I just started at a LTC facility as a CNA. I must say, I really do enjoy the work, but since I just started, I'm being oriented and I have been working with other CNA's the past two days. I get this for a week and then I'm on my own.
I find it overwhelming that there are nine patients for every CNA. That's nine people that must be woken up, cleaned, dressed, bed made, room cleaned, in time for breakfast. We only have an hour to get them up, so that's about six minutes a person. Yesterday, my second day, I managed to get two people up on my own, because I like to take the time to talk with them and make them as comfortable as possible. Also, I only managed to get two fed (for the residents who cannot feed themselves at all), because I just couldn't bring myself to shovel the food down their throats like the other CNA's (I wouldn't want the food shoved in my mouth like that, so I wasn't going to do it with them. Plus I spent a lot of time talking to them, even though they couldn't respond back).
How am I ever going to get all of this stuff done quickly? Are there any tips? I don't know how to get nine patients up and give them the care that I want. Heck, I don't even know if I could manage it in that time frame if I rushed. What should I do? I feel very overwhelmed!
:uhoh21: Please give me the name of a facility where it isn't happening. I can't imagine or even dream of a facility where you have less than 9 pts. to a nurse or cna. I've worked at places where it is more than that. Sad but true. I worked under the identical circumstances as the original poster for 6 weeks while waiting for my LPN nclex results. To tell you the truth, I wouldn't do it for another 6 weeks unless my children were starving to death. A good cna is worth double heror his weight in gold. :)And a bad cna(and there are a few) canmake an8 hour day seem like an unbearable eternity. I always brag on my great cna's bring in cookies or buy them a drink(coca cola) as a little token of appreciation and always brag about them to the DON and other supervisors. :p Thanks to you cna's that truly are in it for the welfare of the pts. it shows in your work.. and makes the day of us nurses a little easier.
I agree with you. I graduated today @ 1000 and I plan to work in a ltc facility. I am presently a cna and I have had good and bad experiences as a cna. I know cna's are a very important part of nursing and good ones are hard to come by. I worked in a ltc facility only 3 months as a cna and the biggest gripe from other cna's was the nurse's do not help. It was only one who would help and I noticed they would take advantage of her because they knew if A patient was dirty she would clean them up even if they had nothing to do. How do I help my cna's without being taken advantage of?????? I've been told don't start helping if you can not keep it up, but if I'm in a room and a patient needs something or is dirty, i don't think I should walk out of the room to find a cna????
I have some questions about the bed bath ...I was shadowing/helping a CNA last Saturday at a LTC. There was a resident who was not really coherent (not sure what was /is wrong and did not ask) She was on gastro tube and oxygen and we actually had to lift her into a chair and shower her in the tub room ... I asked why this type of patient was being showered instead of full bed bath and the CNA said ...that takes too long ...WHAT T F???? This poor lady could have easily fallen ..we had her propped up on the side of the shower chair wheeling her down the hall ..the nurse was freaking out but did not stop us.
complete madness! also saw lots of food shoving and denying the uncooperative patient food ...is this what LTC is all about ??????? i better start saving my $$$$$$ so i don't end up there.
please help ..not sure i want to do the CNA thing
Poor you! What an experience! Your gut about these things being out of line was right on target...
first of all, how the pt is bathed is determined by the care plan, based on safety and the patient's needs. She may be up to a shower, but what is convenient for the NA is not the decisive factor! Secondly, never transfer a patient IN a shower chair! The patient should be in a normal wheel chair or gerichair and then transferred to the shower chair in the shower room. The patients comfort, safety and privacy is protected that way. The nurse should have interviened. And the food shoving and denying is abuse.
Poor you! What an experience! Your gut about these things being out of line was right on target...
first of all, how the pt is bathed is determined by the care plan, based on safety and the patient's needs. She may be up to a shower, but what is convenient for the NA is not the decisive factor! Secondly, never transfer a patient IN a shower chair! The patient should be in a normal wheel chair or gerichair and then transferred to the shower chair in the shower room. The patients comfort, safety and privacy is protected that way. The nurse should have interviened. And the food shoving and denying is abuse.
