CNA/Nursing expectations unrealistic?

[kiku1209]

Currently I work in a LTC facility on day shift as a CNA part time while I am attending nursing school. We have 12-14 patients a piece on a good day and it just seems impossible to get done on time. I've been a CNA for a little over 2 years and never seem to get out on time. Everyone tells me I do stuff the right way and take great care of my patients, while I've seen others just not change their patients at the end of their shift.

I know most employers want you to get done on time, but this just compromises care, and I don't feel that it's right to the residents. I've had a talk with my supervisor and pretty much have just been told that this is the nature of nursing, which isn't right. Due to only working part time I haven't gotten in trouble for punching out late, but was told I potentially could if I were full-time and picking up overtime.

I don't feel that picking up extra time is the issue, it's the quality of care these residents are receiving. I've personally seen people skip providing the level of care patients deserve due to time constraints and it's morally wrong on many levels. A LTC facility are these peoples homes and they don't deserve to be treated the way they do.

The time constraints and issues I've encountered on day shift have made me consider no longer working as a CNA during school, or maybe that nursing isn't even for me. I love what I do, but I don't love having to rush people or get put in a position where the expectations of my job are unrealistic.

Has anyone else had a similar situation while working as a CNA or in the nursing field, I'd love to hear some other stories?

[NurseSpeedy, ADN, LPN, RN]

I started out as a tech while I was finishing LPN school and am now an RN. I tried working LTC as a nurse. I lasted about a year. One of the reasons that I left was due to the crappy level of care that I consistently walked into every day that I worked there. These residents were paying top dollar for the facility that they were in and were not getting the services that they had paid for.

Now, when I worked in the hospital and the staffing was hairy, no one gave me a hard time about needed a little more time at the end of my shift to wrap up the loose ends in my charting after a particularly crazy day. Now, if I had been twiddling my thumbs in the break room or chatting with someone during the shift, well I completely agree that something needs to be done to manage time effectively and get out on time.

When I worked in LTC briefly, my new manager told me 'nursing is 24 hours. your shift is 8. Give report at the end of you shift and the rest can be done later'. While I had a hard time doing that, I could see her point. I would go into OT, she would get chewed out because I went into OT, and the nature of the job (I worked both shifts) after a certain time, things slowed down and there would be the opportunity to take care of the one or two things that I couldn't get to that day for whatever reason. Same thing for the nurse that I followed. She didn't get to one or two things because once again, staffing stunk, I picked up where she left off and the cycle continued.

I do like your attitude though. These people do deserve quality care and thank you for being one of the people that consistently provides this to the residents who can no longer care for themselves. I have had two grandparents who unfortunately had to go into this type of setting after years of being care for at home before it became too much. They remembered the caregivers that treated them well over the years and truly appreciated everything that people like you did for them each and every day. Don't loss that quality. However, don't let it break you. Find a way to balance everything. If it means asking for help or seeing if one change could be done by the next shift, find out from your employer how they would go about handling it. There will probably be a day when you want to work full time and this is something that you could look into now to figure out the answers.

[Livetoride]

OP, I highly empathize with you. I was ready to quit being a CNA and to get away from Nursing after an experience in a poorly managed facility. It took me quitting and going to a different facility that I became happier and renewed my love for the field. I now work noc part-time at a facility that is fully staffed with stable management.

As far as your co-workers go, I don't think it is right that they leave the residents unchanged at the end of the shift. That is not fair to the next shift nor the resident. Leaving a resident wet can get aides in trouble. It sounds like they are cutting corners to me.

LTC is fast paced and you got to get a routine down. That's what I find. I feel like that is not right to the residents sometimes cause it is their home and they can be treated like they are guests on the staff's time.

If I were you, I wouldn't give up yet. Maybe you just need a change.

[Zyprexa_Ho]

I recently quit a LTC CNA gig because of the ratios. I was assigned 13 patients, refused my assignment, and was given the choice to either quit or be fired.

You could always write a letter to the DON or administrator stating that you will accept the assignment, but that you are doing so under duress because you feel that adequate care cannot possibly be given. Make plenty of copies (you'll need them). When you go to submit the letter to management, have two copies (one for you and one for them) and ask them to sign it and keep a copy with their signature stating that they received it. If they refuse to sign it and give you a copy, have a nurse or another person witness that they refused to sign your copy and document that instead.