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 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.
We each do about 2 or 3 showers a day, which, I think, works out pretty well.
Btw, the schedule above for days works for me now. They just switched me to days.
Whoa! Maybe "wipe them down" sounded bad, though that's exactly how she put it. Everybody gets 2 showers a week at our facility, not just one. The reason it came up was because I couldn't find a basin to give a bb with. Apparentally, this resident didn't have one! The other CNA said they always just use the sink and "wipe them down". I'm sure she didn't mean to never rinse the cloth or anything. That would be yucky! I KNEW what she meant. I'm sorry if it wasn't clear. I figured you'd use a little common sense! I guess that's why these online forums don't always work so well.
Good grief! I've already got someone writing me up on here and I didn't do anything wrong!!
BTW, not having the right materials to work with has been a pet peeve of mine.
Edited to add: I'm a very good CNA even if I am fairly new at my job. I actually LOVE my residents, much more than some so-called nurse who looks for reasons to write people up instead of teaching them.
This might be my last post on this site. I didn't come on here to be attacked for posting.
As a Charge Nurse in Long Term Care for Ten years let me just say that CNA's have the hardest job. Please know that you are appreciated.
At my facility the CNA's have ten Residents each. But, We also have one of the CNA's come in at 6am to get our fall risks up..so this takes some of the burden off the Cna's coming in at seven...also nights gets up a couple as well.
I think the biggest need to make any floor work is communication. I always made it a point to talk to my CNA's..I want feedback from them..what works what doesn't. We are all part of a team..but, like with anything there are good and bad in all fields.
I have worked every shift..so I know the ins and outs of of all of them. Each shift has its challenges. Many of the CNA's I work with work 7-3 at another place and then come and work 3-ll with us...this is the norm. They need to do this to survive. Of course the solution is to offer higher pay but I'm not sure it would mean you would get quality CNA's...it takes a special person to do this job but it would certainly help them make ends meet. The reality with Nursing facilities is funding...State and Federal government cuts is really taking a toll...Nursing homes are not getting reimbursed for their care.
I know we have tried adding an extra CNA to come in from 7am to 1pm to help with the am care and the feeding at the meals. But, What kept happening is the other CNA's would call out..so then we ended up being short most of the time and Resident care suffered instead of improved. Another thing that happened..on the days everyone did show up less got done..showers and shaves were being missed.
There is no easy answer but communication is key. Many times my CNA's would not tell me that an assignment was not working out or it was too heavy until there is this big blow out. I always remind them..you are doing the care not me..if its too heavy lets see what we can do...Sometimes its as simple as switching some showers onto evenings or switching residents to different assignments to try and balance the load.
As far as lack of supplies...Nobody tells me they need them..we have a supply list that the CNA's can check off what they need..its like pulling teeth to get it...(sorry thats my pet peeve)
Please don't get discouraged...I know its hard. We are all expected to do more with less..its not easy..but we need good CNA's.
totally off subject: I have been waking in the night with pressure in my chest, it doesnt last to long, and today I took my bp (not during the time I was feeling bad), and it was 160/100.
Does that sound like a panic attack? Great scott! Menapause is a trip...
As far as lack of supplies...Nobody tells me they need them..we have a supply list that the CNA's can check off what they need..its like pulling teeth to get it...(sorry thats my pet peeve)
Laura /Nurse Manager,LPN
Re the supply list, I think that might be a case where aides are afraid they may be overstepping their bounds. When I was a CNA we had supply shortages all the time and we (nurses and aides) always complained about it but nothing ever got done. One of the nurses I worked with told me if I ever have a problem with supplies to write it in the 24 hour report book and it would be addressed in morning report. That really came back to bite me in the ass because the supervisor came up and told the unit manager "One of your CNAs complained about..." I wasn't complaining about her! I was complaining about supplies! I wasn't even complaining, I was only doing what my supervising nurse had told me to do! That was the last time I ever did that. Following that incident my nurse gave me a "shopping list" and told me to go into the supply room and write down everything we needed. That turned out to be a really a good idea, it was a specific task aimed at giving aides some control and a voice and nurse directed and mandated at a specific time ("OK, you need to do this NOW. This will be our routine from now on.") so it didn't look like fingers were being pointed at anyone. And we got what we needed. OK. We occasionally got what we needed.
Some of us have taken to bringing some supplies from home. I carry around my own tube of Desitin. And I know a couple of other CNAs who actually bring their own can of air freshener.
I agree about the lack of communication. We've had a real problem getting accurate I&Os, because we don't seem to work together on it. I'm going to start asking that they let me pick up my own trays, otherwise I end up guessing how much was consumed. I try to write down on the meal slips the food and fluid intake on every tray I pick up, but a lot of them don't do that.
totally off subject: I have been waking in the night with pressure in my chest, it doesnt last to long, and today I took my bp (not during the time I was feeling bad), and it was 160/100.
Does that sound like a panic attack? Great scott! Menapause is a trip...
