CNA to patient ratio

Nursing Students CNA/MA

Published

Hi everyone! This is my first post, so please forgive me if I put it in the wrong place!

I'm currently in nursing school, and I work as a CNA now, as well. My first job started in May, and I've loved it. I get so much experience, especially because I work in resource and am able to go to all kinds of floors. This first job was located in my home town, but I still work there over my breaks.

I've started working at a new hospital during the school year in the city that my college is located. It has a reputation for a great burn ICU and a great psych program, so I was excited to get experience in these areas (I work resource here, as well). Now that I'm off orientation, I'm feeling frustrated.

At my first job, the ratio is 1:7 or 1:8 on a very busy day when someone called out or is pulled to be a sitter. I was able to manage my time to do vitals, catheter care, feeding, blood sugars, collecting garbage/linens and taking them all out, rounding on every patient every hour (we're supposed to switch off with the nurses for hourly rounding, but I know sometimes it gets crazy, so I do every hour to be safe). I feel I'm able to provide great care there, and it's been reflected by patients nominating me for care awards (at my facility, every patient is encouraged to recommend someone upon d/c). I love being able to sit with a patient or family for a few minutes and provide emotional support or education that's appropriate for me to provide (for example, why the bed keeps inflating and deflating--to prevent bed sores, why this crazy loud alarm goes off when they get out of bed alone, etc). The nurses can be so busy, and sometimes patients just need someone to sit and give them a little more control over the little things while they're in the hospital.

However, at my new job, the CNA to patient ratio is 1:10 on a very very VERY good day, and it's not unusual to have 1:20. The population here has many more drug/alcohol withdrawal patients that hallucinate/wander/are incontinent/generally need more time. Plus, it's an acute care area, so most people need a high level of assistance anyways.

To make it harder, at this job, CNAs don't give report to each other and the nurses rarely accommodate my request for a quick one. In fact, when I show up, I typically get a "hi" from the CNA on shift before me, and then they leave without another word. We have a "report sheet" that's supposed to be updated at the end of every shift, but many times it isn't updated with even the new patient's name, let alone whether they have chest tubes, are a feeder, blood sugars, etc.

There are some shifts, that I walk into a room to answer a call light and I honestly don't even recognize somebody as a patient I took vitals on a few hours ago, when I KNOW I did, because I chart in the room to ensure I keep track of it all. We have sign-in/out sheets on each patient door for staff to sign for rounding, but they don't mean a thing, since typically nurses sign all the way down for their shift before the first hour is even over. With 10 patients, I can usually accomplish all of my rounding, but when it's 20, I can barely get vitals, blood sugars, and meals done. I feel I'm not giving great care anymore and I'm starting to feel burned out.

I know I'm not the only CNA that feels this way about this hospital because I have a friend in nursing school who works here as well, and she's told me similar things without me even asking about it. I want to love this job so badly, but I'm not sure how to make it easier for myself. I'm usually great with time management, and with bringing everything I could possibly need into the room so I'm not running in and out. We even use Vocera so I don't even spend time searching for nurses to give results to. I DO however, spend a LOT of time searching for/having to take necessary supplies from other units, which is a whole other problem in itself....

Does anybody have advice? Have I just been absolutely spoiled with a great employer as my first CNA job? Is all of this normal at other hospitals? Am I just being a complainer?!

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