I am a newly certified CNA. I just got my first job and have worked 4 days.
As I worked with my trainers (somebody different each day) I found that almost everything they taught us in CNA class is not being implemented by not only the long time CNA's but also those new to the work.
I have worked both 2nd and 3rd shift, and NOBODY seems to 1-knock, 2-address the resident, 3-announce themselves, 4-let the resident know what they are going to do!!!
This is crazy! One CNA said 'We don't have time to get them snacks tonight" and just didn't do it. The ADL books are only half filled out. Also, it seems that it is ok to throw dirty briefs and linens on the floor!?! What??? I can't even believe it.
The place where I work has a very good rating, everyone seems very nice (especially the residents), and there are all KINDS of things in place to report abuse and other things, but it just seems gruff and dirty.
Is it like this everywhere? It seems that it is just a job to many, and the fact that these people are in need, have lost much of their dignity, and are really PEOPLE has left these workers' minds. I am trying to get into the RN program where I live, so CNA work is not what I want to do forever, but I am wondering if I can take it if it is going to be like this.
Does anybody have any advice? I try to be kind, apologetic, and understanding to all of the residents, and give them the time and care they need and DESERVE. Am I a freak who is going to fail because I won't have enough time to actually do my job?
Any advice or encouragement would be really appreciated.
I was also surprised, but after working over a year in the real world I have found you will not have time to do every step as in class. You will be super busy, things will happen, people will fall, unexpected things will take more time than you thought...ect.
Dirty linens on the floor is no biggie. I do always knock though and announce I am there (they all know me now), and usually chat while doing whatever I am doing. I care, but since there is so much to do and little time some things are not as important as others.
Orthornurse is obviously right about the dirty linens and clothes on the floor. Sometimes its unavoidable, but I dont think its too hard to carry a basket or linen container into the bathroom with you so you can toss everything into there. At the very least try taking a bottle of disinfectant around with you(but dont leave it unattended) when you work and spray the floor and sink when your done. All it takes is one C diff outbreak and a facility will really crack down on aides throwing linens onto the floor.
Also, as far as knocking before entering a room, I got into the habit of always knocking on a door or wall as im entering and will greet the resident when im entering their living space, unless they are asleep. Its now been programmed into my muscle memory to the point I often find automatically knocking on the door before I use the bathroom or open a closet.
Also telling residents what you are going to do seems like basic courtesy, and will make your job a lot easier, especially with confused combative patients/residents. Sometimes Ill make an excpetion if the person is extremely hard of hearing, so Id have to end up yelling into the persons ear, repeating what I said 3 or 4 times and waking up and agitating a roomate.
It's all coming back to me now!! All the idealism I felt when I started out as a CNA student, all excited about the adventure ahead of me -- looking at the pictures in the text book of relaxed-looking aides bending over their nice and tidy little patients doing things like putting a nice warm blanket over them so they won't feel cold sitting on the toilet -- imagining myself flying through the hallways with my cape flapping -- SUPER CNA ON DUTY!! Then reality hits. Heavy back-breaking workload, gossipy uncaring co-workers, a whole shift's worth of nasty Attends overflowing the wastebaskets, incontinence pads placed over wet linens because the evening shift aide didn't want to do a complete linen change on last rounds......and the real kicker -- NOBODY CARES WHAT THE CNA's HAVE TO SAY ABOUT ANYTHING !!! Nobody really wants your input or suggestions about what could make things work better......just show up for your shift and do the work as quickly and efficiently as possible. After I got over the initial shock of what my job was going to be about, I did become really fast and light on my feet -- none of my people were ever neglected and as much as possible I didn't make any of them wait too long for me to get there and help them. Today I no longer work in long-term care because the low pay was not worth the risk to my back -- however I am glad for the experience I gained.
I cannot kudo your post enough!
I came out of class thinking too that I was going to be SUPER CNA on duty. That lasted, oh say, 3 days
If we didn't care, would we show up day after day to work this hard for this little money? No. Of course we care. Most of us are doing the absolute best that we can do to care for too many people with too little time. Where I work now, I rarely have more than ten at a time and that feels GREAT! But if I were trying to do things the way I learned them in class I could only handle half that number. Give it time, you'll either adjust and learn to prioritize (not introducing yourself to residents that already know who you are is unimportant, making sure you're not hurting them during transfers is important) or you'll decide this job is not for you.
One thing I have learned while wroking as a CNA is that nothing is done like it is in class. Now this doesn't mean that nothing is done safely but, in reality nothing is done just like the textbook says for the very reason that it is a text book and scenerios are perfect. In the real world no situation is perfect. You'll say "I'll never take short cuts" (I know I did) but, you do. Sometimes you have to in order to get your job done. This is one thing I hate about my job,I wish so badly I had more time to spend with my residents. There are a few I could chat with all day and it is these residents that make it all worth it. Without them the job would be impossible. So don't let the training get you down and try as hard as you can to not pick up on your co-workers bad habits so that when you train someone in you can be proud to show them your work ethic. And remember that some things just don't matter like dirty linens on the floor (as long as they are brought directly to the dirty laundry when your done) it is more important that the resident is safe and clean. Hang in there!
And about the snack thing. Why do you think this girl said she didn't have time to pass the snacks? I'm guessing the answer is (drum roll)... she didn't have time! Usually the person that passes the snacks doesn't get to toilet her people. How many residents do you think you can take care of in a day (I'm really asking). I doubt you'll say "10 or 15." If you're dawdling with one resident for too long, it's not fair to the others who are sitting in pee or waiting with their call light on forever.
