Advice PLEASE!!!

pers · Jun 6, 2009

Working as a CNA can be a good experience and open your eyes to the what working in healthcare can be like (especially what it's like in that particular facility) but it's really not a good indication of what it will be like to be a nurse as the jobs are very different.

That said, it is normal to be nervous and uncertain when starting out. I think it's actually more difficult in LTC because the patient ratios are generally higher and most patients require moderate to total assistance. If you are struggling with the physical aspect of the job (the weight of lifting a patient) that is a very different thing than struggling with the technique (learning how to lift a patient). If you are not able to safely (for yourself or the patient) lift or transfer a patient you need to have the assistance of another staff member. If your boss says you are expected to do it on your own, run don't walk from this job because it's not worth what it will cost you in terms of your health!

Delta18 · Jun 6, 2009

I agree with Pers. This is an opportunity and a learning lesson that has hit you square in the face. There is no other way to put it. Yes, I empathize with you pain in regards to being a CNA and being put in the middle of a lot of "scut work". It may not seem glamorous and it may not even seem possible. But the higher you get, the same principle always remains true. You are on your own, but you have a lot of power at your finger tips. A lot of nurses (RN's) are in this field for the wrong reason - and the "power" is all they want. But if you really want to be an effective nurse, realizing that you are "alone" makes every day more precious - you take a greater appreciation in having your job; you end up being more careful; you start thinking more critically; and you end up making better decisions for your patients, as well as great decisions for yourself. Take your time - be the advocate for your patients. Do not rush, but don't dawdle either; if it is skill speed that you are talking about - ALL NURSING SKILLS that are done well are done so because of TIME and EFFORT that has been put into learning the skill and refining them. This is a "growing" time for you, and if you really want to "find out" if nursing is for you...do what you can to credential for an LVN, while you are working toward your ASN or BSN (RN). No one says that this is not possible, and for the detractors saying that it is a "waste" - pay no mind. I know many RN's who still appreciate, value, and guard their LVN/LPN licensures. Working toward small goals may be a way to making the time go a little faster. But it will also give you the necessary confidence and "information" you need to decide if Nursing is were you want to be. So what happens if you get to be an LVN and you start practicing, only to find out you don't like it after all. Well, in places like California, you can challenge the board (with some additional classes - a few you can pick up at a JC that offers them) to become a "Scrub Tech". Which opens up a whole new world to the medical profession.

Don't just quit, just because of the poor attitude of a "manager", who should be using therapeutic communication with patients and ALL staff (including UAPs). Unfortunately, that is the reality of nursing - a lot of bad eggs will get through only to practice everything that they were taught to avoid. YOU CAN get through this! YOU CAN make a difference in your life and in the lives of others. It all depends upon how badly you want it. I hope that this has given you some ideas and encouragement to carry on. Best of luck to you in all your future endeavors!

(Just remember a nurse will forever be a student...that is the profession we are in...the moment you actually believe that you are the sum total of all wisdom and truth - you have just screwed yourself and your patients). It's good to be confident...condfidence always needs a little support every now and then...cocky is something totally different.

Sincerely

A Fellow Student stuck in the "scut".

sprintin08 · Jun 6, 2009

thank you very much responding. i really appreciate it. my job is only for the summer before i go back to school so hopefully ill start to get more comfortable. i think the main problem is that i am very doubtful of my abilities to do things correctly. i havent done anything really "wrong" yet so idk why i am so tense and nervous. i am like this in pretty much every aspect of life though, so i guess i just need to work on fixing it. becoming a nurse really means a lot to me so i just hope i can get more comfortable eventually. just the thought of having someone elderly person's life in my hands while trying to help them do something as simple as getting out of bed (let alone when i graduate having to give them meds and stuff) is really nerve-wrecking in my mind... im so nervous about hurting them that i cant concentrate on anything else.

LinzyRN · Jun 6, 2009

I worked as a student tech one summer full time. It was hard dirty work but I wouldn't trade it for anything. The skills I learned helped me through nursing school and will hopefully make me a better team player as a RN. I know that I will never take a tech for granted, and appreciate the hard work they do. As for lifting a patient by yourself, I would not recommend this. I would recruit the nurse and the other techs on the floor, lifting by yourself will hurt you and potentially the pt. I think that I was offered my job as a graduate nurse because of my experience. Good luck!

Delta18 · Jun 6, 2009

Sprintin08,

From the sound of it, you are going through something that a lot of us have gone through. If you are being exposed to this field for the first time, then you have nothing to be "ashamed" of. It is good that you still have the "fear" in you. The reason I say this, is because I've had the opportunity to watch a few of my class mates in while I was in my 1st and 2nd year make total fools of themselves in regards to cockiness. It is what I had mentioned before, you will slowly gain confidence. But confidence should never ever be replaced by cockiness or a willingness to do what you are not "cleared" to do by your level of instruction. Case-in-point, you are being shadowed by your instructors and by your preceptors at your clinics/hospitals - you are ultimately practicing under their license. It does not mean that you can do everything that they are licensed to do. A classmate of mine ended up giving a narcotic IVP when our instructor was not with him, all because a nurse who wanted to get things done fast - blindly asked if he could do it. He said sure. Suffice it to say we lost that facility for our school, and he was expelled from the program. A great deal of humility and confidence go a long way in seeing you to your success.

