If I were your assigned CNA...

mianders, RN · Jan 21, 2008

It depends on where you work. Everywhere I have worked the CNA was assigned to certain rooms. They might be under several RN/LVN's. Some of the best CNA's I know anticipate what will be needed, so a lot of the time you don't even have to tell them what to do. This is so important. Especially in the ER. Good luck.

EmmaG, RN · Jan 21, 2008

Communicate.

Meet with me at the beginning of the shift after report so that I can update you on my patients and tell you what I anticipate their needs will be.

Know what are normal readings for vitals, blood sugars, etc., and tell me when something falls outside those parameters.

If you find that you're going to be tied up and can't do vitals or I&Os or accuchecks or whatever, please tell me so that I can do them. Don't just let it go for me to find out hours later something wasn't done.

If you think a patient just isn't *right*... tell me. Don't feel silly expressing your concerns.

If you need to position or lift a patient, always ask for help.

casi, ASN, RN · Jan 21, 2008

It really depends on the kind of setting you are in. I really haven't worked in a traditional LTC setting so I really don't know the dynamics there.

What I've found as a CNA helps is throwing yourself in full throttle. Ask the nurses what they need from you. Learn to read body language. If the nurse is running around crazy with patients crashing, her hands full with nursing tasks, and hasn't gotten to charting yet and you find them in a room doing basic patient care be willing to tell them. "You go do nursing stuff, I can handle this."

ptadvocate81 · Jan 21, 2008

I am a nurse in one of the critical care units and there are 15 beds in my unit. Typically, we have one tech/CNA for the entire unit. What we expect at my hospital is that the CNA takes temperatures (vitals are done by the monitor), blood sugar checks, helps clean pts if needed and assists in turning and bathing the pts. They are also responsible for stocking bedside carts with supplies and medication rooms with needles and syringes. Hope that this helps and always remember- if in doubt ask. Most nurses are happy to have the help and we are thankful that you are there. I started out as a CNA and know what it was like- just remember that you do not have to do that job forever- stay in school. Best wishes and I'm sure you'll do great.

pagandeva2000, LPN · Jan 21, 2008

I appreciate the fact that you are asking nurses even before you start what the expectations are. Kuddos to you for that!! Each facility you work for should have a job description, but also look at the 'culture' on the floor. As someone mentioned previously, look at body language, be observant of what is going on, and how you can fit in within your scope of practice. It usually goes a long way in forging positive relationships with the health care team.

I am an LPN, now. Yes, I am a nurse, but am not an RN. There are things that RNs do that I can't. So, when I see certain things happening, I immediately begin to think of things that I can do within my scope of practice to relieve the RN so she can feel free to do what I can't do. For example, if a patient is crashing, I can't do an IV push, but I get the crash cart, get the meds ready, and pass them to her. Or, I may say, I can hang her piggybacks, administer medications, do some patient teaching, dressings, nebulizer treatments, etc...so that she can trust that a competent person will have her back.

The same thing for the aides. If you see that the nurse is busy and you know that a stool specimen needs to be collected, do it (as long as you know how to), bring them what they need, ask them if you can help with something, just your presence alone can help a long way. In most cases, a nurse that knows you are dependable may say to herself that she has some free minutes, so, she may do some of your vital signs, put a person on the bedpan, change a brief, because she KNOWS that you are dependable.

Also, you never know. If there is a program or a tuition assistance benefit available, they may highly recommend that you get an opportunity to attend nursing school (if that is what you wish), obtain additional training not readily available to everyone, or a position within your scope of practice that can relieve you of some of the grunt work. We had some CNAs at my hospital receive training in medical coding, and started working in patient accounts. This is how I became an LPN...because of the work I did, I was able to receive a leave of absence for two years WITH FULL PAY to become an LPN. My tuition was paid in full as well as my books. They paid for my NCLEX review class, and I had an automatic job as soon as I obtained my license.

I am already impressed by you for asking early. If you were on my side of the globe, I would tell my employers "Consider THIS person. She cared enough to ask questions on allnurses.com!" Good luck!

TazziRN, RN · Jan 21, 2008

communicate.
meet with me at the beginning of the shift after report so that i can update you on my patients and tell you what i anticipate their needs will be.
know what are normal readings for vitals, blood sugars, etc., and tell me when something falls outside those parameters.
if you find that you're going to be tied up and can't do vitals or i&os or accuchecks or whatever, please tell me so that i can do them. don't just let it go for me to find out hours later something wasn't done.
if you think a patient just isn't *right*... tell me. don't feel silly expressing your concerns.
if you need to position or lift a patient, always ask for help.

