First day as a PCA nov 10 and im SCARED TO DEATH

cjcsoon2bnp, MSN, RN, NP · Nov 1, 2008

So Summer... What exactly are your duties as a PCA? Does it require you having a CNA license or any kind of certification? Have you had any sort of experience working with patients before? Personally I wouldn't say that I have a "super weak" stomach but some things bother me more then others but you have to realize that this is your job and that the patients need you (otherwise they wouldn't be there.) It does take some time to get used to it but if your someone who gets squeamish around blood and the idea of cleaning up various body fluids makes you sick then your probably in the wrong field. I wouldn't tell you not to try this and I certainly hope it works out for you but if you know right from the beginning that you can't handle the dirty jobs then you might consider a job that isn't as patient oriented. Here are a few tips:

Remember to wear gloves and proper protective equipment and you should be fine.
If the smells bother you, some people will use Vicks gel and put a small amount under their nose to help cover up unpleasant odors.
Don't ever let a patient see you get grossed out about something. It doesn't matter if its an odor or their hygiene, if they know that you are grossed out by them or they think you are then you have ruined the patient-caregiver relationship.
If you know that you are bothered by this job or you just can't do it, then do yourself and your patients a favor and find something else. Too many times you will find nurses aides who have stayed in the job too long (for whatever reason) and they have become cold or unfeeling which causes patient care to suffer.
Know your limits and be realistic about what you can and cannot do.

!Chris :specs:

gregmotz · Nov 1, 2008

I think you'll do great. You sound like a person who cares about things being done right. I bet you'd have similar worries about any new job you'd be starting in few weeks. And you've had the same concerns on the first day of jobs you've already had. Maybe the first day at a new school was nerve wracking. It's part of what makes you you.

To be nervous and frightened is OK. However, I'm not comfortable issuing blank cheques for two or three free freak outs. :wink2:

For some real world comparison, I too watched the series of videos before gaining any clinical experience. They are great videos for sure. But remember they are presented to teach about all the difficult situations you'll encounter, not the mundane daily routine. I had a grim outlook after taking in all that video information without benefit of an instructor to soften and humanize it.

I was relieved to discover later that some patients can actually get up and go to the bathroom with just some help walking. Some do the whole task all by themselves:D Not everyone needs spoon fed. Not everyone is suffering from the onset of Alzheimer's or senile dementia. Not everyone needs help dressing every stitch of clothing. Some just need a little help with buttoning buttons and tying shoes.

While there may be surprises, there always are, full bedpans don't materialize out of thin air. You'll have warning and time to gradually prepare. For example, you'll have helped raise the bed and already helped get them onto the bedpan.

I thought I was big and brave but even I had a breakdown about the third time I toileted a patient. It was in a small enclosed patient bathroom, all concrete and tile. For some reason the smell was really bad and it got to me. While trying desperately not to vomit, I dry heaved. Loudly. Echoing off the walls it sounded like a lion's roar. Luckily I had an empty stomach or there would have been quite a mess.

The most important thing was that I stayed with the patient. I said something honest and apologetic, "Wow, Mr. Smith, I'm sorry. That caught me by surprise. Hope I didn't startle you. Are you OK...?"

I believe staying with the patient regardless of the situation is paramount. You can excuse yourself after help arrives. You can apologize after if needed. I try to look at any potential apology being about my behavior, not what may have caused it.

The biggest motivator for me to develop a stronger stomach was that someone else was relying on me, counting on me, for strength and help. I just didn't want to let them down.

That's something I read in what you're asking. You fervently want to do well. And that will get you through.

mochabean · Nov 1, 2008

I'll be working as a nursing assistant later on this month and I've been having the same thoughts. This thread has been very helpful.

SummerLin · Nov 1, 2008

thanks so much guys for the responses. I desperantly want to do a great job and make the patients feel right at home when they are with me. My dad underwent open heart surgery earlie this year and while he was completely bed ridden and helpless for week, the nurses never seemed to let that bother them and made him feel like he was the only one in the whole hospital. That is the kind of person i want to be. I am extremely compassionate and caring about other people (maybe too much) and I want to help them out in their worst times.... im just scared im going to make a fool outta myself and dry heave and maybe do worst when i actually see something.. that story was quite humorous i must add (it does make me feel better that this happens to other people).. im also imagining the very worst of a patient. as in, completely paralyzed, unable to speak and soiling themselves every 5 minutes... I was reading the horror stories about nursing it the other section and it scared me off even more! I guess maybe im preparing myself for worse than is actually going to happen!

i wanna do the best job possible.. im just really nervous ill make a scene or pass when i see my first naked older man/woman. I been trying to prepare myself by watching the nastiest shows possible on TV to get me used to the blood and whatever (which surprisingly itsnt my worst fear) but the toileting i think is going to disturb me the most.

