How to they do it?

[southwest]

how can you get an estimated percentage of how much a patient has eaten from his tray? i get stuck on the inadequacy of "eyeballing" what a person ate to get a percentage. so many patients eat so very little, i know that it is not being recorded correctly. same thing with liquids, i had to ask about the containers because i couldn't figure out how many ml each one held. how are the other people doing it. guess work is no good.

i am having difficulty keeping up with my patient load like the other cnas. i had just about six days of orientation. i work the day shift, in the med/surg dept. with an average of 11 patients.

i try very hard to duplicate what i was shown in the first days, but i just can't keep up. i fall behind every time at just about 10 am. once i start trying to get everybody cleaned up with bedbaths, showers and linen changes; everything just falls apart. my phone starts ringing and and i'm stopping and starting for the rest of the day.

another dilemma is the charting. i have to compete with the doctors and nurses for the charts. if i can get some charted then fine--but wouldn't you know it, the very ones that i don't get charted; that's the one that the nurse calls on and wants the vitals. i never see the other cnas running back and forth to chart, only two or three times a day. how are they keeping up with the information.

i want to get it right. when i am an rn, i don't want to have to agonize with getting rid of bad habits, when i can do it right from the start.

please help

south-west

[AuntieRN]

Southwest..

Are you a new CNA? Or are you just new to the facility? Either way with time you will get your own routine and will not be running back and forth so much. You will be able to keep up with your assignment and trust me there are days when the best CNA in the world can not keep up. I have been at it for 24 years. As far as figuring out how much people are eating...that is kind of subjective in my opinion...because if I think the patient ate about half of their meal the next person make think they ate about 70%...just try to gauge it the best you can against what they had on their tray to what they actually ate. The fluids....just remember there is 30mL to an ounce so if you know that the milk carton contained say 4 ounces and they drank it all then you know they drank 120mL. Charting will always be a dilema especially when you work days when everyone wants the charts. You just have to do the best you can. What I do is obtain all my vitals first then make a copy of the paper for each nurse and then chart the ones I can.

I work on a busy med/surg floor and I swear everytime I start to do something with one pt...another needs soemthing whether it is to go to the bathroom or a drink. You will learn to prioritze and do not be afraid to ask for help. Ask your nurses for help. Pt care is all part of nursing regardless of whether it is the CNA or the nurse who has to toilet a pt.

Sorry my post is so long. Hope I helped you out a bit and good luck to you!!

[jb2u, ASN, RN]

South-West,

Yes, CNA work is demanding, thus the high turnover rate. Just do your best and go home knowing that you gave your patients 100% of what you could.

As far as "eye-balling," yes, it is good enough. If the pt needs a more accurate nutritional assessment, then they will order a "calorie-count." The percentages will come to you with time. Ask one of the Nurses there if there is a "cheat sheet" for I&O's. This will give you how many ml's are in milk, coffee, and juice containers, as well as, soups, water pitchers, etc. As far as meal %, where I worked in LTC we divided the tray like this...meat was 40%, starch 30%, vegetables 20%, and dessert 10%.

So...a pt eats 50% of his steak....that's (50% of 40%)= 20%.

he eats 100% of his baked potato...that's (100% of 30%)= 30%.

he eats 75% of his corn....that's (75% of 20%)= 15%.

he eats 50% of his cake....that's (50% of 10%)= 5%.

So, this pt ate 20%+30%+15%+5%= 70% of his meal.

I hope that helped. Good luck to you. CNA work is tough and Med/Surg, in my opinion, is very demanding.