First day as a CNA. How did you know what to do when?

[glittermoomin]

Hi there!

I just graduated as a CNA, and start tomorrow in my first ever CNA job.

I read a lot of posts from new CNAs asking experienced CNAs what their own first day was like. But they tend to be more worried about things that don't worry ME so much - that they are too slight/petite, that they are too shy, etc.

What I am worried about is more the logistical side of being a new CNA, and was hoping people who were/are experienced CNAs could shed some light on this.

My questions are more along the lines of things like -

• How do you know if someone is weight-bearing or not?
  
• How do you know WHEN to change the bed linen? Is there a schedule?
  
• How do you know WHEN to give somebody a shower? Again, is there a schedule? Is it the same for all patients, or different for each?
  
• How do you know which order to get residents up in?
  
• What on EARTH to you do if noone will help you with, say, a two-person transfer?
  

My questions might sound basic, but to me, they are complete mysteries. I did my clinicals in a not that great facility, where the CNA staff were pretty sullen and unhelpful to pretty much all of the students in my class. We just sort of, trailed around after them all. They never explained WHY they were doing WHAT they were doing WHEN they were doing it, and I just kept wondering to myself, "How do you know so and so needs a shower today?" etc.

Help!!

[Stryker105]

Hi!

I'm short on time right on time right now but I think I can help with some of your questions. A lot of the logistics are dictated by the facility you are in. My background: Med-Surg CNA; I've never worked as a CNA in LTC. When it comes to things like if somebody is weight-bearing etc. the best thing to do is ASK. The previous aides who give you report should know, if not always ask your nurse! At first you will be overwhelmed by the logistics but realize that learning the order to get everyone up, etc. comes with time. The best thing to do is keep busy and do your best to maintain continuity of care (ie: resident C likes to get up at 7:30 am to be washed up, therefore you should try to get resident C up at this time. Once again, this will come with more experience working with your residents.

Also, if you have a resident who is a 2-assist and no-one is around, find someone. Never attempt to do anything that you know will make you and the patient unsafe: if the person is a 2-assist, use 2 people. Ask your fellow aides for help and or the nurse you're working with. It is just as much their responsibility as yours to take care of the resident/patient. WE ARE ON THE SAME TEAM!!!

[aminisonya]

Lol. You're going to do just fine. Nobody expects a CNA to do everything perfectly on their first day, especially if they know it's your FIRST CNA job.

• How do you know if someone is weight-bearing or not?
  Ask someone! Another CNA or the nurse will know.
  
• How do you know WHEN to change the bed linen? Is there a schedule?
  Usually morning shift does this, but pretty much whenever it is visibly soiled, or when they take a shower. That's just me, some CNA's never change bed linen.
  
• How do you know WHEN to give somebody a shower? Again, is there a schedule? Is it the same for all patients, or different for each?
  There should be a shower schedule, like a shower binder or they'll let you know each day which of your patients need a shower.
  
• How do you know which order to get residents up in?
  You'll learn as you go!
  
• What on EARTH to you do if noone will help you with, say, a two-person transfer?
  Hopefully you'll be able to find someone to help. If not, do NOT attempt the transfer by yourself. Notify your nurse, most likely they will help you themselves.
  
  
  Don't worry and good luck! :)
  

[ItsThatJenGirl, CNA]

It's been a while since I was a CNA, but I'll answer based on what I remember.

How do you know if someone is weight-bearing or not? It should be noted on their chart. You can always the patient (or the nurse).

How do you know WHEN to change the bed linen? Is there a schedule? Generally, yes, though it was dictated by my nurses and the routine that I created for myself - you'll figure it out as you go. For me, I would check vitals, serve breakfast, then it was personal care (I'd bathe/shower/assist), during personal care, I'd change the linens.

How do you know WHEN to give somebody a shower? Again, is there a schedule? Is it the same for all patients, or different for each? This is up to the patient. I always asked, when picking up the breakfast tray if they were up for bathing/showering.

How do you know which order to get residents up in? I always looped the same way - for food, showering, vitals, etc. So by the time I finished changing linens on the last patient, I'd ambulate the first. Unless there were specific orders on the chart.

What on EARTH to you do if noone will help you with, say, a two-person transfer? Don't do it. Note it on the chart (after making sure you've told the nurse and/or the charge).

Just remember that your priority is what the nurses priority is. You'll have call lights to answer, and other things to take of, but you'll still be able to fall back into whatever routine you create (or is given to you, I had a lot of autonomy).

Good luck!!