Clinicals - Is this normal?

[Tallync]

So I just finished my CNA class this weekend and I am horrified at what I saw/heard during clinical.

When I went into a residents room with the CNA on staff, the CNA was pleasant, but she talked down to the resident and complained about the resident's room being cluttered. Even a child could figure out that it was not appropriate nor nice. Afterwards she complained that said resident was "mean and angry all the time". Well, duh. Treat her like she is and she will be!

When we were instructed by our teacher to do hand/foot care, the LTC facility supplied our wash basins and supplies. There wasn't even enough basins (in the whole facility) for the few of us there were, let alone one for each patient. And the nail files they gave us were used! I almost downright refused as this seemed like abuse on the patients to me.

So many of my fellow students saw things that were way worse, like the CNA leaving them alone to do a full body bath (for the first time). Many of them stated that they would never work in a LTC facility after being there. It makes me sad to hear that. Those residents NEED good CNA's. THAT made me want to be there, to do the right thing, even if it was going to be hard or go "against the grain".

Are all LTC facilities like this? Just cut corners, cut costs, no matter who it hurts? It drove me crazy!

[CoffeemateCNA]

In a nutshell, yes.

All of us that work in LTC get to deal with this trash on a daily basis. Not enough staff, no supplies, rude coworkers. We make do with what we have.

The majority of CNAs do talk down to residents.

Not surprised there weren't enough bath basins. We don't even have any in the supply room. If the residents don't already have one in their room, they probably won't get one. And it is somewhat common to have community hairbrushes, deodorant spray cans, nail files, etc. (which I hate hate HATE).

Most CNAs are too busy to supervise students through a long and drawn out procedure such as a full bed bath. When students get sent to LTC for clinicals, they more often than not get treated as an extra CNA.

[KimberlyRN89, BSN, RN]

I didn't go to a facility like that when I had clinicals. In fact the facility I went to was quite nice, & its rate 5 stars(out of 5) on medicare.gov. One of my friends @ work had an experience like the one you're experiencing now. Some facilities are really nice, but sadly some facilities are disgusting, understaffed and always low on supplies. My advice is to you that you do your research on a facility before you apply there. Good luck :)

[yousoldtheworld]

The lack of supplies thing is DEFINITELY common. Sometimes at my facility, you have to run into 4 or 5 rooms before you can find a box of gloves, we regularly have to hunt down wipes, shampoos, soaps, and we have one amazing laundry lady, but the others are TERRIBLE.

As for talking down to the residents, depending on what exactly you're talking about, I do think it happens a lot, but I think most who do it don't have bad intentions, they just don't think about it. It's really easy once you get to know your residents to get really informal with them and talk to them just as you would anyone else. I think this is a good thing as long as you aren't RUDE to them.

I always hated when I worked in geriatrics and people would babytalk the residents (except in cases like dementia where the resident is mentally regressing in age, then it's a little different, you kind of have to go with the flow).

When I worked in geriatrics, I tried to talk to the residents as I would my own grandparents. Now that I work in a pediatric facility, I talk to the residents as I would my own kids (and yes, that might include a little babytalk with the little ones. Can't help it!)

So yeah, the problems are pretty widespread, but don't let that deter you. You find ways to work around the obstacles and get through the day, and the residents are better off for you being there.

[fuzzywuzzy, CNA]

Here we go again... every couple of days we have a thread from some self-righteous student complaining because the CNAs at their clinical place didn't greet them at the door with a hot cup of tea and a free ipod... or the CNAs at their clinical place had the nerve to manage a huge workload the best way they can... or the CNAs at their clinical place didn't break into a musical number about how each and every one of the residents is a special shining star. I don't think it's "horrifying" that the CNAs left students to give a bed bath. Isn't that the point of clinical- to practice your skills on real people? Those CNAs didn't ask to have you there and they are not getting paid any extra to deal with you.... if you need your hand held, that's what your instructor was hired for. When you get a job at an LTC because no hospital or home health agency would hire you without experience, you will have to give a bed bath *by yourself.*

[CoffeemateCNA]

Here we go again... every couple of days we have a thread from some self-righteous student complaining because the CNAs at their clinical place didn't greet them at the door with a hot cup of tea and a free ipod... or the CNAs at their clinical place had the nerve to manage a huge workload the best way they can... or the CNAs at their clinical place didn't break into a musical number about how each and every one of the residents is a special shining star. I don't think it's "horrifying" that the CNAs left students to give a bed bath. Isn't that the point of clinical- to practice your skills on real people? Those CNAs didn't ask to have you there and they are not getting paid any extra to deal with you.... if you need your hand held, that's what your instructor was hired for. When you get a job at an LTC because no hospital or home health agency would hire you without experience, you will have to give a bed bath *by yourself.*

*standing ovation*

[ctmed]

Yep...