As far as your "fears" are concerned - they will start to fade with time. But you will be surprised that new ones will pop up, but your experiences will help you deal with adjusting to them. I am speaking from experience. (This was ONE of my many "trying" moments) I was assigned to care for and move an elderly patient who was demented and was status post Hip Surgery because of a fall at the local SNF. The patient was combative and very incontinent. I know that this may seem like a made up story, because so many nurses have their "moments" to share. Still though, many of us have had cases like this where all with similar feelings of bewilderment ended up kicking us in the gut, because of the "fear". This is where your inner "chicken" should start feeling like "Oh, crap...now what because I feel like peeing myself silly". What you can do is Step back physically (if you can) and do it mentally before you attempt anything. Know what you can do; remember what you've been taught; and use the (now) experience to learn! Actively LEARN - that is nursing. Oh, and it sounds like maybe "endurance" and strength may be a fear for you. You might want to take up an exercise routine, running and toning your upper body will go a long way for your life in the clinic. Why running - endurance...Why toning - because it helps with the moving and lifting. Plus, the extra energy and O2 go a long way at helping with the long nights studying. By the way, all the NCLEX books mention that you should do it to get you out of sitting in the "rut" that I mentioned in the previous post to you. Plus, while all your classmates are running around exhausted - you've got the "physical" part to hang in for a 12 hour shift.

Remember, you are not the only one out there...Even if it feels that way. You are alone when it comes down to something that goes wrong - so make sure you are doing things SAFELY for your patients and yourself - and the rest will come. Safety ensures that you become a nurse, it ensures that you remain a nurse, and it makes you a better nurse. Fear is a good thing, it makes you know that you are human and very aware of your limitations. But you shouldn't exaggerate your limitations to the point that they become debilitating obstacles. Best of luck making your way through this part of your life...make a decision that you know you will not regret years from now. That decision is still up to you.

Good Luck

kkk222 · Jun 6, 2009

I know how you feel. I am a student nurse who took on a Nurse assistant job for the summer on med surg gero floor. I wish I hadn't because it is now making me second guess the whole nursing thing. However, what is getting me through it is the thought that this is great experience, it will help me with my classes, and hopefully it will help me with getting the job that I really want when I graduate (to be an L&D nurse). Also, I am making a ton of money!! I bet you are too. Just think those thoughts when it gets rough. I messed up the other day with a colostomy bag and got yelled at by the other NA, I left the hospital after my shift in tears but my mom and dad said "you are learning!" It's true, I just started and it was my first time working nights. So by making that mistake, I now will never ever make the same mistake and remember to be more careful.

Daytonite, BSN, RN · Jun 6, 2009

you're post reminded me so much of my nursing aide experience as a nursing student! i worked the weekend night shift in the second year of nursing school in a nursing home. i worried about everything back then and was always scared i would accidentally kill someone. the aides i worked with were older and very experienced. i only knew what i had been taught in nursing school and was determined to practice what i was learning. it was a lot harder than the textbooks made it sound like! and, the aides just kind of stared at me when i did things "differently" according to them.

you have to use good body mechanics when moving patients and encourage patients to do as much independent moving on their own as they can and then patiently wait while they move because they are slow. the more they can do for themselves, the better it is for them and for your back. if you have patients that you know you are going to have to turn or lift during your shift be prepared for it from the start. get turn sheets under patients that you will be turning with your first round. use the lifting equipment that the facility has. stay over one morning or come in and talk with the physical therapist about specific residents that you are having concerns or difficulties with moving. the physical therapist is not only your resource, but should also know these individual residents and is there to help the staff and the patients. they will also know what equipment the facility has to lift and move patients and show you how it is used. explain your concerns to the physical therapist and ask for advice.

lastly, talk with your instructors. think about how you would handle this if you were the director of nursing and someone else were in your shoes and was a new nursing assistant worried about lifting patients on their own. what education do they need about lifting and moving patients? where would that information be found? who could they talk to for the information? what books could they find this information in? when you are an rn part of your role will be to educate and train those working under your direction. your current boss may have failed you, but that does not mean that you will when your time comes.

sprintin08 · Jun 6, 2009

thanks again soo much to everyone that responded. i really appreciate it and its nice to know that other people have felt the same way i do!!! i really hope i slowly become comfortable at the job this summer b/c i am really passionate about becoming an RN so hopefully this will all work out b/c i do not have a second choice for a career lol! and like i said, i only have one year of nursing school down so far so i still have 3 more years before i get my degree to get more comfortable. thanks again it was really helpful to read the responses :)

Delta18 · Jun 9, 2009

thanks again soo much to everyone that responded. i really appreciate it and its nice to know that other people have felt the same way i do!!! i really hope i slowly become comfortable at the job this summer b/c i am really passionate about becoming an RN so hopefully this will all work out b/c i do not have a second choice for a career lol! and like i said, i only have one year of nursing school down so far so i still have 3 more years before i get my degree to get more comfortable. thanks again it was really helpful to read the responses :)

As I mentioned above, if you have indeed completed the 1st year of an RN program, you should have classes under your belt that could merit you a chance at testing for an LVN/LPN licensure. Depending upon where you are though, there maybe a few other requirements by the board. But if you are able to challenge the board, then this would definitely give you an advantage at a more advanced position with better pay. Plus, the added experience of working in a "closer" capacity to the RN's on-board will give you more of an advantage with your education. Just a thought. Remember, depending upon how "eager" you are - look toward as many opportunities that present themselves to you - because not everyone is aware of them and some shy away from them (saying stuff like, it's too hard to do concurrently - knowing your limitations is great, applying someone else's limitations to yourself is just ridiculous). Remember safety for your patients and yourself. But never turn down even the most "menial" of certifications or "add-ons" to your license. It all adds up. Hopefully, you are more encouraged to reach down deeper into yourself to find that nurse in you. Just remember, 1+1 =2 and 2+0 = 2; same result just a different route to get there. Good luck!