Everyone is going to nursing school

Red Kryptonite · Dec 13, 2014

Well I certainly don't want to remain an aide the rest of my life! That said, I have met many CNAs who are not going to become nurses. Usually they feel they are too old to return to school and are looking toward retirement. Also, some for whom CNA work is a huge step up from their family history and they're not looking any further. And lastly, some who've decided that they enjoy the direct patient care role and don't want the extra responsibility of being the nurse.

WookieeRN, BSN, MSN, RN · Dec 14, 2014

Many people use working as an aide as a stepping stone to a nursing position when they graduate nursing school, especially in areas that are not new grad friendly. They may (or may not) get an edge over other candidates because they become classified as an internal hire, and they have had a better chance to cultivate relationships between HR and nursing staff (including nursing manager) that may help them get their foot in there door, too.

verene, MSN · Dec 17, 2014

In my area nursing schools pretty much require that prospective students work as CNAs before applying. So many people are becoming CNAs not to stay CNAs but because it is the first step on the path to becoming a nurse. That being said not everyone working as a CNA is set on going to nursing school. Where I work I'm the only one set on going to nursing school at this point. I try to look at my job as a paid internship - it is great experience for me as I'm learning new things every shift I go in, gaining valuable skills, and being able to network with providers and learn quite a bit about different clinics and hospitals in the area - as a bonus it pays some of my bills. When I start feeling burnt out on school, work motivates me to keep going because I can see the real-world application all of these pre-reqs, studying and theory will one day lead to.

A few of my coworkers are older, being CNA is a far as they want to go - this job serves their needs. However most of us either work a second job, or are going to school. One coworker is a goal of getting an MSW but is still trying to get through undergrad. She works full-time for us, and plays in a band that is taking off (equivalent in time and pay to second part-time job) while trying to save up money to get her bachelor's degree. She really enjoys working as a CNA for now, even if it isn't what she wants to do for the rest of her life. Another works as a waitress as a her main job but has decided she wants to go into health care but isn't really sure where she wants to go with in healthcare and is using her time as a CNA to learn more about the different roles out there and to save up money for whatever training she does decide to go for in the future. A couple others work as a CNA at our facility as their second job - one works in software programming as his day job, but needs an outlet for his desire to work with people and a bit of extra income so working part-time as a CNA is actually something he does for his mental health.

I feel fortunate that for the most part my coworkers want to be in their jobs. For whatever reason people either really like working in my facility and become long term (2+ year employees) or really hate it and leave in less than month. We have low staff turnover which I think contributes to why those of us who stick around really like it, we become friends and become very supportive of each other. Our residents are also a pretty great bunch if you take the time to get to know them and they make it clear that they really appreciate the staff the work there (most days, other days I've been called more names than I care to think about).

That being said nursing is becoming an over saturated field and is already over staturated in many areas. Once working as a CNA first gave a prospective student a step up in admissions and then in job hunting later on,now it is an expectation that a student has CNA experience rather than an exception. Unfortunately I think this can lead to a some people having the attitude that they are just working as a CNA because they "have to" and that they are really better than that because "one day they will be a nurse", which leads to unpleasant attitudes and coworker relationships, and sometimes even substandard care for patients/residents because said individual hates their current work.

cd365c · Dec 17, 2014

That being said nursing is becoming an over saturated field and is already over staturated in many areas. Once working as a CNA first gave a prospective student a step up in admissions and then in job hunting later on,now it is an expectation that a student has CNA experience rather than an exception. Unfortunately I think this can lead to a some people having the attitude that they are just working as a CNA because they "have to" and that they are really better than that because "one day they will be a nurse", which leads to unpleasant attitudes and coworker relationships, and sometimes even substandard care for patients/residents because said individual hates their current work.

Now, what exactly do CNAs do in mental health specialties? How would your day be different than at a hospice floor. I can see the result of that attitude even in myself. But, I think that knowing someday I'll be a little higher on the totem-pole helps me cope with the issues I'm faced with daily. Some days I wish I'd wake up and actually want to go to work.

verene, MSN · Dec 18, 2014

Now, what exactly do CNAs do in mental health specialties? How would your day be different than at a hospice floor. I can see the result of that attitude even in myself. But, I think that knowing someday I'll be a little higher on the totem-pole helps me cope with the issues I'm faced with daily. Some days I wish I'd wake up and actually want to go to work.

My roles in mental health and hospice are a little different. I'm a CNA (residential caregiver is job title) in mental health. I work at an assisted living facility that specializes in the care of low-income individuals with chronic mental illness.

