CNA Troubles

[kidinabstract]

Hi, all. I haven't used this platform much but I really need some career advice from a CNA perspective. I know a lot of you nurses have been a CNA or at least know what we go through and I'm hoping for a fresh set of unbiased eyes on my situation.

This is my second night at a new job. It's an LTACH, which I've never worked at one before, so the work is fast-paced and constant. No problem. I worked in a big hospital for two years before this and pulled shifts in every unit there (I needed full-time, I was PRN there, not important right now).

My problem is I've never been more unhappy at a job so quickly before. I've already had a total meltdown and, after this second shift, I'm beginning too see why. Coming from the hospital I worked at I was allowed a certain amount of freedom and was allowed to advocate for patients when needed (of course after going tough proper channels. I never did anything beyond my scope of practice but if my NPO DNR patient desperately wanted ice chips I'd ask the nurse and charge nurse and they'd usually run it by the doctor to make sure it was all good). It's been made very clear I'm not allowed any of that freedom here. I cannot advocate for patients to the nurses because I'm a "CNA." There's no way I could possibly know or recognize anything that's going on with these people. I can almost understand that, being so new, but my main issue is that not a single nurse advocates or even seems to care for their patients. They complain about their patients a lot (I'd rarely seen that in the hospital). They don't entertain the idea of trying something new (keeping pillows off sacral regions was huge in the hospital but here they want that sacral region under pressure constantly, no excuse, I'm just a CNA they're the nurse they know better). They don't clean equipment between patients (I'm aggravatingly obnoxious about cleanliness and infection prevention and this makes me sick but, again, I'm just a CNA, I don't know better; and that finger they used to check the SpO2 might've been up that patient's butt a second ago but they'll be damned before they clean it between patients with an alcohol swab because that's wasteful of resources and time).

TL;DR: it's been two shifts (one and a half, really, because they sent me home early the first since I was the ONLY CNA in the ENTIRE HOSPITAL and had no one to orient me to their ways) and I feel like a worker ant with no voice or input in my new job.

My question is: how long should I stick it out before deciding if this place really sucks or if I'm too much of a stickler for rules and regulations and advocacy? Should I pick myself up and leave before they ruin me? Or should I keep at it a while and see if maybe their approach is better? I'm grinding my teeth writing this and I'm sick too my stomach with anxiety and the fear of coming back for a third shift (I will because I told them I'd work).

I need some honest feedback on this. I'm sorry it's so long and ranty. I'm just honestly floored by the obvious lack of caring these nurses exhibit.

[kidinabstract]

A little more to this: the lack of caring is actually visible on the patients and in their rooms. There is garbage on the floors and needle caps, used alcohol wipes, blood stains, and all kinds of other things in the beds. If the nurse sees a stain on the sheet, the sheet is not changed, it's simply folded over and ignored. The rooms reek of BO and I've been trying to clean faces of patients who require total care and change the linens while doing my other regular CNA duties. This was never a problem at the hospital or any of the places I did clinicals at during my stint in nursing school, so cleaning faces was quick and easy. I spent ten minutes this morning cleaning chunks of eye boogers away from a patient's skin. I'll be visiting another patient later to clean the blood off her chin that's been there since Monday at least. I don't want to leave all these people in this condition, but at the same time I know I'll be killing myself and my passion for becoming an RN if i stay. I don't know what i should be doing anymore.

[JKL33]

I can't give one cohesive opinion, but here are some principles and ideas that you may be able to apply to your situation:

- There is no point in destroying your soul with problems for which other people are responsible

- A heavy personal burden for situations where really wrong things are going on but you don't have the power to stop them is a source of significant moral distress, which has links to burnout and can even involve PTSD symptoms. You are not obligated to subject yourself to that based on having walked into such as situation.

- You may be able to make a difference in lives of the residents and possible even be a force that eventually improves the culture of caring, but (in my humble opinion) you do not have an individual moral obligation to do so. It is a choice that only you can make a decision about, or if you want to look at it this way - a risk that only you can decide to take, and others cannot tell you that you have to take it.

- I say "risk" because in situations that are troublesome like this, you may be subject to others' jealousy or dislike of your actions/caring. If your intolerance of the situation poses any risk to higher-ups and their sense of security, you cannot control the ways in which they may try to rid themselves of the threat you pose. Examples: Tarnishing your employment record through inappropriate disciplinary actions or unjust termination, making accusations that have legal implications, etc., etc.

