nursing clinicals and glorified cna work

ThePrincessBride, MSN, RN, NP · May 25, 2013

It depends how far you are into your schooling. In our first semester, that is what we mostly did was CNA care, but by our second semester, we were passing meds, inserting / dcing foleys, performing wound care, etc ON TOP of CNA work.

Believe it or not, RNs/LPNs still do plenty of CNA work, especially since some facilities don't have aides or don't require them (ex: ICUs where nurses have very few patients and can do total care).

I work as a PCA (have over a year under my belt), but I have no problem doing PCA work at my clinicals. It is part of the learning experience, and you'd be surprised how few students have performed CNA skills pre-nursing school

Anoetos, BSN, RN · May 25, 2013

Common nursing procedure work (foleys, IVs, NG tubes, lab draws, etc) are the second easiest part of the job. The easiest things are the "core nursing work" (or, CNA work if you like, which is why we employ CNAs to do them), but by "easy" I do not mean not time consuming or physically undemanding, they can be both, and they must be done right. But do them enough times and muscle memory just kind of takes over, and all you have to expend mental energy on is problem solving, and problem solving is where good nurses butter their bread.

So, for where you are now, just suck it up and roll on, it's all going to get a lot muddier very soon.

carolinapooh, BSN, RN · May 25, 2013

I can empathize with you even as I think you're taking the wrong approach. I bet you have a few classmates who are completely lost. Maybe it would help you out to help THEM out - with six years' experience as a CNA I'll bet you're an expert on a lot of that sort of stuff. Offer your knowledge to help others if you see them struggling.

I know there's a lot of stuff I go to my techs for help with - they know ALL the tricks. Having trouble getting a bed changed with the pt in it? Get a tech to show you the tricks! Can't get someone positioned right under a bedpan? Ask a tech for tips. And no, I don't dump the job on them, I ask for help. We tend to lose touch with that sort of stuff as RNs.

Mewsin · May 25, 2013

I'm a CCA and I'm trying to teach my classmates that the CCAs will be a great asset to us and to not dismiss them as lower than we are and not as valuable. The work they/we do is so important, and even as a nurse we will need to pitch in and help, afterall it is for our clients we are doing this. The nurses, I have worked with, who are "above" MY type of work are really not good nurses.

And yes, my first set of clinicals is all personal care, I can hardly wait to get started. Getting up 1 person from 7-8, lovely. I'm sure I'll have time to help my classmates who are not aides as well.

megank5183 · May 25, 2013

I was a CNA all through nursing school....I was SO excited to graduate and not ever have to do CNA work again:sneaky: Of course, I started I got a job in an ICU with no tech. ICU nursing was actually way grosser than CNA work and more involved because the patients can't help you at all. Point is, you sign up for nursing, it is pretty hard to totally avoid the nitty gritty stuff.....

ArrowRN, BSN, RN · May 25, 2013

Im in clinical rotation and it seems like all I do is glorified cna work...I dont pay thousands of dollars for school to do cna work (Ive been a cna for over 6 years now) ...I want to learn core nursing skills so my question to you all is,is all clinicial rotations like this?
The nurses I work with dont do cna work so why are we the students expected to do the cna work? Cant all the ADL's be delegated to the cna? (sorry if i sound negative but I really want to know the answer so I know what to expect.
Thanks

Don't fall into the same trap I did.

I just finished my first semester and for my clinicals that was all I thought I had to do and I too was becoming irritated. Next thing you know the clinical instructors is asking us all sorts of nursing questions and what we did for the day to actually improve the patients conditions. Also she had some people doing actual nursing procedures and really did not communicate the expectations of what we are really suppose to do. But you can't do any procedures if you don't know how to do it can explain what to do and explain the rationale why you are doing it and understand the side effects.

My advice is the get as much of the "CNA" part done early and incorporate nursing theory into it and then what you need to do is stop thinking like a CNA(task oriented) and start thinking like a nurse and doing things like a nurse(rationale oriented). A CNA does a bunch of tasks. A nurse knows the rationale behind doing those tasks. So even though they can be delegated then does not necessarily mean the CNA knows why the task is being done. Are you allowed to look at the charts? do you know all the meds on those charts and what they do, why the patient takes them? do you know why your patient is the way they are? find out, do that, see what is going on with the patient, find out if there is any basic procedures you guys are able to do with supervision. We were able to do insulin shots, IM injections tube feedings,dressing changes and a lot of basic stuff in addition to what you may call "CNA work" which is actually nursing work by the way.

