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!
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!
You have asked for some pointer on how to cut down on time when doing your NA work:
As soon as you get your assignment, review your pt. bath list. Then locate supplies, and take what you will need to each room. Then hit the floor running! I wash and dress those who are going to the dining room. Of course, respect individual wishes on this. More independent folks just need set-up to ready themselves. You'll get to know people. If there is any wet linen, strip this now. Tidy spreads on all beds. You can change linen later.
If your LTCF allows, those who are to be showered will need only hair brushed, glasses, dentures (or teeth brushed) and depends changed, and can go to the dining room in a robe.
Those who are bed bound need hair brushed, teeth brushed, glasses and dentures, depends changed, and pulled up in bed. I elevate the head of the bed, and place the tray in front of the pt. Be sure to tidy the spread. Tray should be clean.
At this point, every one should be dry, and tidy! Right after breakfast cleanup (have wash cloths handy for hands and faces) start those showers. Your 10 o'clock rounds are a good time to wash and dress bed bound patients that are not getting a shower that day.
Hit everyone every two hours, and be certain that bed bound pts are turned, and wheel chair pts.get a pressure release, even if they are dry.
I've got to admit; I skipped lunch and breaks a lot, so I am not your best source of information on efficiency. I did find that what happened before breakfast could make or break my day. Frankly, with the pt to NA ratio in most LTCF, doing this right is IMPOSSIBLE, but my patients and families were always pleased. You always have time to show respect and give TLC.
When I could take lunch or a break, I would think through how to best address the needs that afternoon. Sorry, I am no super NA, but maybe my ideas will stimulate some better ones from the real wiz-NAs!
A not too seasoned but hopefully tenderized CNA.
(OH, load the linen cart at the laundry before your shift starts, and everyones day goes better!)
You have asked for some pointer on how to cut down on time when doing your NA work:
As soon as you get your assignment, review your pt. bath list. Then locate supplies, and take what you will need to each room. Then hit the floor running! I wash and dress those who are going to the dining room. Of course, respect individual wishes on this. More independent folks just need set-up to ready themselves. You'll get to know people. If there is any wet linen, strip this now. Tidy spreads on all beds. You can change linen later.
If your LTCF allows, those who are to be showered will need only hair brushed, glasses, dentures (or teeth brushed) and depends changed, and can go to the dining room in a robe.
Those who are bed bound need hair brushed, teeth brushed, glasses and dentures, depends changed, and pulled up in bed. I elevate the head of the bed, and place the tray in front of the pt. Be sure to tidy the spread. Tray should be clean.
At this point, every one should be dry, and tidy! Right after breakfast cleanup (have wash cloths handy for hands and faces) start those showers. Your 10 o'clock rounds are a good time to wash and dress bed bound patients that are not getting a shower that day.
Hit everyone every two hours, and be certain that bed bound pts are turned, and wheel chair pts.get a pressure release, even if they are dry.
I've got to admit; I skipped lunch and breaks a lot, so I am not your best source of information on efficiency. I did find that what happened before breakfast could make or break my day. Frankly, with the pt to NA ratio in most LTCF, doing this right is IMPOSSIBLE, but my patients and families were always pleased. You always have time to show respect and give TLC.
When I could take lunch or a break, I would think through how to best address the needs that afternoon. Sorry, I am no super NA, but maybe my ideas will stimulate some better ones from the real wiz-NAs!
A not too seasoned but hopefully tenderized CNA.
(OH, load the linen cart at the laundry before your shift starts, and everyones day goes better!)
Wow! Thanks! I know it took a bit of your time to write all that out! I'm comparing it in my mind with what I do. I think I'm mainly just slow right now. I've noticed that it takes longer for me make an occupied bed or dress someone than the more experienced CNAs. Once, I was sent on a wild goose chase looking for a male urinal bottle. Everybody was too busy to help me. You add a few minutes here and there and it really adds up! Surprisingly, the last two evenings I worked I got all my residents in bed, dry, clean, and fed by 10:00 (2200) Some say that should have been by 8:00 (2000) but I felt pretty good about it anyway. :)
Wow! Thanks! I know it took a bit of your time to write all that out! I'm comparing it in my mind with what I do. I think I'm mainly just slow right now. I've noticed that it takes longer for me make an occupied bed or dress someone than the more experienced CNAs. Once, I was sent on a wild goose chase looking for a male urinal bottle. Everybody was too busy to help me. You add a few minutes here and there and it really adds up! Surprisingly, the last two evenings I worked I got all my residents in bed, dry, clean, and fed by 10:00 (2200) Some say that should have been by 8:00 (2000) but I felt pretty good about it anyway. :)
Sounds like you are doing great!
I literally ran, and still never felt like I was done! You will be fine....don't fall into the black hole of searching for supplies.....making occupied beds fast takes alot of practice, and goes best with two NAs....wish I knew more about 2nd shift...anyone out there have a schedule or plan they use?
God Bless!
an old, tired, mildly seasoned and somewhat tenderized CNA
I can make an occupied bed by myself (unless care plans say differently) almost as fast as I can make an empty bed. I start by laying all my stuff fitted sheet, draw sheet, pink pads or chux and/or brief if called for on the side of the bed then I roll all of that up along side resident. Then I roll all used linen and tuck under side of resident. Then I tuck new linen under old linen and use chux between the two if needed to keep new linen dry. Then I assist if resident can roll self or I log roll res. over the linens using my legs and lower body I brace my self so that there is no way resident can roll out of bed. I pull all linen out from under resident and lay res. back down on bed. Then I go around to the other side and rplace fitted sheet and straighten layers. If I did it right the pads and /or briefs are just perfectly fitted under resident. I have been doing it that way for years and can do an occupied bed in just mins. It did take practice to get the brief or pad in right place but once I got it. I rarely miss.
