CNA working night shift on a Med/Surg Floor

FutureC.N.A · Sep 20, 2012

Also, what's the patient to CNA ratio at the hospital you work? She told me outright during the interview that this hospital is understaffed at the moment and that the patient to cna ratio is usually 18 patients to 1 CNA and that during night shift there are usually only 2 CNAs working. She also said she wants to cross train me to be a Unit Secretary. Do any of you guys have experience working as a Unit Secretary as well?

funtimes · Sep 22, 2012

I work nights on Med/surg. My guess is your instructor was right and they wont hire a brand new aide, but its always possible.

Med/surg is just that, medical patients and surgical patients. Youll be doing pretty much the same thing youd be doing in a nursing home on night shift, except youll be checking vitals constantly and most of the patients will have IVs running and some will have tubes and drains attached you dont normally see in LTC. Like LTC you'll still be toileting people, recording I/O, repositioning people and cleaning them up when they are incontinent.

A lot of the medical patients come from nursing homes and taking care of them wont be much different, only theyll be weaker and more confused in most cases, and will often try to yank IVs and NG tubes and even foleys out or try to get out of bed, dragging everything attached with them. Occasionally theyll be in restraints, especially if they have an NG tube, but thats rare. usually you just have to keep an eye on them constantly.

Ambulating and repositioning orthopedic surgical patients can be a little different than other people, since there are things to keep in mind depending on if they have say hip surgery or knee surgery. Knee patients might have a CPM device hooked up at night that goes through range of motion.

The biggest difference between med/surg and long term care is the variety. LTC is the same grind shift in and shift out. Med/surg varies greatly and you will constantly have new patients.

How sick your patients are might depend on how big the hospital is. If its a smaller hospital you will probably have sicker and less stable patients much of the time, since the next step up is the ICU and patients might not qualify for that. Big hospitals have units that are more acute than med/surg and less acute than ICU, so med/surg patients are probably easier generally. Ive only worked in a small hospital so thats just a guess on my part based on patient transfers Ive done as an EMT to bigger hospitals.

Edit*

One more thing. In a hospital you will probably have to be BLS certified and respond to any code blue/cardiac arrest on your floor. If you have more than one CNA or PCT they may just designate one to be the responder while the other one/s take care of patients. The nursing home we worked at CNAs did the same thing, only there almost everyone was a no code so it was almost a formality. Not that cardiac arrests on med/surg are common either, but they are a little bigger consideration than LTC.

Patient ratio varies where I work. You might have 8 patients or 18 depending on admissions and discharges.

FutureC.N.A · Sep 24, 2012

Thank you so much for the reply! She also told me that I will be doing blood sugar tests and I was worried about that because we weren't taught that in school so I was wondering if that was in a CNAs scope of practice? Also, I know this is a stupid question and I probably already know the answer but I just wanted to be sure- I know she said that they do vitals and repositioning throughout the night- so you go into their room and wake them up for that every time. What if they are really cranky and refuse? It is a smaller, county hospital and I live in a pretty small county in Georgia. I am BLS certified but I don't know any of the hospital codes and I've never done CPR on anyone, so I'm a little nervous about that.

funtimes · Sep 25, 2012

Blood glucose checks are really simple, no big deal at all.

Yes if someone is q 2 turns, that means you turn them throughout the night. It makes it tough for them to sleep, but if the alternative is they have a decub develope, then what else can you do? If they refuse then you notify the nurse and chart the refusal. Yes you will have cranky, rude, even combative patients who dont like being woken up or disturbed at night, but its a hospital, not the holiday inn. If you just left them alone in their room all night and their temp spikes up to 105, or their o2 sat or BP drops or they have skin breakdown, guess whos responsible?

As for responding to a code, as a CNA your responsibilities will be really limited, so theres nothing to be stressed about. Fetch the crash cart, do compressions, and maybe act as a runner is about it, and in some cases maybe just stay out of the way.

Shonqueen1 · Sep 26, 2012

I had my very first CNA interview today for a night shift position on a medical surgical floor. I was just wondering if any of you worked med/surg and what it's like? Pros/cons? I had lots of questions I wanted to ask during the interview but I felt like I would've looked incompetent if I had asked them. However, during my CNA training we never really went over surgical patients much or even what a hospital setting is like. My teacher spent more time teaching us about geriatric patients and nursing home settings because she said that was where we would most likely get hired for our first CNA position.

I went through a PCT/PHEL course and they taught us everything. I am a Certified PCA/EKG/PHEL. I am only working as a CA- Clinical Assistant working with children. We worked with the older population during my course. I did blood sugars and took out Cath in hand, arm or private. I work with children on a Med/Surg floor at night and love it. I just have to get used to working at night. I miss drawing blood and taking sugars. I have to wear PPE because most of our patients are on contact precautions.

TN CNA · Nov 6, 2012

I got hired as a CNA (night shift) on the MED/SURG floor straight out of class. I had no experience and had not worked in over 12 years. We do Q4 vitals, constant I&Os on all drains, etc..., ambulate, turns & brief changes(usually with no assistance), bathroom assist, bed changes (if needed), stock supplies & linen, clean rooms..... The surgical patients on my floor are all types, so you will learn to do all kinds of techniques. I love learning the new stuff! --(day shift does baths, bed changes, and meals)

Our patient ratio sucks though. We are lucky when we have two CNAs. We have 42 beds and I've personally had 36 patients before. and YES that's me taking them to the bathroom and getting 36 vitals three times a night! Hence why I say it sucks. I started on day shift and had between 12-20 patients. Let me just say, patient care is sacrificed in order to just get people to the bathroom and try to keep them changed every 4 hours at least. I love the nights I can come in and have around 10 patients. I feel like I'm helping then. I am able to get people cleaned every 2 hours and check on them like I should --as well as stock some supplies for day shift.

Our RNs are overwhelmed as well, so they can't really help. They have up to 10 patients and more at times. ---This is why I'm now in school for respiratory therapy!!!---- Love my patients that I get, but can't deal with the bureaucracy!