From CNA to RN at the same hospital

Ruby Vee, BSN · Jun 1, 2018

I'll soon become a nurse at the same hospital & unit where I've worked as a CNA for the past few years!
Do you think it's harder or easier to be an RN on a unit where you've worked as a CNA?
Some people have told me that I might have trouble being taken seriously because I've been a CNA on that unit....or, that the role transition might be heard for me, and I might have trouble taking myself seriously and having the confidence that I need.
I have all the normal new nurse worries, and I've always struggled with having enough confidence in general. Many of my clinical instructors were very positive and encouraging about my skills, but said that I needed to build up my confidence.
Does anyone have any tips, ideas or insight that they are willing to share with me?

I never worked as a CNA before becoming licensed as an RN, but I have precepted a number of nurses who worked on our unit as CNAs before and during nursing school. Some of them found it easier to take their first nursing job on our unit because they already knew people, knew the patient population and knew where to find that last IV pump that was hidden away. Some of them found it more difficult because they found it difficult to switch roles and supervise their former peers, found the role transition more difficult than expected or were worried about others taking them seriously.

As for the experienced nurses on the unit -- we had input into which CNAs were hired on our unit and which weren't. If we had concerns about someone's work ethic, ability to get along with others, etc., we informed our manager before that person was hired as an RN. The former CNAs who did get hired as nurses were the ones that were liked and respected as CNAs, and who we anticipated would do well as nurses. We were excited about precepting those folks. Most of the former CNAs who were hired as nurses on our unit did well; a few didn't.

I haven't given you any definite answers because there aren't any. It depends upon the person. Hopefully I've given you some food for thought to help you sort things out on your own. I wish you well, whatever you decide.

berdawn, ASN · Jun 2, 2018

I am working as an aide while I get my ADN. I plan to graduate in Dec so I have been picking up shifts on different floors and units to see if they might be a good fit for me. I think it would be very difficult to stay on the floor where I've worked as an assistant for a while--this way I will have some familiarity but not have such connections that might present difficulties.

thoughtful21, BSN, RN · Jun 4, 2018

We were excited about precepting those folks.

All the nurses have been awesome and encouraging. But I'm worried that I'll be so slow and not know so many things that I should, that they'll get frustrated with me.

Honestly, I'm probably being my own worst enemy.

Thank you for answering! If anyone else has stories of being in a similar situation, or advice, it would be very welcome.

Ruby Vee, BSN · Jun 5, 2018

All the nurses have been awesome and encouraging. But I'm worried that I'll be so slow and not know so many things that I should, that they'll get frustrated with me.
Honestly, I'm probably being my own worst enemy.
Thank you for answering! If anyone else has stories of being in a similar situation, or advice, it would be very welcome.

We don't expect you to know anything, really except where to hang your coat. Well, since you've worked there before you can probably find the employee restroom, the utility room and the laundry rack. But as far as actually knowing anything "nursey" -- we get that you won't know much of anything when you first start. All of the things you thought you knew will probably vanish as soon as you walk into the nurse's station and get your first assignment. Gradually, you'll start remembering things. We know that you're not going to pull it all together your first week of orientation. In the beginning, you'll remember a normal PTT but not be able to relate that to the heparin dose or the color of your patient's urine. As you work with us, you'll start putting more and more things together. After a year you'll be comfortable and after two years you'll be competent. We know that, and we expect that.

You'll have a leg up on the new grads who have never been CNAs. When I started my first job, I had no idea how to weigh a patient, or get vital signs.