Good luck and God bless!
an old CNA
thanks so much for validating my feelings ....i have been to 2 different LTC and seen the same things going on ( i was hoping the best for the 2nd one but it turned out to be pretty much the same) overworked, overwhelmed CNA's who are doing nothing like the text book says ..which is fine
but i have witnessed some serious lack of respect and dignity of residents
perhaps that is my OPINION ...but i won't ever send my family to a facility like the ones i have been in
thanks so much
ps never saw a care plan, never heard about it etc..i am sure these CNAs are seasoned so they do not need to refer to care plan but i know it is probably just like any other job ..there are certain "standards" but those only apply to when someone is "watching" i just think it is much different when dealing with a LIFE ! hello ..it sucks that CNAS are paid so LITTLE ...yes..in my state there is certification but i feel my little brother could pass the test ....the care i have seen is horrendous
I have some questions about the bed bath ...I was shadowing/helping a CNA last Saturday at a LTC. There was a resident who was not really coherent (not sure what was /is wrong and did not ask) She was on gastro tube and oxygen and we actually had to lift her into a chair and shower her in the tub room ... I asked why this type of patient was being showered instead of full bed bath and the CNA said ...that takes too long ...WHAT T F???? This poor lady could have easily fallen ..we had her propped up on the side of the shower chair wheeling her down the hall ..the nurse was freaking out but did not stop us.
complete madness! also saw lots of food shoving and denying the uncooperative patient food ...is this what LTC is all about ??????? i better start saving my $$$$$$ so i don't end up there.
please help ..not sure i want to do the CNA thing
I've had situations like that, where the resident was in actual real danger because they couldn't support their weight and two aids had to be there to help do the bath because the poor thing was falling out of the chair. I got kind of p-od about it and started asking questions -- along the underground grapevine -- and what I was told is that if the patient is not on hospice care (or if the family has not specifically requested it) we are required to get them out of bed for baths -- and feedings as a matter of fact. It kind of sucks to watch but the idea is that if the resident or family wants full care than that's what they get. They are to be treated as we would treat any other resident. I know I've had a hard time working in those conditions but I understand where the whole thing is coming from.
Secondly, never transfer a patient IN a shower chair! The patient should be in a normal wheel chair or gerichair and then transferred to the shower chair in the shower room.
I know this is going to open myself to attack, but hey, here it goes anyway. BTW, I am a new CNA so be gentle please.
It's a little impractical, especially if the resident is difficult to lift without help, to go from the bed to the wheelchair, to the showerchair, back to the wheelchair, to wherever!
Have you noticed that those showerchairs have wheels? They are built for transferring, but only for the purpose of going to and using in the shower room. I always hold them when transferring and never use the showerchair if they can't sit up on their own.
And I ALWAYS protect their privacy and also try to keep them warm. I don't transfer them through the halls naked or anything like that! I also make sure I hold them while they are on the shower chair. We have a special shower chair for those who can't sit up. I've only used it once so far.
As far as I can tell, this is the way it's done at our LTCF. I can ask the DON to make certain. It could be that everybody is doing it wrong and the nurses are letting us get away with it!
Personally, I don't think all CNAs rinse well enough during the bedbaths. Any leftover soapscum irritates the skin. There are a few residents here who only get bedbaths, but I think everyone who CAN get a good shower SHOULD get one, at least once a week! If you have doubts about whether someone really should be getting a shower or not, ask the nurses! Actually, at our LTCF, it's the nurses (RNs and LPNs), not the CNAs, who decide who gets a shower and on what day, so it's not up to us anyway.
I'm still waiting on tips for making mine and others' work more efficient. Unlike what you may think, I often have to skip my breaks and work fast just to keep up! Maybe some of you have CNAs sitting around on their butts where you are at, but not here!
I don't want to spend so much time doing everything "just so" with a couple of residents and then end up short-shifting someone else!
Being a CNA in LTC is physically and mentally hard work. I have been a State Registered Nurse Aide here in Kentucky for going on three years now. There are weeks that go by when I hate being a nurse aide so bad and I want to quit nursing all together but then you have a good day and you think this is why I got into this, this is a great wonderful job. I wish that the good days came more often but you get more of the stressful days especially at first. Ask questions if you need help ask, so many new CNAs that leave the LTC facility that I work at say that the CNAs never show them anything, tell them who anyone is, etc. I try to show the new orientees stuff that I know, some soak it up others get an attitude and tell me that they don't need help. I hate to admit it but long story short, the level of care provided is not the same as the level of care taught in the CNA classes, its just not possible. I have fed four people at once before, done entire bedchecks by myself, and done countless showers by myself. Hang in there, you are doing hard work in a hard situation.
I know this is going to open myself to attack, but hey, here it goes anyway. BTW, I am a new CNA so be gentle please.
