients are doubles.

1845 report until 1915

1915 pass out hs snack with evening girls

1930 evening girls on break nights put people to bed, answer buzzers. We have a lot of buzzers, some nights we can get 4 people into bed some nights we can get one.

2000 evening girls are back we are still putting people to bed and answering buzzers

2200 if we have finished putting everyone to bed nights go on break

2300 rounds. turn and change those that need to be changed

2345 start books answer buzzers

0000 rounds floor checks (just ensure no one has fallen)

0015 continue with books

0100 rounds with turns and changes

0145 start nightly duties (includes washing wheelchairs, stocking linen carts, stocking dining room cart, getting any supplies we need for next day, putting out crumb catchers, filing, oh yes and answer buzzers)

0200 rounds, floor checks

0215 continue nightly duties

0300 rounds, turns, changes, empty catheters

0345 try and grab a snack

0400 bed bath those who are in bed all day and night (right now we have 3)

0445 get ready to get people up

0500-0700 get people up for the day and answer buzzers (we try and have up 8 people, 4 are baths)

0700 garbage and laundry

0715 home

if you want days I can probably do that also lol. There are 8 aides on days.

0645-0715 report

0715-0845 people up and down to the dining room

0845 we break up, 6 go down to the dining room (one in large dining room 5 feed the people who need help), 2 stay back and do water jugs and make beds.

0915 lay down those people who go to bed after breakfast

0930 4 CCAs go on break the others are finishing getting people to bed and making beds

1000 4 CCAs go on break make sure bowel care has been recorded, laundry and garbage out

1030 get people up and down to the dining room for lunch

1100 4 CCAs go for lunch the rest get everyone up who is left and get everyone down to the dining room

1130 4 CCAs go for lunch. Everyone else go to assigned position(large dining room, feed people, or roam)

1200 Everyone is back, getting lunch to our clients

1215 start laying people down

1300 report starts but we are usually late so probably 1315 in reality

1400 report over get people up for afternoon snack or programming or both

1430 8hr CCAs go on break, 12hrs still getting people up

1500 12hr CCAs go on break, evening CCAs in report, snacks being handed out

1530 stock laundry carts

1600 start taking people down for supper

1715-1830 those who go to bed early start laying down

1900 garbage and laundry

1915 home

Glycerine82, LPN · Feb 6, 2013

Sure. I worked on a 54 bed unit. I did 7-3 for awhile and 3-11 for awhile. Both shifts are different in their own ways.

On 7-3 I had about 10-12 patients. I didn't work on the dementia unit, although some of them were confused and about half of them were incontinent.

Get to work, hit the ground running to have as many people up, washed and dressed as possible for breakfast at 8. Mandatory 2 showers a day where you would have to get help to transfer the patient into a shower chair and then roll them into the shower to wash them. Go from room to room, washing and dressing everyone. Only a few patients would stay in bed all day in which case you would still wash and dress them and roll them to change their beds. Pain in the bum I tell you.

As i was getting everyone up I would change them or toilet them. Then pass breakfast at 8am and feed anyone who couldn't feed themselves. After breakfast continue to wash/dress/change/toilet patients and make everyone's beds. I can't remember when we stripped the beds, I think every day. By this time its about lunch, so pass lunch trays, feed patients, and make rounds again changing/toileting everyone. Then its 3pm and time to go home.

On 3-11 I would have 13-16 patients. I would get to work, make rounds and do vitals. Toilet/change patients and get whoever wants to go ready for dining room at 5. Pass Dinner/feed patients, then go from room to room toileting/changing and getting everyone in pajamas and putting them to bed. Also 2 showers on this shift. Once everyone is in bed its 9pm at the earliest and then I'd make more rounds changing everyone/turning them every 2 hours and by this time Its 11pm and time to go home.

funtimes · Feb 6, 2013

I work night shift on a Med/Surg/Telemetry unit in a hospital. The shifts are 12 hours long and begin when I get a report from the day shift RNs and PCTs. Then I get report from the night shift RNs assigned to my patients. I usually start the shift running, with call lights going off while im getting report, and it usually wont let up for at least the first 2 or 3 hours, and sometimes it doesnt let up all shift long.

I start by getting a first set of vital signs on everybody, make sure they have everything they need for the night, help wash up any patients that cant do it themselves or need help, and start repositioning patients who cant do it themselves and need it to prevent bed sores. Many of these patients are also incontinent, so I have the fun job of cleaning them up and keeping them as dry as possible, which is pretty much never ending. Repositioning is a lot harder than it sounds for people who never worked as a CNA, and can be a back breaker at times, especially if a patient is on a vent, as I have to help repo patients in the ICU.