But, you can bet your scrubs you will get yelled at or fired if any family member complains if you actually work there.

Fortunately, not all LTCs are brown filled cesspools of incompetence and out of control egos... but many are.

I did not like the place I interned at, either.

It would be nice if all the elderly had their own personal CNA... but in reality.. you must do what must be done.

EDIT: and like above posters implied: suck it up!

[Sally Lou]

Very normal.

When i did mine the CNA's left us completely alone. We dealt with the patient and our instructor (who was pretty much just there watching us do transfers when needed). We did all patient care and paperwork ourselves.

[2ndyearstudent, CNA]

You are correct about the OP whining about the CNA leaving the student alone to do a bed bath. If the student felt uncomfortable, he or she can grab the instructor. Besides, you should be able to lurch your way through a bed bath if you have a CNA cert.

As for the other stuff, I agree with the OP. I worked in a horrid facility where CNAs were disrespectful to the residents and there was rarely needed equipment around. The other CNAs would hide or throw away wash basins because they didn't want to use them.

I was lucky during my first clinicals at a nursing home because I was at a very expensive one. Most of the residents were extremely wealthy. It had reasonable staffing ratios, although everyone still worked hard, and aides were expected to act appropriately.

[camiwannabeRN]

Here we go again... every couple of days we have a thread from some self-righteous student complaining because the CNAs at their clinical place didn't greet them at the door with a hot cup of tea and a free ipod... or the CNAs at their clinical place had the nerve to manage a huge workload the best way they can... or the CNAs at their clinical place didn't break into a musical number about how each and every one of the residents is a special shining star. I don't think it's "horrifying" that the CNAs left students to give a bed bath. Isn't that the point of clinical- to practice your skills on real people? Those CNAs didn't ask to have you there and they are not getting paid any extra to deal with you.... if you need your hand held, that's what your instructor was hired for. When you get a job at an LTC because no hospital or home health agency would hire you without experience, you will have to give a bed bath *by yourself.*

Wow when did it become practice to be agressively mean to students? You may not be getting paid for it but hell why not spend a couple extra seconds to help answer a few questions and be a mentor to a student. My god when I was at clinicals we had the instructor and the CNA's around the place helping us. Anything we needed, questions, reassurance, or just a quick chat. By the end I felt good about it, the first day I felt like crap. My resident didn't like me, was in the beginning stages of dementia, kept slapping at me and crying, and my partner kept running off. You know it wouldn't kill you to give a few minutes of your time to someone. I don't know that I would have survived my clinicals without it, and after all isn't it part of your job to be an advocate. Well then advocate helping to make good CNA's. So, then maybe you won't see so many of them in the news because they did something wrong and accidentally hurt or god for bid killed someone. I help new students now when they come out for the first time, and it may not be in my "job description" but I'm happy to do it. Seriously, have some compassion you were a student once too. Try and remember how you felt on your first day.

[fuzzywuzzy, CNA]

I do remember how it felt, and I'm never mean to new CNAs in person. I bend over backwards trying to help them get used to the routine where I work- but then again, no new CNA where I work has ever had the ovaries to call me a bad CNA! I remember being put off during my clinicals as well because the CNAs were busy or crabby. When I started "walking the walk," so to speak, I had a huge wake up call. If a student is going to come on here talking a bunch of crap about something they know nothing about then yeah, I'm going to set them straight. Especially after hearing the same story a bazillion times. Time and again students come on here and insult experienced CNAs up and down when all they were doing were their jobs. What these snobby students (who are always convinced that THEY'LL never be like that) don't realize is that once clinicals are over they're going to be the same way and it won't be their fault either. Then we'll see if they appreciate being called bad. I don't know if you've worked as a CNA or not, so here's the thing: sometimes we don't *have* those few seconds to be a mentor. I post on here enough to make it clear that I like to talk about my job, and if I had a bunch of free time to talk to students I would love that. But we have way too many residents apiece and not enough hours in the day, and my first priority is always going to be the residents, not the student. Again, that's why the instructor is there.

[CoffeemateCNA]

It may sound sentimental to say that CNAs are advocates for students, but they're not. CNAs are advocates for their residents or patients. And most of the sob CNA stories in the news are due to CNAs being lazy and completely careless. CNAs that use Hoyers by themselves or take inappropriate pictures of their residents (both in the news this year) will not have their problems solved by getting a gold sticker, trophy, and an "Atta boy/girl" from their preceptor. Those problems run much deeper than that. We would all love to take all the time in the world with students and help them to get perfectly comfortable with skills, but not doing so doesn't make us bad CNAs. It makes us CNAs working in a bad system.