I've learned that clinicals are what YOU, the student makes it to be. If you want it to be just CNA work then you won't get the full experience. Let me get you an example. A CNA knows that say an immobile elderly patient needs to be turned every 2 hours. But can you say why? ok yeah to avoid bed sores? why else? what are the stages of bed sores, how are bed sores treated? is it sterile or unsterile? with medications does a nurse use to clean bedsores? how is this all done? how often?

ok the CNA does not bother with most of those questions, but those are the questions you should be asking, finding out and expanding yourself to think critically and this is what I mean by thinking as a nurse. While you are doing your "CNA" stuff are you assessing the patient? and you observing and are you asking questions? do a full physical examination while bathing them, do anything to expand your knowledge. Are you trying to figure out what nursing interventions a registered nurse would want to do ? are you right in your deductions? are you bugging your instructors with these questions? or are you just thinking its another patient poop i gotta clean up? Are you just cleaning up poop or are you look and noting its color? observing for signs of blood? understand what medications affecting it texture?

Also if you still feeling bored, don't EVER stand around at the nursing station, look for the busiest nurse, CNA anybody, shadow her and bug her with questions. Don't take their answers as gospel...go back to your textbooks research and find the answers yourself.

If the instructor ain't giving you stuff you do, make stuff for yourself like care plans and nursing diagnosis. Be observant, take notes, watch what the nurses are doing. Trust me, there is more to clinicals than you realize.

Ok so you can't pass meds and you can't do a tracheotomy but you can, reposition your patient and see if it improves their breathing, you can get them something to drink and understand how that is going to affect their electrolyte balance. you can take vitals signs every 2 hours and understand why its done. There are many things a CNA does that is a critical part of the nursing care so start expanding yourself, you head should be spinning with ideas and overwhelmed by the clinical experience.

The only limitation in your clinicals is yourself.

Edit: In addtion to the above, based on what others say, you should be a great asset to your class. Some of your classmates probably never ever seen no one but themselves without clothes, so giving a simple bed-bath could take you 10mins and them 1 hour, so help them out, let your instructor know you are helping them out. Take the lead and the clinical instructor will put you on a pedestal.

MorganB · May 25, 2013

1st semester is as you called it glorified cna work. I guess I didn't think of it that way. I figuredit was foundational, Though I did bathing, toileting etc I also passed meds, gave injections, fed patients, vitals, in addition to suctioning, primingivs, trach care, cath etc. Heck I was just happy for the opportunity, You should be elated that you are doing glorified cna work as you call it. You should have used it as an opportinity to help your fellow nursing students perfect what you already know. There's no shame in hardwork. The other skills will come. But honestly there will be times as a nurse where you revert back to your cna skills. Suck it up and enjoy the ride.

LightMyFire · May 25, 2013

While we try to find "nursing" stuff for students to do, sometimes there's no one who needs a foley, NG tube, or new IV started. It's irritating to have students refuse "CNA" tasks and just sit around doing nothing because all they want to do is skills. There's always something to do as a nurse, even if it isn't exciting.

ixchel · May 25, 2013

Forgive me, but I think your attitude is a bit appalling. I absolutely adored the time I spent in med/surg doing "glorified CNA work" and was excited to be side by side with the CNAs. The demeanor in your OP feels very much like you feel being a student nurse gives you some kind of status above CNAs. When you've worked as a CNA, have you enjoyed working with nurses who felt they were somehow better than you? Do you think CNAs will enjoy your delegation when you are looking down your nose at them?

Honestly, I loved helping with ADLs. I loved finding ways to make the day easier for my nurse and CNA. I was an extra pair of hands, and an asset to helping all of the patients they had have a better, more comfortable day. Adjust your thinking to see it this way, and your nurses and CNAs will not only love having you in their work space (don't forget that we are their guests, and many times in their way), but they will go out of their way to make sure that you do get opportunities to do more things that are in the RN's scope of practice, and they'll be more than happy to answer questions you need for your care plans. They'll give you a heads up if you're about to miss rounds. They'll tell you when a patient is going for an interesting procedure so you might tag along. They'll hold their IV meds or suctioning so you can do it. Be a team player, and they'll include you in their team. Not one part of the nursing team is above doing the "glorified CNA work". Perhaps this is just a case of you feeling underwhelmed so far, but patience will pay off, and you can't make the mistake of feeling the work of a CNA is worth less than it is to the RN's success in patient care experiences.