Other things I do are toileting and ambulating patients, bladder scans, setting up orthopedic devices for some surgical patients, emptying drains and catheters, checking blood sugar, answering call lights and bed alarms, emptying NG tube containers, ostomy bags, keeping track of I/O, helping with dressing changes and other things the RNs need done, taking more vital signs, doing rounds, taking patient samples, transporting patients who need diagnostic tests, help prepare patients for surgery, do a LOT of charting, weigh patients, help admit new patients, and occasionally discontinuing things like IVs, NG tubes, and foleys. I also have to respond to any cardiac arrests on the floor, doing compressions and acting as a runner and providing an extra set of hands. I also sometimes sit with combative or confused patients and try to calm them down or just make sure they dont hurt themselves.

Towards the end of the shift Ill have to empty drains and record the output, sometimes give bed baths, and finally give a report to the oncoming shift and catch up on any charting that wasnt finished.

No two shifts are exactly alike, and there are many other tasks I sometimes do, but this is a general run down of a typical shift.

Ive worked in LTC as well. There is less variety and I dont have as many tasks to perform in LTC, but the work is more physically and mentally demanding, with the only exception being I usually have less patients actively dying when I work in LTC, not that death is rare occurance in LTC.

esand · Feb 6, 2013

I work in a nursing home.

I wake up at 6, go in at seven and get a cup of water and get to my hall. I start getting residents up while cleaning up and dressing the ones who are all ready awake. Then, I potty everybody while I wait for breakfast. Once breakfast is around, I help transport residents who sit in wheelchairs to the dining room, then go get the trays for the residents that eat in their rooms. I deliver them all, making sure to keep track of who's is who's. While they eat, I sit at the computer in the hallway and do ADLs and answer call lights as they come on. I write down intakes on papers along with the name of each person, and put those into the system as well. If I get time to, I pass ice water and tidy up rooms.

Once I see people start coming back with residents, I walk to the dining room and start transporting patients back to their rooms, toileting the ones who didn't have a chance to go yet, etc. Once things are calm again, I answer call lights all day, which keeps me pretty busy. Once lunch comes around at 12:30, it's basically the same thing as breakfast. I'm also specifically assigned to a man who is in a private room. I clean him up right after lunch, empty his catheter and dress him and fresh clothes and sit him in his chair with his coke and remote. :)

I work on a specific hall, called short hall. There are 24 patients on this hall, and I pretty much take care of all of them alongside the other aide I'm partnered with. It really just depends on the day.

IHeartPeds87 · Feb 9, 2013

Hi. I work as a PCT on a neuro floor in a hospital, night shift.

Here is a "typical" night shift/my routine:

Arrive at hospital at around 6:40 p.m, print off patient sheet for the floor and get organized. We are an 18 bedded unit. If I'm lucky, I get another aide. If not then i'm the only aide for the whole floor and my night will be invariably busier. I would say about half the time I get another aide and half the time I'm the only aide for the unit. If i'm the only aide on the unit the nurses will each take a patient that they will do vitals on, but it still makes for a much more hectic night. We all get pulled to other units in the hospital on a rotating basis , in which case the duties vary a little bit but more or less stay the same.

At 7 p.m we have a team report where we join the nurses for a general overview of what happened during the day shift. Then we break away from the nurses and I get report from the aide/aides from the day time. I try to catch each of my nurses for a quick report from them because sometimes the aides are incorrect or don't know about upcoming changes (example: patient will be NPO after midnight, day time aide was probably unaware of that, etc). I would say that the vast majority of our patients have vital signs due Q4 hours. I also check with the nurses to see if they want to turn their Q2 patients on the odd or even hour and I make note of that so I can help them with the turns.

Along with all the duties I have listed, answering call lights is a given at any time. Any time a patient presss their call light and we answer them. Typically they either want pain medications, which is something I will let the nurse know or they want to use the bathroom in which case I assist. Other requests are tended too on an ongoing basis : requests for water, ambulating patients, etc. Also ongoing are random tasks the nurses will ask, like reattaching EKG leads, taking a discharged patient downstairs to the lobby, doing a bladder scanner, getting random supplies (like nasal cannulas, 02 cylinders, IV pumps, IV poles, etc), putting on condom catheters, assisting with postmortem care (thankfully doesn't occur a lot, but it does happen) , collecting SCD pumps, assists with transfers, taking someone's vitals again (for different medications the nurses sometimes need an extra set of vitals or they typically will want one before calling the doctor, etc). Sometimes you will be acting as a sitter for the entire night or a portion of the night. Sometimes you are a sitter for an hour to give the sitter a break. Also, new admissions: helping with transfers and setting up the rooms. It can be a myriad of unexpected things that take up a large portion of the night shift!

As soon as I get report it is time to start vitals due at 8 p.m. I go to each of my patient's rooms, introduce myself, tell them who their nurse will be for the night shift, write name/date/nurse/my name on the white board in the room. I take vital signs and record them. I am very organized about this and make sure to report any abnormalities to the nurse. If they are borderline abnormal I will wait until I have collected all my vitals to report. If they are way out of the normal range I report to the nurses immediately. I keep track of having told them or not because it can be easy to forget to report something abnormal. You want your nurses informed. I will also grab left over dinner trays if they are in the room and record intake on my patients.