In hospice I am patient care volunteer at an in-patient hospice center affilated with a local hospital (across the street) that between in-patient and field-care serves 2 counties with approximately 800 patients on any given day. When I started in-patient volunteering it meant that we could pretty much do everything the Techs (CNA) under tech/RN supervision. (they gave us a LOT of training before hand). Recently we underwent some changes and volunteers now can't do as much direct patient care - pretty much everything that involves lifting is now "not okay" (which in terms of liability was probably a smart move), that said I still help out the techs and RNs with a lot of things centered around patients - in part because they know I am a CNA and can trust that I'm comfortable and confident being in the room while they work and because I actually know what supplies they need and can do a lot of the prep work / taking things away for them so they don't have to constantly explain what they are asking for or monitor my work as closely. I can also still help with oral care, combing hair, applying lotion etc, and this can help speed about the amount of time they spend in the room.

A typical day in my mental health job starts out with me coming in for 3pm start - potentially bombarded with all manner of questions and requests be residents who see me coming in the door, getting settled in and checking in with day shift for any issues to monitor. Once we've gone over things I check through any administrative tasks that need to be completed in the evening (rides for next day medical appointments or urgent needs to get some on in to PCP or psych, or follow up with case manager or provider) and work on getting those set up. Once medication pass starts the focus is on tracking down residents who need reminding that it is time to take their medications, reminding residents that dinner time is coming up and that they should come eat, as well as checking in to see who might need assistance with showers, dressing, room cleaning etc. If there is time or need we will also do extra loads of laundry in the evenings.

After medication pass and dinner time it slows down a bit, this is a good chance to go talk to residents who need support, restock supplies, work with our hoarders on room decluttering, assist with clothing changes and bathing for those who like to change earlier in evening (usually our early-to-bed crowd). It's also a good time to work on paperwork - each CNA has a caseload of specific residents we monitor and are responsible for in terms of in-depth documentation and for checking in with resident that certain tasks (nail clipping, hair trims, etc) are being accomplished on a regular basis.

We also have to document anything regarding changes in resident bx, health issues, conflicts that arise or resident needs (X needs new socks) and start the ball rolling on these issues be in contacting RN, CM, or something that we can do ("Assisted X with sorting clean laundry and putting away in dresser - 14 pairs socks found, new socks do not need to be purchased). Even things like degree of social participation are important to watch, because for many our residents isolation is one of the warning signs that decompenstation may be eminent. This is for ANY resident in the house we observe anything that needs to be document while on our shift. Some nights there's not a lot, other nights I spend my evenings writing novels.

Around 7:30pm it's time to do prep work for 8pm snacks. Snack time runs 8pm-8:30pm and and then time to clean kitchen afterwards, usually until 8:45pm depending on what was made and on how dirty the dining area became during snack time.

More running around from 9pm-10pm checking in on emotional needs, folding laundry, assisting with getting ready for bed, etc. 10-11pm is cleaning time in which we do a quick once over of kitchen, dining, entry, office etc, and make sure all toilets have TP, paper towels and soap for the night.

This is a more ideal day - things are subject to change at anytime and you may find yourself diverted from snack time in order to take care of a resident who fell, or helping with laundry turning into a semi-therapy session for a resident who has an emotional breakdown and needs to let it all out.

My hospice day is different in part because I'm a volunteer and in part because it is only a 4 hour shift for me rather than normal 8 hours. I usually get in, drop my things off, check in with the nurses station to find out patient load and potential needs. Usually there is time for a quick clean of the kitchen and making of fresh coffee, then I help the techs with turns, bed bathes, and other patient care, spend time restocking the kitchen, and wing supply closets, and make sure patient rooms have needed supplies (linens etc). If there are patients or families with high emotional needs I'll spend time sitting with them, some times answering questions, sometimes just talking, sometimes sitting quietly because they just need someone to be there more than they need interaction. I also check in with families and patients to see if there are any needs that they might not have brought up with nursing staff during stress of admission - things like where to find a nearby place to eat, or letting them know that we can loan them a phone charger for the one they forgot, or just checking in on anxious patient/family to let them know that nurse is busy but will be by shortly to answer their questions/supply medication etc. If a patient passes away on while I am there then I help gather supplies to prep the body for family viewing - usually the techs like to prepare on their own, but occasionally I have been asked to help clean and prepare a body for viewing.

I will usually make at least one run to the main hospital for the staff while I'm there typically to the pharmacy to pick up needed medications, but I may also drop by linens or supplies if something is needed.

If a day is really slow and not much patient care is needed and supplies are well stocked I may just find myself dusting the family room, or assisting with random administrative tasks (making education packets, filing, etc.)

If I was actually working at hospice I would have more patient care to do, and would be responsible for taking vitals and charting on patients. A few of the techs and RNs have nudged me to apply as a tech, but with my other job and with school now isn't a good time for me to pick up a position there - I am considering it for the future though.

cd365c · Dec 18, 2014

It is impressive that you are doing all the patient care you do in the hospice setting. I bet that it is good getting to see both sides of mental health and hospice. That way, as an RN, you have many different avenues to consider. Thanks for the detailed response!