does it help to have CNA experience in clinical nursing school

**RosesrReder, BSN, MSN, RN** · Aug 30, 2005

I have asked this question at school as well and most people tell me that it does help a lot during the first semester. After that everyone is in the same boat (learning wise). I will have to see when I get there. Best of luck to you :)

mandrews · Aug 30, 2005

I never had any experience and they taught me everything I needed to know in nursing school.
I did notice those who were CNAs or LPNs already did seem to be more organized and comfortable, and I fumbled about at first. So it definately an advantage, but not necessary.
Good luck to you.

I agree with tweety. The students with cna and lpn experience were more comfortable especially the freshman year. When we got knee deep into the nursing aspects it was all new to them also ( especially cna's), meds, assessments, careplans, etc. LPN's fared better because they were familiar with charting and meds, DEALING WITH THE DOC'S, etc.

I had no experience and I am doing fine and you will too. :)

melissa

elthia · Aug 30, 2005

I'm confused by that too. By "detaching" are you insinuating that they have a hard time separating wiping butts/doing bed baths from delagating those tastk to the butt wipers/bed bath givers? :rotfl: If so, that's one of the most hilarious things I've ever heard of. :

Not quite so funny to me...but then again I was hired as an RN on a floor that I had worked on as an unlicensed staff member...so delegation WAS extremely difficult... and had a lot of attitudes to overcome. And I've talked to others I graduated with that were CNA's/health tech's and they said they also had problems with delegation (the if you want it done right, do it yourself attitude and the it's MY patient attitude.) It took awhile for me to realize it's better to delegate and keep up on the RN duties, than NOT delegate and get behind. Anyone can do the CNA stuff, but onlythe RN can do RN duties.

Daytonite, BSN, RN · Aug 31, 2005

What do you mean they have trouble detaching from their CNA roots? I am also a nursing student who was a CNA for over 20 years. I am just wondering now if there is something I should be doing to "deprogram" myself now to be ready for my new position?

Well, I wouldn't go so far as to call it '"deprogramming". What I am suggesting is that it is human nature to regress into behaviors that we know, are comfortable with, and give us a sense of satisfaction. As a CNA of 20 years you know how to do basic nursing care of a patients, yes? Do you think you will feel as comfortable the first time as an RN you have to decide that you need to call a doctor for one of your patients to inform him and to ultimately get an order for something? I guarantee that your heart is going to be pounding, your breathing a little faster and somewhere you will be aware that you might be sweating! You're going to be thinking, "am I doing the right thing here" because you will be a little uncertain. It only takes a little bit of uncertainty to set off these physiological manifestations of stress. Those are terribly uncomfortable sensations for anyone to endure! Yet, as a new RN (and as a nursing student) you are faced with these reactions by your body many times every day.

Now, which would you rather feel? That sense of self-esteem and confidence when you (very efficiently, I'm sure) give that bed bath or take care of a patient's elimination needs? Or, that uncertain and uncomfortable stress of calling a doctor to get an order? Now, be honest here and think about the situation. Our instincts want to guide us to do the less stressful--give the bath, give a bedpan. Whew! That's much easier! I did something for the patient. I knew what I was doing and did it well. You have performed at a comfort level that you like. But, you and I both know that you will never become proficient in your new RN job that way. You have to dig in and get your feet wet despite how uncomfortable it is going to be.

What I was referring to in my previous post is that some new RNs in an attempt to get that comfortable satisfied feeling will fall into the trap of continually doing CNA or patient care tasks that they have already mastered and feel confident and comfortable doing. They justify this by saying "I'm helping out my aide." "Those lazy RNs never helped me when I was an aide and I'm not going to be that way." At the end of their shifts they are incredibly tired. At the end of doing this day after day, week after week, they burn out. Their view of nursing has changed and they nearly start hating something that they once loved.

Some new RNs want to keep busy and when they are stymied or just don't know what some of the RN tasks are that they should be doing resort to doing (a lot) of basic nursing care. I can find all kinds of RN stuff to do during an 8 or 12 hour shift and still not take a break or lunch. And, none of it will be CNA work. Newbies doing their aide's work satisfies their idea of keeping busy all the time. But look at what happens over time. (1) as new RNs become more and more acclimated to the job and start to take on more and more RN responsibilities, they really don't have time to do that basic nursing care that their aide now expects them to do. They either continue to do it because they can't get out of an established pattern or they don't want to look bad to their own aides. Burnout and disappointment with career are right around the corner. Even worse is when (2) the other experienced RNs they are working with begin to notice that the new RN isn't working up to par as an RN. She's forgetting (or just not doing things), not following up like she should, leaving IVs or doctors orders for someone else to finish up (the list goes on). There is grumbling among the other RNs. No one takes the newbie by the hand and tries to help her out because they feel they don't have the time or it just never occurred to them. They do something that is just human nature--they start to distance themselves form her. You'll hear it in the posts on this site. "Everyone is acting like I have the plague." "Everyone is giving me a hard time." "No one will answer my questions." "Everyone is giving me attitude." These more experienced workers are playing the psychological game of "you' have to guess why I don't like you as a co-worker anymore". That is their way of "telling" her that she doesn't fit in, that she ought to just go away because they don't want her there anymore. It's wrong of those people to do that, but it happens all the time. What have you seen over your 20 years as a CNA when a new CNA just didn't fit in or wasn't learning to organize her work well enough to get it all done? Were you patient and did you help her out again and again, teaching her as you helped her? Or, did you sit with the other CNAs and grouse and complain about how you had to do her work or wonder when they were going to show her the door?