If your coworkers are rushing wordlessly into rooms and flipping residents who don't know what's going on around, that's a shame, and they're only making it harder for themselves when those residents stiffen up and become uncooperative. It doesn't mean you have to do things that way. But you will never find a facility where you're able to control how the other aides act.
It sounds like alot of places are understaffed. I dont understand how they think you can take on so many patients and be able to get things done. By the way if anyone cares to share, how many patients are you usually assigned/ and what type of facility do you work at? What do you think would be a more realistic number of patients to take care of?
It sounds like alot of places are understaffed. I dont understand how they think you can take on so many patients and be able to get things done. By the way if anyone cares to share, how many patients are you usually assigned/ and what type of facility do you work at? What do you think would be a more realistic number of patients to take care of?
I work at hospital/SNF thing.
Days: 8 patients
Eves: 11 patients
NOC: 21 patients
In my imaginary CNA world, I see 5 being a good number to work on. A person can dream, yes?
I just started my clinicials for LPN class. We are spending our first week in a LTC. I have been A CNA for years and I am sorry to tell you but this is the way it is most everywhere. While I agree that you will find some CNA"s that dont care, most r not this way. You have to understand, There r many residents, and a very limited amt. of time to get things done. And an even more limited amt. of CNA"s to do all. You have to do the best u can with what u have to work with. You said in your post that u plan to attend RN school. Thats great and good luck to you. However before you do, please rethink the comment you made that u " Dont want to do CNA work". Once u become a RN, dont forget where u came from. There is nothing worse than a nurse who thinks she to good to wipe butt. When I am a LPN, I promise I'll never forget who is the backbone of the whole operation, the CNA"s
In my imaginary CNA world, I see 5 being a good number to work on. A person can dream, yes?
Im still in training during the day in a hospital (seeing how things go), but I would say 8 has been the fewest number of patients we had. I think we had 11-13 the other day. Sometimes alot of completes. Its scary thinking I will have to do this all alone. OVERWHELMING!
I work day shift in a nursing home. On my regular unit CNAs have to work in pairs and each pair has 16 residents. This unit is all long term demented peeps, mostly total care, and most of them have behavioral issues. Our rehab units are better staffed- they all have 3 aides for every 15 patients (they don't have to work in pairs, obviously). I used to work over there a lot and you do get your PIA patients that make you roll your eyes and an occasional train wreck but it's sooooo much easier that it actually gets boring. Especially on days because everyone is in therapy for hours. And of course half of the patients are independent and ready to go home, and they are all more "with it" so you're basically doing nothing but emptying their toilet when they ring, keeping track of ice packs, and passing out food trays. There's no feeding, incontinence care, etc.
Go figure. I guess we know who rakes in all the money!
I work in a hospital, so it's a little different than a LTCF, BUT here are my grains of wisdom:
1. You may not always have time to do a lot of little extra things for your residents. Make sure important things get done, like baths, peri care, feeding, etc.
2. Knocking and addressing the resident: I work night shift(1900-1730) so sometimes it's not appropriate to knock when entering the room if it's the middle of the night and my pt is sleeping and I just need to check on them, but if they are otherwise awake, alert, etc. I would always knock and introduce myself. Although, since I have new pts every shift, my pts never know who I am or what my title is, but I can see how introducing myself to the same alert and oriented resident every day would get a little old… for myself and the resident! lol
3. I would always tell them what I'm about to do, residents are not mind readers…
4. One of the most important things for you to learn to do is to prioritize your care. For example, snack time is not more important than giving peri-care(with a few exceptions, but you get the drift…)
5. In the grand scheme of things, as long as you're providing good, safe care to your residents, that's the most important priority. Throwing dirty linens on the floor while you're changing a bed isn't that big of a deal. It may be your only choice when you're in a pinch!
6. Don't judge your co-workers too harshly at this point unless they're truly unsafe.
7. Nurses do the same things we do, and more! When you become a nurse, don't expect not to have to provide peri-care to your pts because it's "CNA work." Please don't fall into that mentality.
8. CONGRATS ON BECOMING A CNA!!!!! Good luck in your new job!
I work day shift in a nursing home. On my regular unit CNAs have to work in pairs and each pair has 16 residents. This unit is all long term demented peeps, mostly total care, and most of them have behavioral issues. Our rehab units are better staffed- they all have 3 aides for every 15 patients (they don't have to work in pairs, obviously). I used to work over there a lot and you do get your PIA patients that make you roll your eyes and an occasional train wreck but it's sooooo much easier that it actually gets boring. Especially on days because everyone is in therapy for hours. And of course half of the patients are independent and ready to go home, and they are all more "with it" so you're basically doing nothing but emptying their toilet when they ring, keeping track of ice packs, and passing out food trays. There's no feeding, incontinence care, etc.
Go figure. I guess we know who rakes in all the money!
Having 2 CNAs for a group of LTC pts would be awesome! You'd always have a buddy to help lift, answer lights, etc! That's a great idea!
sunshine100
58 Posts
I was also surprised, but after working over a year in the real world I have found you will not have time to do every step as in class. You will be super busy, things will happen, people will fall, unexpected things will take more time than you thought...ect.
Dirty linens on the floor is no biggie. I do always knock though and announce I am there (they all know me now), and usually chat while doing whatever I am doing. I care, but since there is so much to do and little time some things are not as important as others.