CNA'S [Your] First Day [ All welcomed! ]

fuzzywuzzy, CNA · Nov 24, 2008

I'm self-conscious and easily flustered, so I had a lot of anxiety when I first started. I came home crying sometimes. It's really great that everyone was nice to you! A lot of CNAs will kind of ignore you for a while until they get used to you and see that you can do your job.

As far as advice goes... time management is the most important thing. A lot of that will come to you as you get to know the residents and anticipate their needs (and yeah, that whole "what can they do?" thing is really hard to remember at first, so write it down). Before you know the routine, ask another aide to give you the rundown on what order to do things on your assignment. And never ever assume that "there's nothing to do right now" because that's never true. Any minor detail that can be attended to during a second of free time will be a huge help later. You will find that as a CNA you'll be making lots of trips to the linen cart, supply room, kitchen, etc. for very minor things, which wastes time and mental energy. Picture this: you check on a resident. They're wet but there are no clean pads in the room. On your way to the linen cart you see 3 call lights going off, another CNA asks for your help with a transfer, and then a resident's chair alarm goes off and you have to run in there and make sure she doesn't fall. 15 minutes later, you still haven't gotten that pad and now another resident is ****** off because she wanted to go to the bathroom 10 minutes ago. Oh and someone else asked for a box of tissues 3 hours ago. Hopefully you remember by the end of the day! When you finally get back to the incontinent resident's room another call bell is ringing but you decide not to neglect the same person yet again so you duck into their room only to have the charge nurse follow you in there without knocking to point out that call bells are going off. And by the end of your shift you realize some vitals are still not done. Meanwhile you're racking your brain trying to make sure you haven't forgotten any alarms, seatbelts, correct bed position, or any of that other stuff that the next shift will report you for. So make sure your rooms are fully stocked with everything imaginable, and if not, take it with you on your way to the room! You don't want to fetch someone the kleenex they asked for and then discover they are out of denture tablets or briefs and you have to run out AGAIN.

Communication with other aides helps a lot too. Saying, "I'm going to get Mrs. A on the toilet right now and then can you help me get Mr. B up? Then I can help you wash Mrs. C?" is good because then everyone is one the same page and stuff gets done faster when everyone has help.

And when you do ask someone for help, make sure you're prepared, for the sake of the other aide. There's nothing worse than agreeing to assist with the hoyer and run into the room only to discover that

the lift pad isn't underneath the person and the hoyer is nowhere in sight and the other aide is still in the middle of washing their face or fussing with something else. It's a waste of everyone's time.

yousoldtheworld · Nov 24, 2008

One thing that is really helpful, not just for your first days as a CNA but your first days at ANY new CNA job/hall/floor/unit is to TAKE NOTES.

If you get report at the beginning of your shift, write down what will help you take care of each patient. Make note especially of how they transfer and ambulate, and if they are continent or need to be on a toileting schedule. Throughout the day as you work with the patients, continue to add to your notes - the things that will help you remember and get your routine down. I make note of the people who like to get up/go to bed at a certain time, people that have certain dislikes, people who have a specific routine that must be followed, etc.

Stock your linen cart at the beginning of your shift - make sure you have enough towels, washcloths, gowns, whatever you will need. When you go around at the beginning of your shift, drop off a couple of towels and washcloths in each room so you will have them when you're ready and you won't have to run back into the hallway. It saves major time.

I'm assuming you're working days? If so, my routine went something like this:

Stock linen cart

Make first round to check on everyone, pass out towels and washcloths, and introduce myself

Start getting people up/dressed/ready. I usually start with the people who will take the longest - you don't want to save those until the end because you run out of time so quickly. Try to get everyone toileted before breakfast.

Help out with breakfast

After breakfast, I help those who want to lay down, toilet those who need it, and then start my showers/baths.

After showers and baths are over, it's usually time to get them ready for lunch. I do another round and check on everyone, and get the ones who laid down back up.

Toilet them.

Help out with lunch.

Toilet them again,

and at this point a lot of people like to nap.

of course in the midst of all that, you're going to have call lights, but if you try to toilet everyone before and after each meal, I find you do have fewer. If you remember to go into every room on your rounds, you'll have fewer call lights, too because you can do what they need then, instead of when you're in the middle of something.