edit** sorry i will be getting trained in phlebotomy and EKGs along with my CNA certification!

cjcsoon2bnp, MSN, RN, NP · Nov 1, 2008

thanks so much guys for the responses. I desperantly want to do a great job and make the patients feel right at home when they are with me. My dad underwent open heart surgery earlie this year and while he was completely bed ridden and helpless for week, the nurses never seemed to let that bother them and made him feel like he was the only one in the whole hospital. That is the kind of person i want to be. I am extremely compassionate and caring about other people (maybe too much) and I want to help them out in their worst times.... im just scared im going to make a fool outta myself and dry heave and maybe do worst when i actually see something.. that story was quite humorous i must add (it does make me feel better that this happens to other people).. im also imagining the very worst of a patient. as in, completely paralyzed, unable to speak and soiling themselves every 5 minutes... I was reading the horror stories about nursing it the other section and it scared me off even more! I guess maybe im preparing myself for worse than is actually going to happen!
i wanna do the best job possible.. im just really nervous ill make a scene or pass when i see my first naked older man/woman. I been trying to prepare myself by watching the nastiest shows possible on TV to get me used to the blood and whatever (which surprisingly itsnt my worst fear) but the toileting i think is going to disturb me the most.
edit** sorry i will be getting trained in phlebotomy and EKGs along with my CNA certification!

I'm going to agree with the previous posters that you really do seem to care about this job and your patients and that really is the most important thing. Developing good technique, speed and a strong stomach do take time but if you know this is what you really want to do and you are determined then you will make it. Someone else also said, you will have patients who are literally at your mercy and need your help for everything and then you will have patients that may not need your help at all so you will have a range of responsibilities. I think we already talked about the bad odors part but seeing another naked person is a little shocking at first but just remember that we are all human beings and across the stage of life (from birth to death) our bodies and needs change. Not to make light of it but to give you an idea, you will see older women with breasts that can hang down almost to their belly buttons and you will see older men whose scrotum hangs halfway down their thighs. Its something that you don't draw attention to and if a patient makes a comment about it reassure them that it is normal and not sound judgmental. As someone who is a phlebotomist I can tell you that when I first got trained it was very nerve racking for me, I was so afraid to hurt a patient that my hands shook. My best suggestion is that you remain calm and be honest with a patient, if you miss a vein then pull out the needle and tell the patient that you missed (don't "fish around" with a needle or the patient will be in a lot of pain and want to kill you). Most patients are afraid of having blood drawn either because they are scared of needles or someone who has drawn their blood before has "fished around" with the needled in their arm and has really hurt them. Just make sure you talk to your patient while you are drawing their blood and try to help them to relax. EKGs are fairly straight forward just make sure to keep the patient as covered up as you can, give them the privacy and respect that they deserve and you should be just fine.

Good luck and if you have any more questions just be sure to ask us!

!Chris :specs:

Muttlover · Nov 1, 2008

I admire your honesty and for sharing your feelings. I think a lot of people may feel the same way, but may not want to or be able to admit it. Isn't it human nature not to like the smell of feces? -- we're just not programmed that way It's o.k. If we did like the smell and it didn't bother us, we probably would not have evolved! I start my clinicals for my CNA program Monday evening, and I'm nervous and scared, too. Bottom line, your heart certainly is in the right place -- your patients are lucky to have you! I know I'm in for my share of learning curves, and I'm frightened, but I want to help others. When I think of being "grossed out", I remember the care my mom received and it gives me courage. She was in a coma for 2 weeks and eventually died. The nurses that took care of her treated her with such dignity and respect and I'll be forever greatful. It's a gift I hope I can return to someone else's family. Best of luck to you!

1styearsucks · Nov 1, 2008

Ahhh, i remember my first time..lol. I was a CNA in nursing school. You are human you will be grossed out by certain things, you can not help that. But what you can control is your outward reaction even though you are freaked on the inside. The first time I changed a residents depends I throw up in the bathroom. I washed my hands, my face and came out smiling and keep going. Keeps us posted on how you do. :nurse:

Muttlover · Nov 2, 2008

Thanks! I also plan on packing "vicks" with me! :cry: :cry:

cjcsoon2bnp, MSN, RN, NP · Nov 2, 2008

Thanks! I also plan on packing "vicks" with me!:cry:

It really does help, just don't go too overboard on it because then you will really get sick of smelling Vicks all the time.

Muttlover · Nov 2, 2008

Thanks for the heads up. This website is so helpful and informative. I'd be lost without it. Thanks for passing on your advice!

ecmb · Nov 6, 2008

If you aren't a licensed nursing assistant I'm assuming that the facility that hired you knows this and that they are providing all of the training. Is this correct?