Horrible time at clinicals

[dancingpre]

Hi. I'm in serious need of a reality check I guess. I'm 2 days away from finishing my CNA course. The first part was classroom stuff - learning skills, lectures and tests. I went in to clinicals with a 98% average.

I knew going into the actual site and working with real residents/patients was going to be completely different than working with my classmates pretending to be patients. I consider myself very patient, I feel as if I talk slowly and use a kind tone of voice.

We went to 2 different clinical sites. One for four days, then the next for four days. The first site we went to our instructor was a woman who taught the class the whole time. The next site was an instructor that we met the last day of class before heading to clinical. When we got to the first place, we were thrown in. After signing the HIPPA statement, our instructor gave us our resident we would be providing complete and total care for, and then we were supposed to just jump right in. If one of the CNA's who actually worked there came in, our instructor would say "don't worry they'll take care of her/him today, we got this". For my first resident (sweetest lady) my instructor said she wore dentures. I went in the room, introduced myself and then started to find everything I would need (toothbrush, her brief, clothes, etc). Only found the top dentures that were absolutely disgusting and looked like they hadn't been washed. I cleaned them, and looked for the polygrip. Nothing. I wasted time looking. As I was searching, one of the staff CNA's came in so I asked where the polygrip was. Her reply "She wears dentures?" WHAT?! I said "They're in her drawer" SHE says "oh, well she doesnt wear them". Ok done wasting my time. Jump to bed bath, change the brief, get her dressed, take vitals, etc.

HOW DO YOU WORKING CNA's DO morning care for 9+ people??! Second day I had the same person. Went MUCH more smoothly and faster. We changed up from then on out and I thought I was getting better.

Apparently not! Moving to the next site - assigned to a man who was not all there (as many aren't..) but it was the first time when someone just refused to have stuff done! He was sleeping and when I tried to get started on the day he wouldn't respond to me or would yell "I SAID LATER". This new instructor pops her head in and tells me "just get it done". I try my best to coax him into waking up, brushing his teeth, making conversation. NOTHING. I went into his bathroom and just started crying. Why was I even taking this class? I already have a bachelor's degree; I should just be trying to find a job in that field. But no, I want to go to nursing school and this is a requirement. Finally I give up on the teeth for now and start undressing him to start a bed bath. He FINALLY "wakes up" and his actually cooperative. Instructor pops her head in again "HE NEEDS OUT OF THIS ROOM in 20 min!" (I know, all you working CNA's are prob like wth can you be taking so long getting him ready? right!?) The only male cna student comes in asking if I need help and I said I was about to put a new brief on, etc, and wouldn't mind help turning him to his side. GUY CNA gets resident to do everything he asks of him!? INCLUDING BRUSHING HIS OWN TEETH after I attempted once the bed bath was done. Resident refused to brush his teeth or let me do it. By the time I got him out of his room it was our lunch time and I was one of the first in the room! the way the instructor kept popping in yelling that i needed to hurry and get him out i thought was the last one still working! No, I was one of the first ones done.

The next resident I get couldn't form what she wanted to say and would try to hit people all the time. She wouldn't let me take her pulse and would scream and try to hit me. I remained patient and tried different approaches to get her to allow me to do it. Nothing. Another student comes over and all she says is "can I take your pulse to give to the nurse?" SURE THING! She gets it.

At the first site, cups were on the housekeeping cart. At this site...I always had extra cups already in the room. On the last day of clinical there were no cups in the room so I go out in the hall and first person I see is mrs. instructor, who gives me an outrageous look like why would I dare be out of the room if the resident was not yet ready. So I asked her "are cups on the housekeeping cart?" You would have thought I had 10 heads. NURSING CART, DUH. Then she asks me "is your room ready to get out of bed?" I said "Shes been sleeping while I've been doing everything and I need to do mouth care" Instructor says "you can do mouthcare when shes out of bed in her wheelchair" So I said ok. She says "so is your room ready to get up?" I said "well then yes, shes dressed and all that". Mind you, the mechanical lift pad was in this residents room the day before when I had her so when the instructor said "ok, go get the lift" I did not get a pad. Instructor wants at least 2 students doing the patient transfer so another girl goes in and starts raising the bed - instructor comes in and starts screaming "wheres the pad??? you can't lift without the pad!" DUH - I OBVIOUSLY wouldn't try to hook her up to nothing and try to lift her?! I didn't even get a chance to say "hey wait, pads not in here". So resident is in her wheelchair (still sleeping!!) and instructor says "take her to the activity room, she needs to get to the activity room!". Now I'm thinking, wait-I had already said I still needed to do mouthcare, so I say to her "do you want me to do mouthcare?!" She looks at me and practically rolls her eyes.