I don't remember my first day, honestly...I did my clinicals at the same facility I ended up working at so it all bleeds together!

But I think the key thing is to establish some kind of routine - otherwise you'll feel like you're just running in circles. And there will be days that you feel liek that anyway. Good luck! :)

mochabean · Nov 24, 2008

I started my NA training at a hospital over a week ago and it'll continue for a couple more weeks and then I'll be on 6 month probation. On my first day I only shadowed another NA (I was there for 3 hours). Next day I was giving tasks and the next day even more. The unit I'm on is actually understaffed. What's unfortunate is that the NA's I was training with did a very poor job of training and supervising me. Most of the time they either wanted to do BGM's or vitals or they just disappeared. The NA's I trained with didn't even tell me how to empty a foley or measure I&O. (An NA who works nights and had already clocked out had to show me how). Yesterday I finally worked with someone who was casual but had been an NA for 4 years. After working with her I learned a lot about time management, having essential supplies on hand so I'm not running around, I&O, when to chart, writing our names, dates, and pt's diet on the dry erase board, etc. We had the "hard side" of the unit (more pt's who need assistance), but we were always a step ahead because the person I trained with was very thorough and had good time management. I feel more confident now since working with her and I will definetly be comfortable on my own in a few weeks.:nuke:

fuzzywuzzy, CNA · Nov 24, 2008

^Well hopefully you get to stay with that aide! The best things I learned from orientation at my job was when I first started on my own, my trainer wrote down the order I should put the residents to bed. Another trainer told me, "Watch the clock... 15 minutes with each resident means 4 residents done in an hour, which is a comfortable pace." I was really slow at the time, so the time frame helped me set my pace when I was working by myself.

When I interviewed there the DON made some comment about how "a lot of the CNAs feel the need to get their work done by 9:30 but I think there's no need for that as long as they get the care they need." This was after they fired my friend (they didn't know I knew her) for being too slow. Not to mention half the residents want to be in bed by 6:30, and the rest all want to get ready before 9!

rancelumsden · Nov 24, 2008

Yousoldtheworld said:

"...One thing that is really helpful, not just for your first days as a CNA but your first days at ANY new CNA job/hall/floor/unit is to TAKE NOTES....".

Exactly right. It helps even to take notes on residents. Eventually, you'll get to know residents, their names, their habits. But initially, you're just trying to keep your head above water. If you keep a note about your routine, or specifics on a resident, and make it a point to check those notes right before shift, it will be a help....

sander6 · Nov 24, 2008

I am hoping/praying to get into the CNA program at my local community college in January...I am just waiting for my fingerprint clearance card to come back...My prayer is that I get the card BEFORE the class fills up...It is killing me...the wait...I know the clearance will go through...but they won't let me apply until it does..grrrrr

mintygirl · Nov 25, 2008

update!::

so today was my first day and a lot happened that, had i not been a total newb i might have been able to avoid. however the first two hours were so over-whelming - i was slow - a lot more than i thought, but i had such a -great- team to help me out. even so for a moment i had honestly though "am i going to make it?" i mean i wasn't in the heart to walk out but i figured i'd do such a bad job they would simply tell me not to come back.

by the third hour i had everyone fed, dressed, dry clean and ready for their day two hours to spare [ but i had a lot of help even the rop and college students had came on our shift so we had extra hands floating]. most of my pts were ambulatory, could communicate with me or had their wits about them and laughed with me when i told them i was new altogether.

i felt like they were even looking out for me *tear* it makes me want to do a thousand time better job for my second day!!!

i want to say that to those who are new or job searching, there's a high chance you won't have a bad experience [ although i tend to read a lot of horror stories..!!! there are even a few in here...]

i was covered with a staff of wonderful team members that were mature, understanding and ever so patient with me. they taught me the ropes, a few tricks and helped speak up for me when administration walked on the floor with me in a daze. they took care of my first crazy round and toward the end of the day i was able to repay the favors they had done for me.

and now i'm able to communicate with them more [ my pts]. i feel that it'll get easier as i go [knowing the tricks to save time, anticipating people's needs] the work is hard, but it was so rewarding at the end of the day. don't lose hope to those out there. i had a wonderful experience despite my own personal mishaps! :redbeathe

shistevens · Nov 25, 2008

I am in the mortgage business, and make too much money to go to school as a CNA first. I will have to go straight into the LPN program, and want to know if anyone has any advise. I am a mother of 4, ages 16, 12, 10, and 8. I have a supportive husband, but worried with full time job and nursing school, well that I won't do well. Has anyone else done this, and been successful??