160/100 is really high especially that bottom number isn't it... and it not being a time when you are feeling the pain. I would be worried enough to go to the dr. and find out what that is. I had chest pains at work the other day and my pressure was 130/84, that is high for me.
160/100 is really high especially that bottom number isn't it... and it not being a time when you are feeling the pain. I would be worried enough to go to the dr. and find out what that is. I had chest pains at work the other day and my pressure was 130/84, that is high for me.
This kills me. Here comes the incontinent police! If things were perfect for the next shift when they came on duty, there would be nothing for the next shift to do. So if a noc CNA has a total of 12-18 residents to care for starting at the time they come on duty and finally gets finished at 0700-0730, the last thing he/she needs to hear is day CNAs saying and I quote from our day CNAs, "I'm sick and tired of coming in here every day and finding residents soaked or FOS!" Whoooe Nellie! EXCUSE ME, but aren't you on duty now? Are these your assigned residents we're talking about here? Well then if you're on duty now, then get moving. The noc CNA is ready to go home and she's very tired. Don't stand around waiting for your assignment until 0900 or sitting down and eating your takeout breakfast you bought on your way to work when there are a few residents that still still need to be fed. If pts are changed at 0500 and you finally check them at 8 or whenever after they or you have eaten, what do you expect them to be? Clean and dry??? Get a grip. Do the job you were hired to do. It's called continuity of pt care and guess what? Now it's your turn. Why do people think the night shift does absolutely nothing all night long? I'll never understand the mentality nor do I even want to try.
Well at least I know that other facilities have this problem.
I work in a SNF of 120 beds. Everyone seem to want to complain that the previous shift did not do their job. Let us get over it :angryfire .
We are at work for our patients. Time spent complaining about the other shifts is time wasted. I have had CNAs tell me at 7 P.M. that day shift did not toilet a resident because they were soaked. My reply? Well who toileted the resident at 4 PM. I have worked all three shifts at my SNF. All three shifts have their own unique challenges. We need to respect each other.
By respecting each other maybe we can create work environments in LTC that people will want to work in. :)
I worked night shift in an assistant living faciliy and had 45 pt, most incontinent. I would start one round, have time to deliver supplies and laundery, start my rounds again.....The last round before day shift was tricky, sometimes by the time I got patient number 30 changed, pt number 1 could be wet again! The day people would come in and tell me that a pt. was wet, so I would go back again, and then end up changing more....and would be lucky to leave an hour into the next shift. I finally hit me that I was changing all the pt again for the first shift people, alot of times while they were shooting the breeze. I can be way to conscientious!
Ended up leaving this facility because of safety concerns. They were caring for folks that should have been in SNF, and I was alone with 45 pt at night ( the med tech usually was downstairs most of the night) with only small elevator and two flights of stairs to get them all out in an emergency. There might have been two who could take the stairs. If the place caught on fire, well, we would not have made it. It is incredible how some places are run.
Well at least I know that other facilities have this problem.
I work in a SNF of 120 beds. Everyone seem to want to complain that the previous shift did not do their job. Let us get over it :angryfire .
We are at work for our patients. Time spent complaining about the other shifts is time wasted. I have had CNAs tell me at 7 P.M. that day shift did not toilet a resident because they were soaked. My reply? Well who toileted the resident at 4 PM. I have worked all three shifts at my SNF. All three shifts have their own unique challenges. We need to respect each other.
By respecting each other maybe we can create work environments in LTC that people will want to work in. :)
I agree...besides there's really no way of knowing what anybody is doing or has done unless you had walked in their shoes. I can't even plan my own day. One morning I thought, "Okay, I'll shower so-and-so, then so-and so, and then it'll be time to pass trays." HAHAHA! The first one I showered began a long slow BM in the shower room and I don't dare leave her to do anything else. Result? I'm behind schedule. And that type of thing happens all the time! We can't predict every thing the residents will need all the time. Nor can we predict when some of them may poop all over their bed, only to do it again right after you clean them up! I try to never judge the previous schedule, or even a same-shift fellow CNA.
It's too easy to just imagine that they (other CNAs) stand around talking while call lights were going on up and down the hall. I would like people to have some trust and confidence in my ability and dedication to my job as I have in theirs.
That was the last time I ever did that. Following that incident my nurse gave me a "shopping list" and told me to go into the supply room and write down everything we needed. That turned out to be a really a good idea, it was a specific task aimed at giving aides some control and a voice and nurse directed and mandated at a specific time ("OK, you need to do this NOW. This will be our routine from now on.") so it didn't look like fingers were being pointed at anyone. And we got what we needed. OK. We occasionally got what we needed. 
Why do people think the night shift does absolutely nothing all night long? I'll never understand the mentality nor do I even want to try.
Carolyn_61
18 Posts
We each do about 2 or 3 showers a day, which, I think, works out pretty well.
Btw, the schedule above for days works for me now. They just switched me to days.