So in the end...instructor says to me "you can't even take care of one patient on your own when other classmates were doing 2". I said, well I was helping so-and-so (another classmate who had a resident in the same room as me) and then she says "well its the last day of clinical and you asked if mouthcare needed to be done - thats a given, were here to provide care". I wanted to SCREAM! I KNOW mouthcare needs to be done, when I said that I was really just TRYING to remind your IMPATIENT, PANICKING self that I still needed to do it! and THEN she says "and I can't believe you didn't know where the cups were!" I said "well they're usually in the room" she says "NO. they are never kept in the room" and I said "well i've always had extra in the room, i never had to go looking for them" (at least at this site). and then she tells me "and you CERTAINLY shouldn't ask your INSTRUCTOR on the last day where things are!"

then she told me "do I think you could go do this job tomorrow? probably not."

the end. I feel so defeated.

I feel slow, I feel like I can't get residents to respond to me no matter how nice and patient I am.

My instructors act like I shouldn't wait for them to be "ready" to start their day - JUST GET IT DONE. I know if this was for real I would have way too many residents to wait around for everyone to be ready - but I wasn't aware you just shove a toothbrush/food in their mouth or just start stripping them of their clothes to get started!

It seemed like I could get every other resident to smile and talk to me but my residents -the ones the instructors were watching me with - nothing. Its like I couldn't take care of them. I feel like I would just be awful at this job and an awful nurse.

Sorry this is so long. I hope someone reads it and lets me know "yes you should look elsewhere" or "its ok".

[mstearns09]

Have other people in your clinicals been reporting the same thing about the instructor? If this was your last day, I'd brush it off and not worry about it even though it has probably bruised your ego.

The thing is, when you're first starting out as a CNA, you aren't going to be SuperAide. You aren't going to be able to take care of residents as fast as a seasoned aide. This was the hardest thing for me accept when I first started a year ago. I often had residents still up at 10:30 at night even though my shift had ended 30 minutes prior. I constantly apologized to my fellow aides for being slow and most were understanding.

Some of your residents may have been resistant because you were someone new; they are likely used to certain people being in their rooms to take care of them and to a certain routine. You'll find that some residents are very flexible and some that aren't. You eventually figure out a routine as to how to work with them.

Lastly, don't let your clinical experience color your future as an aide. Again, most people will be understanding that with being new, you aren't going to be as efficient or fast as the other aides who have more experience. It takes time, practice, trial and error, and patience. Despite the fact that I work in the same facility where I did my clinicals, it was still very different for me to work the floor as an actual paid aide than as a clinical student.

[Boog'sCRRN246, RN]

It's okay. I think your last instructor sounds a little over the top in her reactions. Clinicals are nerve-racking to begin with, but when your instructor isn't approachable and just barks orders or dismisses valid questions, they're even worse. Sometimes you can't "just get it done." You can't force someone to get out of bed, get dressed, brush their teeth, etc. if they don't want to or aren't ready to. You can ask nicely a couple times, but after a certain point, you just have to move on to the next one and come back later. CNA clinicals are extremely short. Don't make decisions about your future career based on eight days and this one instructor's opinion. It will get better...and easier...and you'll learn ways to manage your time efficiently, I promise. :)

[Hygiene Queen]

It's an art.

You learn (over time and many bad experiences) how to motivate your patients, communicate, organize your time and tricks of the trade.

You gather information as you go-- what has worked and what hasn't-- and apply it to each individual patient.

You learn to speed up between patients and slow down when you get to your patient.

You learn what makes each patient tick and work within that patient's world.

You learn what two (or three!) tasks can be done at once and which ones are more important and need to be done first.