It's a little impractical, especially if the resident is difficult to lift without help, to go from the bed to the wheelchair, to the showerchair, back to the wheelchair, to wherever!
Have you noticed that those showerchairs have wheels? They are built for transferring, but only for the purpose of going to and using in the shower room. I always hold them when transferring and never use the showerchair if they can't sit up on their own.
And I ALWAYS protect their privacy and also try to keep them warm. I don't transfer them through the halls naked or anything like that! I also make sure I hold them while they are on the shower chair. We have a special shower chair for those who can't sit up. I've only used it once so far.
As far as I can tell, this is the way it's done at our LTCF. I can ask the DON to make certain. It could be that everybody is doing it wrong and the nurses are letting us get away with it!
Personally, I don't think all CNAs rinse well enough during the bedbaths. Any leftover soapscum irritates the skin. There are a few residents here who only get bedbaths, but I think everyone who CAN get a good shower SHOULD get one, at least once a week! If you have doubts about whether someone really should be getting a shower or not, ask the nurses! Actually, at our LTCF, it's the nurses (RNs and LPNs), not the CNAs, who decide who gets a shower and on what day, so it's not up to us anyway.
I'm still waiting on tips for making mine and others' work more efficient. Unlike what you may think, I often have to skip my breaks and work fast just to keep up! Maybe some of you have CNAs sitting around on their butts where you are at, but not here!
I don't want to spend so much time doing everything "just so" with a couple of residents and then end up short-shifting someone else!
Okay, I'll get my shield out now. Fire away!
sounds like you are a GREAT CNA and doing what you were trained to do at your certain facility
it sounds to me that you work at a place similar to mine ....i have been trained in a few places and one place did wheel them to shower room in a wheel chair but then they were mixing the sexes in there...that really horrified me more than wheeling the incapcitated resident to the shower room (in a wheeled shower chair) where we were in privacy ..no other showers going on etc ..and of course we had her completely covered in her gown etc when we were in the hallway ..and we talked to her and told her what we were doing ...but i still felt like she might fall out of the chair ....and i had help but we were both students ...
we helped our CNA so much ..she had so many patients she could NOT lift by herself ..it was really sad
i guess certain places just do it differently but i bet there is POLICY at all these places and it is NOT being followed >>>>>unless the watchdogs are out
Being a CNA in LTC is physically and mentally hard work. I have been a State Registered Nurse Aide here in Kentucky for going on three years now. There are weeks that go by when I hate being a nurse aide so bad and I want to quit nursing all together but then you have a good day and you think this is why I got into this, this is a great wonderful job. I wish that the good days came more often but you get more of the stressful days especially at first. Ask questions if you need help ask, so many new CNAs that leave the LTC facility that I work at say that the CNAs never show them anything, tell them who anyone is, etc. I try to show the new orientees stuff that I know, some soak it up others get an attitude and tell me that they don't need help. I hate to admit it but long story short, the level of care provided is not the same as the level of care taught in the CNA classes, its just not possible. I have fed four people at once before, done entire bedchecks by myself, and done countless showers by myself. Hang in there, you are doing hard work in a hard situation.
SO great to hear from CNAs who are "with it " and care
thanks so much for validating my feelings ....i have been to 2 different LTC and seen the same things going on ( i was hoping the best for the 2nd one but it turned out to be pretty much the same) overworked, overwhelmed CNA's who are doing nothing like the text book says ..which is fine
but i have witnessed some serious lack of respect and dignity of residents
perhaps that is my OPINION ...but i won't ever send my family to a facility like the ones i have been in
thanks so much
ps never saw a care plan, never heard about it etc..i am sure these CNAs are seasoned so they do not need to refer to care plan but i know it is probably just like any other job ..there are certain "standards" but those only apply to when someone is "watching" i just think it is much different when dealing with a LIFE ! hello ..it sucks that CNAS are paid so LITTLE ...yes..in my state there is certification but i feel my little brother could pass the test ....the care i have seen is horrendous
Beware of seasoned CNAs. There are many great ones out there but there are also many that just want to do the minimum and get out. Ask these kinds of CNAs a question and they'll tell you the first thing that pops into their head.
