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Discussion

CNA - priorities need checking? Or is it the field?

I am a CNA at my local hospital. I have been just so overwhelmed lately, and I just have to know - am I doing something wrong? Or is this just not for me?

I work on the cardiac/ step down unit, so our patients are usually semi to high acuity, three quarters are alert and oriented, and geriatric. Our patient load is 9-13. I find that I am just run ragged between q4 vitals on everyone, call lights, monitor alarms, and what I do within my scope of practice.

I’m never idle (the amount of time for an automatic bp to finish feels like an hour sometimes), I’m always helping someone. But at the end of the day, I am only one human. And yet I feel like I’m not doing enough. My nurses are busy! They have so much more charting to do than me, administering meds, communicating with doctors, just to name a few. But when I’m helping that confused patient to the bathroom and the call light of the needy person that everyone is tired of, and the nurse is in another room starting an IV - what am I supposed to do? I can’t leave the patient and risk a fall. It's five minutes later, the call light is in overtime, and I go into that room and get yelled at by the patient and family for not being fast enough to help with xyz.

I deal with some variant of this every day, and I’m so sick of it. It makes me feel that I’m not good enough, not fast enough, not something or other enough to be working at a hospital. The nurses are great for the most part, and when I inevitably forget something (like a set of vitals because I’ve gotten too many lights and now it’s two hours overdue and their bp is low, or a call light that I answered once on the phone, said I’d be right there, and had to stop someone falling and now they’ve called again and complained), it makes me feel like I shouldn’t be here if I can’t do everything. What if my failure to do that BP leads to harm?

I understand that people in the hospital are always having a hard time. But when I’m getting talked to because I’ve been overwhelmed and someone is complaining... I hate it. Thinking about going to work gives me anxiety to the point I’ll only have 4-5 hours of sleep before work (on dayshift), and when I’m so overwhelmed that I do not have time to pee or have a drink of water for 9 hours, when I am going so fast that I am panting, when I am almost crying because I can’t do things to satisfaction, while trying to maintain a good face for patients - it makes me want to not even try to start nursing school.

Am I prioritizing things wrong? Like trying to take vitals in between call lights? Is there something else I need to be doing? Am I just not cut out for this? As much as I loathed long term care, I was good at it. Had the routine down and I was the hardest worker on the floor. I’ve only been at the hospital for three months, and working healthcare for two years.

I want to hear from you what you like to see from your CNAs

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    • Experts

    Are you the only CNA on the floor? Too much, of course for one person. Speak to your supervisor, bluntly ask her how she wants you to handle it. When you are following the charge nurses system, your non-changing response to the patients is something like: “I am following the instructions of my immediate supervisor on how to do my job. You can direct your concerns to her, but I still must follow my instructions. Thank you for understanding”.

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    • Author

    I am not the only aide on the unit (There’s three, all with the same amount of patients, but I know we’re all just about in the same boat. I was talking with another aide earlier and she spoke of wanting to quit. I overheard that they’ve recently cut the CNA staffing in the hospital too. We’re not short staffed usually, it’s the demanding patient load that makes it so much. And when you’re not answering call lights because you’re in another room, some of the nurses complain about having no help. They do have help; I just have triple the patients they do.

    I will speak to my charge nurse bluntly. I’ve brought it up a little before and she tells me I’m doing a good job. My DON told me that I was doing good as an aide as well, although this subject isn’t what we were talking about.

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    • Experts

    I found it easier from both the standpoint of the CNA and that of the nurse, to do tasks in a lockstep manner. First this, for everybody. Then that, for everybody. Don’t do task 2 until task 1 is complete for everybody. Take NO interruptions, unless life or death. Three CNA: one CNA answers all call lights while CNA 1 and 2, do their assignments starting at one end of the hall or some other criteria, such as easy first or hard first. CNA 1 and 2 work as a team it goes faster and is more safe. If you start in room x today, tomorrow you start in room y, so each pt has chance to be first or last. Whatever system all of you come up with stick with it long enough to give it a chance to work. Iron this out with your supervisor for her input, decision, and support with implementation. Do this as a group so each CNA is not out there doin’ it alone.

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    3 hours ago, caliotter3 said:

    Don’t do task 2 until task 1 is complete for everybody. Take NO interruptions, unless life or death.

    This sounds great in theory, but is not realistic in the insane hospital setting that the OP describes (btw OP, we may be coworkers). If this works on your floor, I am jealous. But for now I can only speak about floors like the OPs.

    Sick patients and distressed families are anything but lockstep. When they need the restroom that doent wait. When they are climbing out of bed doesnt wait. Priorities are shifting constantly.

    We most often are not the ones setting rigid to do lists. Because our desire to get things done doesnt get to take precedent over helpless people who spend alot of the day suffering. Sometimes we cant always do everything they need. Which means, every single day, at least one person is left to suffer when they shouldn’t.

    When patients cant speak, the moisture they are sitting in welting their skin is still agonizing. They just can say it.

    So this whole no interruptions no questions asked (besides life or death) doesnt seem right to me. Thats why this job is so dang hard.

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    On 3/5/2020 at 6:29 PM, Nightshade202 said:

    I deal with some variant of this every day, and I’m so sick of it. It makes me feel that I’m not good enough, not fast enough, not something or other enough to be working at a hospital.

    Kindly: That is not a logical conclusion. ?

    It just isn't.

    The first thing you need to do is recognize that you cannot and should not take emotional responsibility for others' choices. Staffing has been set at a ratio that meets the goals of others. Why should you take responsibility for this? [Answer: You shouldn't, and in doing so you will destroy yourself.]

    Your job is to treat others with kindness and work hard to render excellent care within your capability.

    Take emotion out of it.

    If you have been attending a patient who needs assistance for toileting procedure and another patient/family member is upset at having had to wait, you simply get to the room as soon as you can, have a smile on your face and say, "How can I help?" If they start complaining say, "I was with another patient whom I couldn't leave, but I'm here now--what can I do for you?" Don't get defensive, just be pleasantly straightforward.

    If they complain, stay pleasant. Don't fall apart about being accused of not being able to be everywhere at once. ?. Whoop-de-doo; no one can. So don't fan the flames.

    Just work quickly and be kind/pleasant. The only real problem arises if your manager/charge/upline takes an accusatory tone with you. If you don't have support then that is a problem and you should look for a different place where management is supportive. I don't know exactly what you mean by "getting talked to," but if your management is indeed bringing every petty complaint to your attention as if you should have been able to prevent it, that is certainly toxic and you will want to find a better place to work.

    On 3/5/2020 at 6:29 PM, Nightshade202 said:

    it makes me want to not even try to start nursing school.

    That does bear some consideration.

    Good luck~

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    • Experts

    You can not leave one person’s care to give more time and effort to another just because they or their family are more vocal. Everybody has the same right to care. As described, care is being fragmented. Fragmenting care means someone is not going to be taken care of. The quiet courteous patient who does not make demands is usually the one who gets the short end of the stick. Ask me how I know. I experienced this as a patient, as well as made these observations both as a CNA on duty or the nurse. It all boils down to not having it both ways. Decide how it is to be done and then stick to that system.

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