CNA termination

[Mcpheeh]

Hi everyone so I need tons of advice because I just had the worst day of my life.

I'm a brand new CNA with little to no experience and just started working at a new facility. A lot of the other aides as well as nurses are rude and incompetent. I watch them break rules everyday, and violate many foundations pertaining to residents rights. I've been trying so hard for about 2 weeks now, but I'm still learning and need much more paractice. They decided this week to put me on the floor by myself so I have been behind on all my work and unable to take care of some residents because none of the CNA's would spot me while using a hoyer. Today, the LPN was very rude and condescending to me; and unfortunately I retaliated with a slick comment back. Although the nurse was wrong and shouldn't have spoken to me the way she did, I understand that I shouldn't have reacted either. I was terminated for insubordination and wasn't even given a chance to tell my side of the story. They had no cares in the world about the fact that they have employees mistreating and exploitating residents; but walked me out of the building as if I was some kind of animal. I wasn't loud, nor rude. I just said to the nurse in a calm tone that she was incompetent. O guess my question is, will this affect my license? I feel like such a failure for trying and still not getting it right. All I wanted was help, instead of attitudes for always asking for help. Will I be able to even get a job after this?

[Mcpheeh]

I reference school so much because they taught us that if we didn't go by the books and credentials we were taught, that it's easy to lose your license. I guess I'm just hesitant and worried that if I do anything different from what I was taught that I could get reprimanded or even potentially lose my license.

[mtmkjr, BSN]

I don't have any reason to believe that what you learned in school is incorrect, but now is the time to become familiar with the facility policies and procedures...

It's one thing to say, "that's not how I learned it in school" (might irritate coworkers) it's another thing to expect that policy and procedures are followed.

[Aunt Slappy]

Accidental duplicate post

[Aunt Slappy]

I reference school so much because they taught us that if we didn't go by the books and credentials we were taught, that it's easy to lose your license. I guess I'm just hesitant and worried that if I do anything different from what I was taught that I could get reprimanded or even potentially lose my license.

Once I was out of CNA school I did almost nothing the way it was taught in school. I learned from experienced CNAs and nurses how to be efficient, caring, and effective within real world time constraints. If you do a bed bath as demonstrated in school, it will take you an hour and use approximately half of your facility's washcloths.

Let the experienced staff around you teach you. Your moral compass runs deeper than your CNA textbook, or it should. Just because something is different doesn't mean it's wrong. You should be able to discern actual right and wrong on a deeper level than, "That's not what I learned in school."

[Mcpheeh]

How long did it take you until you felt fully comfortable in what you were doing? Sometimes it feels like I won't ever get it right. I get so scared I'll hurt someone or I'm doing something wrong so I give up quickly. I dealt with a patient imparticularly that had a severe hip fracture. When I was changing his brief I didn't want to roll him on the injured side so it made the process difficult. But when I watched other CNA's do it, they came in and rolled him on his side easily although he was screaming at the top of his lungs.

[FolksBtrippin, BSN, RN]

How long did it take you until you felt fully comfortable in what you were doing? Sometimes it feels like I won't ever get it right. I get so scared I'll hurt someone or I'm doing something wrong so I give up quickly. I dealt with a patient imparticularly that had a severe hip fracture. When I was changing his brief I didn't want to roll him on the injured side so it made the process difficult. But when I watched other CNA's do it, they came in and rolled him on his side easily although he was screaming at the top of his lungs.

It sounds like there was a lot of stuff amiss, and you are trying to process what was morally wrong, what was unsafe, what was rude or unprofessional, what was just not the way you learned it in school and how to resolve what you learn in school with company policy.

You were right not to roll the patient to the side with the hip fracture.

Does your certification allow you to do home health? You might like that better for your next job. It will allow you to focus on giving excellent care to one patient at a time.

[Missingyou, CNA]

When I orientate a new CNA, I always tell them there is the way you learned in class & then there is the real world. There are short cuts you MUST take in order to get decent care done for all your residents. That doesn't mean you risk safety or infection control.

Learning these ways comes with time & watching other aides. It's also something that you probably won't hear us talking about....you just do it out of necessity.

When I first started, I wanted to be all the things we were taught in class. ...you just can't though. Kind of like having to pick & choose you battles. You have to prioritize each need. Sometimes it's a very hard choice to make.

There are good aides & nurses and not so good ones. Don't worry about what they are doing. Just do your job the best you can. By all means, report any abuse or neglect but do it through the proper method. If you feel everyone is doing it wrong, being lazy or rude or whatever. Be different. Be the example. Be there for the residents, not the other employees.

I think it will take you a good month to get settled in a comfortable rhythm.

I don't think you being fired for this last incident will make it hard to find another job but, be prepared to answer the question as to why you left your last position. Include in your answer what you learned and how you will make sure it never happens again.

[Possum_RN]

I'm sorry that you had this experience, I know it's frustrating. While I agree with other commenters that, as a 'fresh' CNA, it was probably not advisable to comment on the quality of experienced staff's work... I've seen bad facilities too (as a CNA). I know it's really distressing. It's great to be a patient advocate, but reacting in anger and being confrontational rarely changes another's behavior.

On one hand, the last time I performed, say, a bed-to-chair one-person assist CNA-school-correct, was probably about one week after I got my first job. On the other hand, I insisted on doing Hoyer lifts with a spotter, pretty much verbatim like school taught me. The LTC facility I worked at had the staffing ratio to allow me this, although I gained a reputation as a "slow" worker. As a nurse, there are short-cuts I do as well, but for instance, I WILL NOT draw up two different patient's meds at the same time - a common short-cut you will see some nurses doing. The fact is that some short-cuts are necessary, but you HAVE to use critical reasoning skills to assess the risks.

Have you considered going into hospice? I now work on an in-patient hospice unit. Usually it's one nurse and one CNA per 5 residents. This week, we had 4 patients in the facility. Because of the acuity of the patients, we had a nurse and a CNA per two patient's - technically, they could have sent one CNA and one nurse home, but they really do their best to allow you to focus on compassionate care for each patient you will be assigned.

In your example of the patient who was roughly turned with a hip fracture....that breaks my heart. If it were my patient, I'd have directed the CNA's to wait to change them until I had given them their pain meds (I have the full blessing to call the Hospice Physician if I need to order a one-time dose of pain meds if they have nothing available). Then I probably would have had the time to go in with them, and help them stabilize the fractured extremity while we turned them (never completely to that side). I'm not saying it still would not have hurt, but we support one another and the patient!

Different fields of nursing and even different facilities within the same field have different cultures of care. I hope this frustrating experience has at least been one you can learn from. Home care, Hospice, and private LTC's tend to have more focus on the patient as an individual, if that's what you're looking for. I'm sure there are other opportunities as well. Best of luck!

[Missingyou, CNA]

In a situation like a hip fracture I try to plan brief changes around Times when pain meds are well in their system rather than when they are almost due for them.

Get good at tucking the brief under the person. If you tuck well enough you won't have to roll them, or will only have to roll once to clean.

Unfortunately, there are times when there is no way to avoid some amount of pain. You just have to plan to minimize it.