New RNs, like in any profession, need guidance. Many are very fortunate to get good mentors and preceptors who, like loving parents, patiently teach and lead them through their early days. Some, unfortunately, get stuck with poor role models who give up on them easily and who just aren't nurturing. These poor souls are left to pretty much fend for themselves. No one tells them when they are doing things inefficiently. For awhile, no one tells them about the things they are failing to do until they end up in a "big meeting" with a manager where she learns, like a slap in the face, that she's not performing as expected. This kind of treatment is wrong, wrong, wrong. But some are just not aware that they are receiving poor orientations. A call to a former nursing instructor would be a big help, but who thinks of doing that? To keep their emotions at an acceptable level, they won't step forward to question or confront. Questioning and confronting someone who has a great deal more experience is an emotionally shattering experience for some, especially the very young nurses. We old timers can kind of hold our own because of the life experiences we've had.

The fact of the matter is that you are pretty much taught most of what you need to know to get you started off as an RN in the job world. However, it is difficult to apply some of these things if you've never actually experienced them. Skills you don't use, you will forget. This is why I say new RNs should keep their textbooks and notes from nursing school where they can refer to them from time to time. New RNs have a great deal of emotion to deal with as well. You will experience it also. Some people are very talented at keeping their emotions in check and letting logic take over. Others are not. But to conquer this they have to recognize that it is happening to them.

The other fact of being an RN is that there is a big difference in the job duties of a CNA and an RN! That is why you are learning the RN role in a college program. RNs have a lot of responsibility and decision-making they have to do about things that are way out of the realm of the nursing aide. Once you become well acquainted with what is required of you as an RN, you will be prioritizing not only your work, but the work of any subordinates under your supervision.

Do you have to deprogram? No. You have some unique knowledge to help you make some decisions at your new position. Recognize that you are going to be doing things that will be uncomfortable at first, but you have to make your way through them. Recognize that it is human nature to slip back into doing things that we feel most comfortable and satisfied doing so you can stop yourself when you realize you are falling into that rut. And, it is a rut. Ruts are hard to get out of.

When a child learns to do their ABCs they repeat them over and over. It is the sense of accomplishment that drives them. As they are being taught to learn to use their ABCs to make words and eventually read they often go back to running off the alphabet. Kids will read their favorite books over and over again because of the emotional satisfaction it gives them. It's a little different when they are presented with more difficult reading--that takes some struggle, and it is easier to override an undesired emotion than one that is fulfilling and satisfying. And so this cycle goes. Eventually with proper instruction and support they can read a newspaper! But, if they are allowed to continue at the level of reciting their ABCs they will never learn to read a newspaper. Learning nursing and the job of an RN or LPN is not any different, just different circumstances.

I hope this gives you something to think on. My 30 years of experience as an RN, supervisor and manager is where I draw these thoughts from.

tyler · Aug 31, 2005

Well, I wouldn't go so far as to call it '"deprogramming". What I am suggesting is that it is human nature to regress into behaviors that we know, are comfortable with, and give us a sense of satisfaction...

OK...back to the OP's question...

Regardless of what Daytonite was saying, I've found that working as a PCA while in nursing school has its advantages. I work my tail off on the floor and the nurses, in turn, take time to show me new skills, situations, and patients (knowing I'm in school) to which I would not have been exposed were I not a PCA (what our hospital calls a CNA). I consider it a leg up on the rest my classmates. Furthermore, many RNs will have to manage CNAs at one time or another and understanding, first hand, what your subordinates' job responsibilities are can only help you be a more effective manager.

My :twocents:

ty

Reddy,RN · Sep 1, 2005

Daytonite, you gave me a great deal to think on and I thank you.

AuntieRN · Oct 4, 2005

Thank you daytonite. I know you are right. I am scared to death to be out there on my own. I already had myself in an "RN" position when I had a patient go unresponsive on me. My first thought was this is ok...I'll just get the nurse...then real quick I realized I was the nurse...that scared the you know what out of me...this must also be why the other day I felt soooo guilty asking the CNA to help my patient get washed up and change her bed...I honestly and truely did not have the time to help her do it. We were told this semester we are not doing on hands patient care like bedbaths etc because we do not have the time..I found that odd until my second day at clinicals...she was not kidding I did not have the time..between the IV meds, all her morning meds, dressing changes, she was on isolation, FSBS, charting and q2 hour assessments OMG...I was standing there thinking...how did I used to take care of 15 patients at night...I hope when I get out of school I get a preceptor as sweet and helpful as you are. thank you sooooo much for making me realize it is ok to not have the time to do a bedbath and to ask the CNA to do it...I was one of those nursing students who swore they would never do such a thing...but I guess I will have no choice sometimes.....

**RosesrReder, BSN, MSN, RN** · Oct 5, 2005

I never had any experience and they taught me everything I needed to know in nursing school.
I did notice those who were CNAs or LPNs already did seem to be more organized and comfortable, and I fumbled about at first. So it definately an advantage, but not necessary.
Good luck to you.

I really needed to hear this Tweety too. I have always begged to differ to the one's at school who degrade those of us who are not CNA's

Jess