After awhile (after working with many different types of patients) you can look at a patient you have never ever seen before, and get a good idea how to approach and work with that patient.

You learn from you failures and gain confidence from you successes and eventually put it all together.

The key is to keep your patients safe as you learn and grow.

It is not realistic to expect perfection right away.

If you stick with it, it should come.

If you give up, it never will.

I know that negative comments pushed me harder and I eventually blew the nay-sayers out of the water.

But... it takes time.

Also, you will learn how to be assertive with care without being aggressive.

Time, my friend... time.

P.S.

The generous side of me thinks your instructor is giving you a dose of reality.

Caring for patients, as you now know, can be hard.

I had an old-school nurse for my instructor.

I called my CNA training "boot camp"!

You got the message you need to be more assertive, improve your communication and learn to manage time.

Take that message to heart (ignore the delivery) and work on those things.

But perfection comes later...

Hopefully, you have a realistic instructor who realizes this, if not, I'm sorry (and I mean that).

Cheers.

[mvm2]

Cant personally give you any advise, but just wanted to give you a (((HUG)))) and tell you that it seems that you have the right caring attitude, and when you land that job you are going to be a fine CNA

[loriangel14, RN]

Sounds like a pretty typical day in clinicals when you are new.Nursing clinicals can be much the same.

[havehope]

You aren't the only one that feels the way you do. I just started working as a CNA in late June and I had one of these kinds of days yesterday and now never want to return. I wanted to cry all day! But...Hygiene Queen gave some good input. Perfection comes with time. I still don't know how to work with patients that are determined I will not do anything for them. I had two of those patients yesterday. One of which did everything on his own and one can't do anything for herself. So all i knew how to do was just write "Pt refused". Your not the only one that feels this way...I promise. It just takes time, unfortunately.

Hygiene Queen-thank you for giving that advice! Because I am still getting residents/patients up at 11:00 and the other CNA had them all up and ready to eat lunch and I felt like a failure. But, thank you for that encouraging advice :)

[mindyfromcali]

I cried every day when i got home from my shift my first week as a day shift CNA. I still don't prefer working that shift in LTC. It is doable, and it does get better, but you have to learn the residents' habits and how they all fit together in a schedule. It takes time. Relax. Breathe. It will be okay. Just focus on passing your CNA testing, and the rest will come together.

[dancingpre]

Thank you all so much for your replies and advice! I know speed comes will come with time as you all re-affirmed. This instructor just made me feel so bad about myself. But I jut heard today that she actually sent someone from the other group home after two days! Didn't pass her, I feel so badly because I can't imagine what she could have done wrong.

I don't know what this instructors deal was. I'm used to having "difficult" people as supervisors or bosses or even coaches. The instructor at the first site was totally realistic (not the nicest either) and didnt sugar coat anything, but she never made me feel like I had no place being a CNA.

I have one more day of class which is mock exams and then hopefully I can schedule my certification exam ASAP!

[Abigail612]

Sounds like a typical clinical for most new people, but dont sweat it to much its not an easy job and its a lot to remeber just focus on your goal! I do have to warn you it does take a little while to get used to it, my instructor told me it takes 6 weeks for a new CNA to be confident in her role and 6 months to be compitent. In my experience in orintating new CNAs this rule of thumb is pretty much true. Just hang in there and you will do fine!

[tomc5555]

IMO your instructor could have instructed more and criticized less. Our instructor would hands on show us what we needed to learn. Its supposed to be a learning process and I would never train or treat someone the way you were during clinicals.

As others said, brush it off, leave it behind. Don't let this dissuade you from nursing.

I commend you for wanting to help the residents you were given, you showed empathy and care. I think you conducted yourself professionally under difficult circumstances.

Good luck.

[Amber628]

Day shift is CRAZY period. CNAs have a tough job but its way harder to be a nurse! Although it sucks now you'll get better; BUT u do need to use common sense. When your a CNA you may have 10-15 pts on your assigment and you have 3 hours to get them all fed & out of bed, not to mention a few will have showers, some will be total care and others you may have to use a lift! It takes time and youll learn your pts and find a routine. Your job will orient you DONT worry. Try to find other aides at your job, seasoned aides can be rough sometimes at first but they can teach you MANY tricks and things to help you along :)