sorry for the length.
I worked as CNA throughout nursing school for 2 years. One of the MAJOR reasons that I got my RN job on the same floor was because of my work ethic and my skills as a CNA. I'm not gonna lie. with 14-21 patients, you may find yourself behind many nights until you get a system down. Don't let them throw you under the bus, let your orientation go slowly, and don't take a full group until you're ready. That's a lot of people.
Not sure of your hours, but I worked 5p-5am and this is how I worked. I would get on the floor at about 1640, pull up a list of the patients already on the floor(ask someone how to get this, as it will help you organize), look at a staffing sheet, see how many admits were still to come, which patients were to go home, and which ones were probably mine based on my room assignment. I could have 1-2 RNs for all my patients, or all 5 could each have a few. I always wrote down which RN had what patient, helped me know who to go to.
I got a manual bp wheeled cart(as any abnormal VS on a dynamap will require a manual one anyways-might as well save the extra trip), thermometer, pulse ox handheld, glucometer, all before report(kept it near me like gold). We did walking rounds, which based on the day could be long or short. depending on the number of incontinent patients, I would often just ask the offgoing CNA to help me check/change those patients as we did report. (that way I was good for about 2 hours).
To start off, I would make sure that I started at the beginning of my assignment and did their VS, required tasks, making sure that they had anything they needed, and informing the RN right away of any abnormal VS(temp above 98.6, pulse less than 60 or above 100, bps of SBP<100 or >150.) NOT when I was done with vitals. It was a lot of walking, but the RNs appreciated that I could tell them right away.
As I got vitals, I answered my call bells, and helped the other CNA if they asked and I could. charted VS right after I was done.
I worked on a orthopedic unit. at 1945, I started getting glucoscans, and also puttting patients on their CPM machines(we did 2 hours from 8-10pm). I'd take them to the bathroom, and while they were there, I might have gone next door taken them, come out and gotten the 1st one back to bed. Once everyone had their CPMs on, I would look at my sheet and figure out who needed a bath on the night shfit.(usually any total care patient was done at night.) While the other patients were moving on the cpms, I would give 1-2 baths. By 2115, I started getting vitals again on anyone who wasn't a CPM patient. then I would go through, take off the CPMs, and get vitals on each patient as I took them off. (tip- learn how to take a good radial pulse...count for 15 seconds and multiply by 4. saves a lot of time. Also, if you are trying to distract someone, and tell them to squeeze your hand, cross your middle finger over your pointer finger. they can't hurt you that way.)
After getting done, and having everyone in bed, I would chart the next set of vitals. I would take a break, answer call bells until the morning rounds, and get vitals/empty foleys, etc. in the am about 2-3 am. my shift ended at 5am.
Take out your garabages during your middle rounds. keep your rooms picked up. number 1 pet peeve is a dirty room with a lot of linen around.
I really hope your expierence is a good one. I learned a lot as a tech that I use everyday as a RN. I still answer call bells, I still take patients to the bathroom, I still give baths if the CNAs are swamped. I shave all my male patients if I need to.
the number one rule of a good CNA: patient care comes first.
Don't lie to the nurses, if you forgot something, admit it. If you have concerns, bring them to the nurse. and don't ever think that "all the nurses do is hide on the computer, and sit most of the shift." we have a lot of charting, checking, assessing, and records to look though. sometimes we have to figure out when to do what, and when to give certain meds. sometimes we're concerned and we're trying to find out best course of action.
Good luck. and EAT before your shift so you can make it through!