Care plan is part of the nursing job, determines pt. ADLs, risks, goals, special needs, nursing interventions, a LOT of work goes into it and each is individualized for each pt. I'm not sure if CNAs are even allowed to see it due to HIPAA regulations. At my facility we weren't but then something changed and they started encouraging us to read pt. charts, care plans, etc. You could see right off the bat who was really invested in their job by who took their break time to haul out those charts and dig in. You would not believe what is going on behind the scenes that CNAs have no knowledge of. It would really help the standard of care if aides had access to even an iota of that information. Barring that, a good CNA will observe what is going on, what seems odd, and learn the system and learn who to question, what questions to ask, and most importantly, not to raise an issue in a critical manner. There is usually some rationale behind what you are being asked to do. Could be something really stupid, in which case you have a problem but usually it's fairly rational and the problem is a result of lack of communication about the what's and whys and wheretofores between staff which is further complicated by those workers who "just want to sit on their butts."
You would not believe what is going on behind the scenes that CNAs have no knowledge of. It would really help the standard of care if aides had access to even an iota of that information. Barring that, a good CNA will observe what is going on, what seems odd, and learn the system and learn who to question, what questions to ask, and most importantly, not to raise an issue in a critical manner. There is usually some rationale behind what you are being asked to do. Could be something really stupid, in which case you have a problem but usually it's fairly rational and the problem is a result of lack of communication about the what's and whys and wheretofores between staff which is further complicated by those workers who "just want to sit on their butts."
Hey! I have a good recent example of not knowing enough about a resident!
Last week one of the residents, a partially paralyzed resident who I didn't think could stand at all, asked me to turn his bed around. I thought it was an odd request but set about to do it for him anyway. I just about had the bed facing the opposite direction when 2 CNAs came running into the room, "What are you DOING!?" I told them that I was just turning the bed around as he requested. They took me outside and said, "Don't you know!? He's only paralyzed on one side. When the bed is turned the "wrong" way he tries to get out of it in the middle of the night and falls!" I honestly had NO idea! :uhoh21:
I don't think the lazy CNAs who truly hate their jobs and care nothing for the residents or patients would spend much of their free time on a forum like Allnurses. It seems like all the CNAs I've "met" here truly do want to do a good job.
I'm the type that bolts upright in the middle of the night if I think I forgot to put the call-light by one of my patients during my shift earlier that evening.
thanks so much for validating my feelings ....i have been to 2 different LTC and seen the same things going on ( i was hoping the best for the 2nd one but it turned out to be pretty much the same) overworked, overwhelmed CNA's who are doing nothing like the text book says ..which is fine
but i have witnessed some serious lack of respect and dignity of residents
perhaps that is my OPINION ...but i won't ever send my family to a facility like the ones i have been in
thanks so much
ps never saw a care plan, never heard about it etc..i am sure these CNAs are seasoned so they do not need to refer to care plan but i know it is probably just like any other job ..there are certain "standards" but those only apply to when someone is "watching" i just think it is much different when dealing with a LIFE ! hello ..it sucks that CNAS are paid so LITTLE ...yes..in my state there is certification but i feel my little brother could pass the test ....the care i have seen is horrendous
Glad to encourage you! You sound like you really care.
Some facilities have shower beds. They are like stretchers on wheels that have holes for drainage. In our state, they are allowed for transport in the hallways. They are great for unstable patients who might fall out of a shower chair. I was told that in NC shower chairs are not allowed for transport in the hallways, but I might be wrong there. Might have been my supervisors opinion. About care plans, if you don't have access to them in your facility, usually the nurses give instruction on which type of bath the patient is to have on the bath list. My point was that this was a decision determined by the nurses, not the NAs, but if you have any concerns of the safety of what was ordered, you can always share your concerns with the nurse. She can give you suggestions, or if she sees fit, change the type of bath. Never act in a manner you feel is unsafe.
We are never so seasoned that we can determine what the pts care should be. That is determined by licensed personel and the physicians. As a NA, you will have insights that are vital, (share them!) but still, we are not privy to all the details of the pt health concerns , nor have we a broad enough knowledge base. But it is a wonderful job, and most nurses are very receptive to your concerns.
crystalclear
78 Posts
I agree with you. I graduated today @ 1000 and I plan to work in a ltc facility. I am presently a cna and I have had good and bad experiences as a cna. I know cna's are a very important part of nursing and good ones are hard to come by. I worked in a ltc facility only 3 months as a cna and the biggest gripe from other cna's was the nurse's do not help. It was only one who would help and I noticed they would take advantage of her because they knew if A patient was dirty she would clean them up even if they had nothing to do. How do I help my cna's without being taken advantage of?????? I've been told don't start helping if you can not keep it up, but if I'm in a room and a patient needs something or is dirty, i don't think I should walk out of the room to find a cna????