You know how the mortgage business is right now, and the economy is directly tied to it. I didn't realize the amount of fraud out there, and frankly it disgusts me. I really want to go into nursing, but want to be successful at it. Please help me

mintygirl · Nov 25, 2008

I am in the mortgage business, and make too much money to go to school as a CNA first. I will have to go straight into the LPN program, and want to know if anyone has any advise. I am a mother of 4, ages 16, 12, 10, and 8. I have a supportive husband, but worried with full time job and nursing school, well that I won't do well. Has anyone else done this, and been successful??
You know how the mortgage business is right now, and the economy is directly tied to it. I didn't realize the amount of fraud out there, and frankly it disgusts me. I really want to go into nursing, but want to be successful at it. Please help me

Honestly shistevens you would have been better off making a new thread since this topic isn't directly related to what you want to know.

Regardless I'll guess I'll answer.. I've met mothers during my schooling hours who asked me those kind of question because I'm young, with no kids. Everyone is different, your either going to say "I'm -going- to do it" and do it. It just means it'll be that much harder on you.

From what I've been told, LVN is something you want to focus on with no distraction and a lot of the CNA's I currently work with are in their field still because they simply don't have the time because they have kids so going to school to further pursue the nursing school career is out of the question for them. It's stressful, emotional, despite what others say and the day of your clinics it's kind of serious to NOT have any interruptions.

Your going to need character if your determined to get through it.

lovelyB · Nov 25, 2008

Wow your working on the floor with only one day of working on the floor? sounds harsh. At my work you have 8 hours of computer orientation and than 5-7 days of shadowing another aide to get used to pts and other aides than they put you with someone else! from the way you put it it seems like you only had one day. I have been there for a year now but my first day(orientating) I smiled at the first resident I saw and he hollared back "what the hell are you laughing at this aint no laughing matter" and than went on the whole day talking about how I was making fun of him. Turned out he had dementia and wanted to go back so bed but wasnt aloud due the the fact him and his roommate had just got in an argument and they were trying to switch his room. lol. Than the first day by myself one of the other aides had a family emergency and had to leave so in the middle of dinner (i work 2nd due to school) we had to swich assignments GUH and I had to pick up litteratly the hardest shower on the floor! I still dont like doing it she hits scratches screams and is pretty strong!! also she told me she hopes I run out in front of a car and die. lol. I love her now just dont like the shower.

Advice- please do not refer to your job as "wiping butts" or having to "deal" with residents. They are human beings and deserve love and respect. You take care of their personal needs and need to be their companion not enemy. I love my residents all 100+ of them (i am a float and work with everyone due to being part time) They have become like family. Your just going to have to pray you have good co-workers and I would recomend talking to an experienced aide or nurse about each resident you have at the beggining of you shift tommorow to know if theres anything important you should now and how to transfer them or if thir sick NPO or anything. Lastly come to work everyday with a positive attitude and dont take anger out on residents. Their innocent, and just want to be cared for.

I love my job and if it payed better I would stay forever.

yousoldtheworld · Nov 25, 2008

While it might not be the best way to phrase it, I know that there are some days in some places that it seems like all you do, literally IS wipe butts. Luckily, I am not in that position but I'm not offended by the phrase. Most people I have heard utter it weren't being rude, but rather were joking around...and let's face it, some days, you need humor in whatever for you can find it.

As for having to "deal" with residents...well, that's just a fact. You have to "deal"with your family, deal with your coworkers, deal with every other person you come into contact with. Saying you have to deal with someone does not mean you regard them as less than human.

I know your post was well intentioned but if you will read on here, those of us who care to find a forum like this and post on it DO care about and respect our residents and patients. I'm not trying to argue with the idea that you need to respect and love the people you are taking care of...the way those couple of sentences were phrased just seemed preachy and like you were talking down to the new aides. They wouldn't be here if they didn't care about respecting their patients :)