I can make an occupied bed by myself (unless care plans say differently) almost as fast as I can make an empty bed. I start by laying all my stuff fitted sheet, draw sheet, pink pads or chux and/or brief if called for on the side of the bed then I roll all of that up along side resident. Then I roll all used linen and tuck under side of resident. Then I tuck new linen under old linen and use chux between the two if needed to keep new linen dry. Then I assist if resident can roll self or I log roll res. over the linens using my legs and lower body I brace my self so that there is no way resident can roll out of bed. I pull all linen out from under resident and lay res. back down on bed. Then I go around to the other side and rplace fitted sheet and straighten layers. If I did it right the pads and /or briefs are just perfectly fitted under resident. I have been doing it that way for years and can do an occupied bed in just mins. It did take practice to get the brief or pad in right place but once I got it. I rarely miss.
It's those darn briefs I always have to go back and do again with an occupied bed change: for some reason, I end up only covering one cheek
the best way to fix that problem is to lay the open brief on the resident then start rolling brief from there. When breif meets rest of linen roll all together... works everytime
the best way to fix that problem is to lay the open brief on the resident then start rolling brief from there. When breif meets rest of linen roll all together... works everytime
I'm curious about facilities that require all baths to be given in the morning. How many baths does that add up to for each CNA? What do the people on evening shift do? Where I worked, CNAs (morning and evening) usually did two to three showers each on every shift. There were 6-11 showers a shift which adds up to a LOT in total and I cannot imagine how the morning shift could handle that alone.
I'm curious about facilities that require all baths to be given in the morning. How many baths does that add up to for each CNA? What do the people on evening shift do? Where I worked, CNAs (morning and evening) usually did two to three showers each on every shift. There were 6-11 showers a shift which adds up to a LOT in total and I cannot imagine how the morning shift could handle that alone.
I worked in an assisted living, that kept patients that really would have been more suited for a nursing facility. I had about 6 showers on day shift. I think the girls on second would have about three, since they had less time before bed.
I worked in a nursing home where you would typically have four showers, and a bit less on evening. For a while, we would an un-assigned NA, who would do all the showers for one nursing station. I remember doing 12 showers one day. I actually liked that, it was great for the NAs to be able to focus on all the other tasks. It gave me time to look at the patients skin, record what I found, and feel less rushed. It was hard work with the lifting and all and I got a bit water logged!
I am an RN. I worked a 10a-6p shift yesterday and when 2nd shift came in 1 aide was assigned to 18 patients in 1 hall. She had only been on this hall 1 other time. For some reason the DON thinks that hall only needs 1 aide. It is next to impossible for 1 to get them all ready for dinner. Many have been laid down by days. There are 3 bed bound patients and many skilled patients. I tried to help her as much as possible but this was also my first time on this unit and trying to figure out who was who took a while. Unfortunately this aide isn't popular with the others so I had to get a little "authoratative" to have another one come help her. OUr facility usually has 2 aides apiece on the other halls and they work in teams.
Organizing all your supplies in the morning, listing the priorities, and time will help you. Good Luck
When all baths were on days, the powers that be said that there wasn't enough time to get the assigned showers on afternoons before 9 and that state would not allow a shower to be given after that or before 5 in the morning leaving no time for showers in the morning (before day shift either). I personally think a buddy of the powers that be worked on the afternoon shift at the time but that is just my opinion. Since we have gotten new DON's and ADON's Showers have been brought back to afternoons but are done before nine. still no showers on midnight shift.. But still all bed baths were on days.. And i believe technically all bed baths are still on days
to have another one come help her. OUr facility usually has 2 aides apiece on the other halls and they work in teams.
chadash
1,429 Posts
As soon as you get your assignment, review your pt. bath list. Then locate supplies, and take what you will need to each room. Then hit the floor running! I wash and dress those who are going to the dining room. Of course, respect individual wishes on this. More independent folks just need set-up to ready themselves. You'll get to know people. If there is any wet linen, strip this now. Tidy spreads on all beds. You can change linen later.
If your LTCF allows, those who are to be showered will need only hair brushed, glasses, dentures (or teeth brushed) and depends changed, and can go to the dining room in a robe.
Those who are bed bound need hair brushed, teeth brushed, glasses and dentures, depends changed, and pulled up in bed. I elevate the head of the bed, and place the tray in front of the pt. Be sure to tidy the spread. Tray should be clean.
At this point, every one should be dry, and tidy! Right after breakfast cleanup (have wash cloths handy for hands and faces) start those showers. Your 10 o'clock rounds are a good time to wash and dress bed bound patients that are not getting a shower that day.
Hit everyone every two hours, and be certain that bed bound pts are turned, and wheel chair pts.get a pressure release, even if they are dry.
I've got to admit; I skipped lunch and breaks a lot, so I am not your best source of information on efficiency. I did find that what happened before breakfast could make or break my day. Frankly, with the pt to NA ratio in most LTCF, doing this right is IMPOSSIBLE, but my patients and families were always pleased. You always have time to show respect and give TLC.
When I could take lunch or a break, I would think through how to best address the needs that afternoon. Sorry, I am no super NA, but maybe my ideas will stimulate some better ones from the real wiz-NAs!
A not too seasoned but hopefully tenderized CNA.
(OH, load the linen cart at the laundry before your shift starts, and everyones day goes better!)