Clinicals

Hey Michael. We were ALL tense! Going to clinicals with a bunch of 'scared' adults was like re-living childhood school days on opening day, or your first day of high school. NO one felt confortable and prepared for clinicals.

How things are going to work, I don't know in that every instructor is going to handle their class differently. That depends on the instructor and how he/she checks on you. Our instructor basically spent the day first tellling everyone where everything was located (linen, waste, etc.), assigning us a resident, giving a short background on that resident, then turning us loose to get the resident up, groomed, toileted, cleaned, out to breakfast, etc.

In some cases, we worked two-on-one. The instructor was there trying to observe everyone in class actually performing a range of skills. In many cases, you were called from your resident to perform a skill on another resident. I had a resident that was bed-ridden. So, I needed to do an occupied bed right away. But, no transfers. I was called to assist someone else in a transfer.

Also, the residents at LTC were asked to volunteer. So, many of them would be transferred, multiple times, from a chair to a wheelchair, for example, as a 'guinea pig' (they were the ones having fun --- we weren't, too nervous). We also did BP's on volunteers. The instructor would purposely get someone who had really low BP to make it more difficult to find and hear. Also, some times a number of us were brought into a room and shown a skill on someone. So, it was a whole range of activities to observe and do the skills.

Anyway, everyone was drained after that first day. As I recall, after a couple days of clinical, students started to relax a bit more. You went into the facility knowing the basics of what you needed to do, and where items were, and could concentrate more on the resident. Some residents were, of course, simpler to work on than others. We traded off (well, the instructor traded off). So, one day you worked with a rather ambulatory person. The next, someone who was bed-ridden and incoherent.

Get a good nights sleep --- you'll need it!

Experiences are going to vary greatly depending on where you're taking your class and what facilities you go to for your clinicals. I took mine at the Red Cross and we had two days at one LTC facility, two days at another, and one day at a hospital. In the LTC facilities, we were split up with one or two of us with a CNA. In one facility, we mostly just stood there, honestly. It was obvious that the CNAs there did not want students following them and slowing them down, so they would quickly explain what they were doing and that would be it. I think the most I did there was make a couple of beds and give a shower. All of our CNAs took advantage of the fact that they basically had helpers, so they would take breaks while we worked with the assisted feeders at lunch time.

The second LTC facility was about the same, except we were able to assist with the sit to stand lifts, and we took vitals using a Rosie. Again, lots of assisting feeders and making beds.

The hospital was a breath of fresh air. I was on the oncology floor, and the CNAs there really took a lot of time to explain things to us and allowed for us to ask all the questions we wanted. There wasn't as much "dirty work" to witness. Instead, this is where we got to really practice our vital signs. We had to do the morning vitals with Rosie, but many of the patients agreed to letting us students take manual vitals later in the day. We made beds when the patients took their showers, and I assisted with one bed bath.

During all of this, our instructor was walking around to supervise what was going on. We were told that if we just couldn't get along with our assigned CNAs or if we got overwhelmed to find her.

We had to take a list of skills with us to the facilities and have the CNAs mark off what all we'd done. I don't think anyone in my class was able to do every skill. I managed to get more than some because as we were nearing the end of the week, I went to my instructor and asked if she could help me find people who needed certain things done so I could make sure I knew how to do it. It surprised me how difficult it was to find a CNA who was about to empty a catheter bag, but I wanted to get it marked off.

Many of the CNAs I met at our second facility were relatively new themselves, having been working for two years of less. They remember what clinicals are like, and nearly all of them will understand what you're going through. A couple people in my class were asked to do things (like empty a colostomy bag) that they weren't comfortable with, and the CNAs would just show them how to do it.

My class spent five days in clinicals at a nursing home. We were given a partner and assigned two residents each. However, many of our assigned residents were fairly active and didn't need assistance. I don't think I did anything at all with one of my residents, as she was up and out of bed all day every day. So for the most part we just went around offering help to any resident whenever they needed it.

The way my days went... I arrived at 7:30, helped distribute breakfast trays in the dining room, and then I'd follow the cart back to the rooms and would assist with feeding whomever needed to be fed (not necessarily my assigned resident). After breakfast, I'd get together with my partner and we had to give one complete bed bath to a very heavy-set bed-ridden woman with dementia who would go back and forth between saying "I love you" and slapping/hitting us... lol. After getting her dressed, we used a mechanical lift to get her out of bed and into the living area.

Our next resident was independent enough to give herself a bed bath, but one of us had to stay in the room with her to make sure she didn't have an accident. She had a catheter which we had to clean and empty, and record I&O. We also had another resident which we had to get her out of bed and dressed, and wheel her into the living area. And obviously we had to make their beds once they were up and about.

We had to do all of this by lunch time, which doesn't sound difficult to do but every day it seemed like we struggled to get everything done on time. The experienced CNA's working there seemed to spend 5 minutes doing things that took us half an hour... lol. There were times I felt quite incompetent, although I'm sure everyone goes through that stage in the beginning.

After lunch, we weren't so rushed, and spent the afternoons answering call lights, helping with transfers/going to the bathroom, taking BP and TPR, and simply hanging out and chatting with the residents.

I definitely enjoyed the experience and felt like I learned A LOT, moreso than could ever be taught in a classroom. My only complaint, however, is that many of the nurses and CNAs who worked there were slightly rude, and seemed to treat us more like a burden than anything else, even though we were doing most of their work, thus allowing them to sit on their butts the whole time we were there. I also was not fond of the charge nurse, who was harsh and abrasive and complained about my partner & I behind our backs (smiling to our face, of course).

I am an acute care CNA, so my clinicals were at a hospital...the oncology/surg/bariatrics floor to be exact (the floor I chose). Two to four of us were assigned to a floor at the hospital. Each of us were paired up with a CNA and shadowed her/him for the entire time. If our CNA worked the same shifts we had clinicals, then we stayed with them. If not, then we were paired with someone else. I was paired with a male CNA (he was terrific...been a CNA for 20 years) the first day. The second day I was paired with a wonderful woman CNA, about my age, for the remainder. My CNA's had me do a lot of things, but they stayed with me the entire time. We really became a great team!

My experience was different than a nursing home, so I can't help you on that. I did some intense stuff...it was great! I assisted in unpacking an open, hip-to-hip incision on a bariatric patient and then showered the patient. I did a bladder scan, emptied cath bags, JP drains, colostomy & urostomy bags...by the end of clinicals my CNA was letting me do vitals and care of incoming surg patients just out of post-op. I also did the typical things that CNA's do everywhere...vitals, bathing, peri-care, feeding, transfers, ambulating, occupied bed changes, etc.

Have fun with clinicals!!!! It's really a terrific learning experience!!!!