- If you are surrounded by people who will generally seek to malign you (tell lies about your work, your actions, your interactions with residents), you have no moral obligation to remain in that situation

- OTOH, occasionally people sooo don't care, that they are willing to 'live and let live' - in other words you may be able to do the work in ways that meet your own standards for personal satisfaction without too much trouble from others. But this seems kind of unlikely because, if nothing else, your own internal compass might not let you feel satisfied with "only" doing your part. Don't you think it will very quickly become intolerable if no one has done x, y, z, [like washed Alice's face or changed Joe's soiled sheets] since the last time you worked?

- You already know their approach is not better

- If you are expected to compromise the care of residents or in any way treat them in an unethical manner in order to (appear to) get the work done, that is not acceptable.

- If you are expected to defraud anyone in any way, falsify anything, etc., that is also never acceptable.

[kidinabstract]

6 hours ago, JKL33 said:

I can't give one cohesive opinion, but here are some principles and ideas that you may be able to apply to your situation:

- There is no point in destroying your soul with problems for which other people are responsible

- A heavy personal burden for situations where really wrong things are going on but you don't have the power to stop them is a source of significant moral distress, which has links to burnout and can even involve PTSD symptoms. You are not obligated to subject yourself to that based on having walked into such as situation.

- You may be able to make a difference in lives of the residents and possible even be a force that eventually improves the culture of caring, but (in my humble opinion) you do not have an individual moral obligation to do so. It is a choice that only you can make a decision about, or if you want to look at it this way - a risk that only you can decide to take, and others cannot tell you that you have to take it.

- I say "risk" because in situations that are troublesome like this, you may be subject to others' jealousy or dislike of your actions/caring. If your intolerance of the situation poses any risk to higher-ups and their sense of security, you cannot control the ways in which they may try to rid themselves of the threat you pose. Examples: Tarnishing your employment record through inappropriate disciplinary actions or unjust termination, making accusations that have legal implications, etc., etc.

- If you are surrounded by people who will generally seek to malign you (tell lies about your work, your actions, your interactions with residents), you have no moral obligation to remain in that situation

- OTOH, occasionally people sooo don't care, that they are willing to 'live and let live' - in other words you may be able to do the work in ways that meet your own standards for personal satisfaction without too much trouble from others. But this seems kind of unlikely because, if nothing else, your own internal compass might not let you feel satisfied with "only" doing your part. Don't you think it will very quickly become intolerable if no one has done x, y, z, [like washed Alice's face or changed Joe's soiled sheets] since the last time you worked?

- You already know their approach is not better

- If you are expected to compromise the care of residents or in any way treat them in an unethical manner in order to (appear to) get the work done, that is not acceptable.

- If you are expected to defraud anyone in any way, falsify anything, etc., that is also never acceptable.

Thank you for replying. I figured I wouldn't get much advice but your take in the whole thing is very eye-opening.

You're exactly right when you say that some people will feel threatened. I wound up getting an awful lot of dirty looks from nurses just for walking into rooms to lay eyes on a patient whose ECG alarm was going off. They are content to watch the monitors from their seats and wait for the alarms to stop. I can already tell that if I work to my own standards I will not be welcome in this place. It's really unfortunate because I feel like I'm abandoning these patients to a fate entirely out of their control. It makes my chest tight to think this way, but in the end I feel as though the place is a lost cause and, until someone higher up steps in to get a better team on board, nothing will change. I don't want to leave because of my desire to help these patients, but in the end I know that I'll lose sight of myself and my goals if I stay. I WANT to be a nurse, and I don't want that dream tainted by working a year or two at this place that just doesn't care. I have to do what's right for me in this situation, even if it hurts.

On the plus side I'm good friends with the DON and the HR supervisor so I will be bringing these things to their attention upon leaving in the hopes that they'll be able to do something to better the place. I'm not disillusioned into believing that if I speak up things will quickly become hunky-dory, hence why I'll wait until I've found another job before speaking up.

In the meantime I'll do my best to make these patients happy and decent (of all things). My work from here-on-out is going solely to the comfort of these patients and if the nurses or other CNAs have a problem with it then so-be-it.

Honestly, I'm not trying to become a nurse to ease everyone else's workload and to make the staff happy. I'm becoming a nurse to take care of people who can't take care of themselves. If advocating means I'll step on a few toes in my time at this place, that's fine. I don't mind breaking a few at this point.