nurseprnRN, BSN, RN · May 26, 2013

Don't fall into the same trap I did.
I just finished my first semester and for my clinicals that was all I thought I had to do and I too was becoming irritated. Next thing you know the clinical instructors is asking us all sorts of nursing questions and what we did for the day to actually improve the patients conditions. Also she had some people doing actual nursing procedures and really did not communicate the expectations of what we are really suppose to do. But you can't do any procedures if you don't know how to do it can explain what to do and explain the rationale why you are doing it and understand the side effects.
My advice is the get as much of the "CNA" part done early and incorporate nursing theory into it and then what you need to do is stop thinking like a CNA(task oriented) and start thinking like a nurse and doing things like a nurse(rationale oriented). A CNA does a bunch of tasks. A nurse knows the rationale behind doing those tasks. ...
I've learned that clinicals are what YOU, the student makes it to be. If you want it to be just CNA work then you won't get the full experience. Let me get you an example. A CNA knows that say an immobile elderly patient needs to be turned every 2 hours. But can you say why? ok yeah to avoid bed sores? why else? what are the stages of bed sores, how are bed sores treated? is it sterile or unsterile? with medications does a nurse use to clean bedsores? how is this all done? how often?
ok the CNA does not bother with most of those questions, but those are the questions you should be asking, finding out and expanding yourself to think critically and this is what I mean by thinking as a nurse. While you are doing your "CNA" stuff are you assessing the patient? and you observing and are you asking questions? do a full physical examination while bathing them, do anything to expand your knowledge. Are you trying to figure out what nursing interventions a registered nurse would want to do ? are you right in your deductions? are you bugging your instructors with these questions? or are you just thinking its another patient poop i gotta clean up? Are you just cleaning up poop or are you look and noting its color? observing for signs of blood? understand what medications affecting it texture?
Also if you still feeling bored, don't EVER stand around at the nursing station, look for the busiest nurse, CNA anybody, shadow her and bug her with questions. Don't take their answers as gospel...go back to your textbooks research and find the answers yourself.
If the instructor ain't giving you stuff you do, make stuff for yourself like care plans and nursing diagnosis. Be observant, take notes, watch what the nurses are doing. Trust me, there is more to clinicals than you realize.
Ok so you can't pass meds and you can't do a tracheotomy but you can, reposition your patient and see if it improves their breathing, you can get them something to drink and understand how that is going to affect their electrolyte balance. you can take vitals signs every 2 hours and understand why its done. There are many things a CNA does that is a critical part of the nursing care so start expanding yourself, you head should be spinning with ideas and overwhelmed by the clinical experience.
The only limitation in your clinicals is yourself.
Edit: In addtion to the above, based on what others say, you should be a great asset to your class. Some of your classmates probably never ever seen no one but themselves without clothes, so giving a simple bed-bath could take you 10mins and them 1 hour, so help them out, let your instructor know you are helping them out. Take the lead and the clinical instructor will put you on a pedestal.

I wish I could like this twenty times over.

I had a student once who was a very experienced CNA. She was one of those who was very skilled at CNA tasks and made it really clear that she "knew everything a nurse did, she was just in school to get the credential."

So one day I found her in the nurses' station at 0900 reading a magazine. A nursing magazine, but still.

me: "What are you doing here? What's going on with your patient?"

she: "Oh, he's all done up," meaning that he's been bathed and changed and breakfasted.

me: "Get back into that room and be there. Even if all you do is sit and talk, go be with your patient."

she: Shoots me a look that would etch glass but stomps off to the room. And about three hours later comes back almost in tears. Turns out her patient had recently been given a terminal diagnosis, and nobody had had the time to just sit with him and let him talk. It took about half an hour of near-silence to get up the courage to do it, but he finally started. He talked about his family, his fear, his loneliness at having to make decisions...she ended up holding his hand, and he ended up thanking her for being there for him.

And that, I told her, is why I say not to mistake what tasks nurses do for what nurses are. Naive students often complain about "glorified CNA work" but that's their ignorance and inexperience speaking. There are none so blind as those who will not see.

loriangel14, RN · May 26, 2013

[ Also if you still feeling bored, don't EVER stand around the nursing station, look for the busiest nurse, CNA anybody, shadow her and bug her with questions]

Good suggestion but I was REALLY busy and someone was peppering me with questions they had better be helping me as well. Sitting at the nursing station isn't good but neither is just watching someone that is really busy without offering to help.

I have said before that the nursing students that make the best impressions on staff are not the know-it-alls but rather the ones that are on time,don't play on their cell phones constantly, offer to help others and don't stand/sit around while bells are going unanswered.

HippyDippyLPN · May 26, 2013

Sometimes I can't wait for the first semester of RN school because it will be really great actually spending time with patients, helping them feel a bit better with a proper bath or doing a bit of nail care on one who has not been pampered in a bit, instead of the pill pushing job at the AL I PRN at. I miss my CNA role at various moments. As a LPN I feel like I can never do enough and as a CNA I mostly always left feeling good that I did all I could do for my patients. I say enjoy the aide work while you can.