I then go around to each of my nurses and give them my vitals sheet and have them look at it because it typically takes me awhile to get to charting the information and I want them to know the information as soon as possible. I ask the nurses which of their patients are able to take a shower if they want one and ask them who they'd like to bathe with me later in the night. We try to roughly set up a time when we are going to do the bathes. Sometimes I'll do 5-6 baths in the night, other times we don'd do any it depends a lot. If there are any people who are on 1-1 feeds I will typically do that right after reporting vitals.

Then it is off to do blood sugar checks. I do quality controls on the blood sugar machines and go to take my blood sugars. I report all the values to the nurses.

Hopefully at this time I have time to do my charting. I chart all of my vital signs, whatever intake and output I have recorded, and whatever call light responses I have attended to (any people I've taken to the bathroom or cleaned up, etc). I will help nurses with boosting patients up in bed and turns.

At this point it is typically around 11 p.m and it is time to once again do a round of vital signs. I go into each of my patient's rooms and do the vital signs in the same way as I did them before (noting and reporting abnormalities). At this point I also try and see what is needed for the room because we stock rooms. I will note down what rooms need gloves, linen bags and trash bags. I also empty any drains that my patients have on this round (foleys, other drains, etc) and record the information. I try and grab a few of the trash bags and linen bags at this point as well.

At this point it is typically around 12:30 to one o clock. The rest of the night is spent catching up on charting and answering call lights. between now and 3 o clock is typically our "slowest" time (not that it is ever slow). At this point after turning everyone again we all typically try to take our breaks, we combine our breaks to take a full hour.

After turning the Q2's again, at three o clock it is time to start vitals again. Again, immediately after I report abnormalities. Also during this round of vitals I try to do any of the extra tasks (like daily weights, etc)

Then typically we do any baths (me and the nurse assigned for that patient, or occasionally me and the other aide and sometimes by myself which I hate doing alone bcasue it takes 10 times longer!) and turn our q2's again.

At this point it is typically around 5-6 a.m. Then I pass out waters, grab any leftover linen bags (especially from the ones we bathed) and trash bags . I then empty all the drains again.

Then it is time to chart all of this information and get organized for report. Then it is reporting off to the day time aides.

It is typically a very busy night. I realized that I wrote an epic novel but that is really what happens on a "typical" night shift at the hospital. It is busy busy busy job but it is INVALUABLE experience for nursing school. The nurses respect me because I work my orifice off - they know it and thank me for it in some way every night that I work. After getting their respect, they let me do a lot of procedures (under their watchful eye, of course) that we learn in school and they go out of their way to show me cool things (ever listened to a bruie or a heart mumor? ever got to put in catheters? ever got to flush IV's? ever got to hang IV's? not at clinical. I have at work!). I work with a great group of people. Of course every group will have it's lazy sectors, but thankfully, I respect about 80% of the people I work with and they mostly have good work ethics.

fuzzywuzzy, CNA · Feb 12, 2013

Nursing home, 7-3. Most days I work on a unit where most people are total care, but we have some hardcore bell-ringers too, just to make things more difficult :)

Usually another CNA and I will follow each other around before breakfast and work together on our residents, for the most part. Most of the rooms have 2 people so we will each take one. I try and get as many people dressed as possible, then around 8 o'clock if I still have a few people left I just change their bed pads then start passing out breakfast and feeding people.

After everyone is fed and trays are picked up, I toilet everyone on my assignment. And I brush their teeth while I'm at it. Sometimes I lay a bunch of people back down for a nap, depending on how pressed for time we are. We are also supposed to pass out snacks that no one wants because they just freakin ate! I wash up whoever I didn't get to before breakfast (on a good day there is no one left), and then I do my showers-- I get 1 or 2 of them a day.

Then we scramble to get everyone in bed up. At 11 o'clock I go to lunch and when I get back I have a half hour to bring people to the dining room. We send about 10 people from each floor there and a few of them are 1-assists so I walk them down there. The more walks I can get out of the way, the less we have to do in the afternoon. But sometimes all the dining room people are already in there because the activities dept brought them so instead I toilet a couple people that eat on the floor. At 12 I go to the dining room and I'm usually in there til 1 o'clock. On days that I don't go to the dining room I feed on the floor and get all the rooms set up for rounds. After that we basically put everyone to bed or toilet them and make sure the rooms are tidy. And we have to walk anyone we didn't get to earlier. Then we pass out more snacks, fill linen carts, and do paperwork. The last 10 minutes of the shift are boring so i usually cut a couple people's fingernails. If I'm on the same floor about 3x a week then everyone's nails stay pretty maintained.

nguyency77, CNA · Feb 16, 2013

fuzzywuzzy: In my state, we are not allowed to cut nails whether we are a CNA or a RN because of the risk to diabetic patients! So my old facility used to have a podiatrist come in but I've never seen him, and people's toenails are always pretty gnarly.