i appreciate the fact that you are asking nurses even before you start what the expectations are. kuddos to you for that!! each facility you work for should have a job description, but also look at the 'culture' on the floor. as someone mentioned previously, look at body language, be observant of what is going on, and how you can fit in within your scope of practice. it usually goes a long way in forging positive relationships with the health care team.
i am an lpn, now. yes, i am a nurse, but am not an rn. there are things that rns do that i can't. so, when i see certain things happening, i immediately begin to think of things that i can do within my scope of practice to relieve the rn so she can feel free to do what i can't do. for example, if a patient is crashing, i can't do an iv push, but i get the crash cart, get the meds ready, and pass them to her. or, i may say, i can hang her piggybacks, administer medications, do some patient teaching, dressings, nebulizer treatments, etc...so that she can trust that a competent person will have her back.
the same thing for the aides. if you see that the nurse is busy and you know that a stool specimen needs to be collected, do it (as long as you know how to), bring them what they need, ask them if you can help with something, just your presence alone can help a long way. in most cases, a nurse that knows you are dependable may say to herself that she has some free minutes, so, she may do some of your vital signs, put a person on the bedpan, change a brief, because she knows that you are dependable.
also, you never know. if there is a program or a tuition assistance benefit available, they may highly recommend that you get an opportunity to attend nursing school (if that is what you wish), obtain additional training not readily available to everyone, or a position within your scope of practice that can relieve you of some of the grunt work. we had some cnas at my hospital receive training in medical coding, and started working in patient accounts. this is how i became an lpn...because of the work i did, i was able to receive a leave of absence for two years with full pay to become an lpn. my tuition was paid in full as well as my books. they paid for my nclex review class, and i had an automatic job as soon as i obtained my license.
i am already impressed by you for asking early. if you were on my side of the globe, i would tell my employers "consider this person. she cared enough to ask questions on allnurses.com!" good luck!

everything they said. especially the part about letting the nurse know if you think something just isn't right about the pt. it may be nothing and the nurse may tell you everything is fine, but on the other hand you could see that nurse suddenly take off down the hall in the direction of that pt's room and have time to avert a crash because you let her know about something. if you have the nurse's back and "take care of" her, s/he will take care of you when you need help. let him/her hang and you will find yourself alone when you need help.

UM Review RN, ASN, RN · Jan 21, 2008

For CNAs starting on Tele:

When the floor is jumping, be a jumper. No wandering around looking lost. Are your call lights off, patients clean and safe, vitals done, rooms neat?

If a patient is having trouble breathing or if the patient even says they're having trouble breathing, get the nurse stat and a set of vitals next.

Get your tasks done on time by starting them an hour before they're due.

Never leave a patient wet or dirty.

Always remember to put the bed to the low position and put bed alarms on if you have not actually seen the patient walk.

Always check your patients before the next shift comes on in case someone's in a mess. Nothing worse than the next shift finding someone in a mess, looks very bad for you.

Valerie Salva, BSN, RN · Jan 21, 2008

MissLo,

I am very impressed by your interest, and desire to do well. Great advice on this thread!

Best of luck to you in your CNA endeavors!

txspadequeenRN, BSN, RN · Jan 21, 2008

i'm glad to see someone looking forward to working as a cna because even though it is a hard job is is very fulfilling. a lot of people that are cna's do it for a check. anyway, i will give you a list here to sum it up....

please make sure you are on time. your fellow co- workers have had a long day and would love to go home.

make rounds with the off and on coming shifts so you will know what you are heading into and what you are potentially leaving undone. there is nothing that i dislike more than controversy between the shifts and he "did this" or he "didn't do that" junk .

know what your assignment is. we have cna careplans. i expect you to have one because all of your patient info is on there and how can you take care of people if you don't even know what room they are in.

after you get report from your co-worker come see me. i will give you a more detailed report . listen to what i a tell you because these are things you need to know..like the patient in room 45 is in respiratory isolation and you need to suit up. several of my cna's have found themselves in trouble because they thought they had it all down.

i will work around your schedule when it comes to wound care and such. meaning that if i have a patient that has a dressing to be done and a shower scheduled as well . i want to do this dressing after the shower and will do it when it is convenient for you with in a reasonable amount of time. these are also things that i know at the beginning of the shift and you will know that i have dressing change to do so we can coordinate a time.

i expect my people turned and dried every two hours unless i tell you different. there are some cases with hospice residents that it just hurts to much to turn and so since our focus is to be pain free; we would reduce the turning schedule to accommodate the patient that is imminently dying. even though i am pretty laid back if i think that the cna is not doing her/his job and compromising my residents. i have a tracking system in place to nab anyone that thinks they will get away with this mess.

please report to me any different behavior a patient may be having. this could be a sign of a real problem. the patient could be experiencing a uti or medication reactions.

i need to know about new bruising or any skin issue. new bruising could also be a medication issue or depending on location and severity could be a abuse issue.

i need all the beds made and the men shaved. nothing looks worse than walking down a hall with sloppy rooms. i have and will make beds if time allows.

there are patients that refuse care( showers) . my protocol is if they refuse and are alert and oriented . try and set up a time that fits their schedule (within reason of yours of course) . if they refuse let me know and i will speak with this person. i have a patient right now that will only take a shower between 2 and 4 pm...if you approach him at 4:05 forget it. if they are confused and tell you no . go back in 15 min and try again chances are they have forgot. if not i will talk them into the shower. people cant maintain health if they are covered in dirt and germs...

i will help you with any transfer and i will answer lights. but also remember that i am not just sitting at the nurses station. the company don't pay me to take care of residents they pay me to chart so they can get paid. my job charting on medicare residents is long and time consuming. if it isn't charted then it isn't done. same goes for you so write on your cna sheet. i am also dealing with families , labs, orders, mountains of redundant paper work and what ever else the boss decides to give me for the day.

since we work as a team and poo poo rolls down hill, if i get it from the uppers chances are you will too. on the same note i will take up for you 100% if i know you are doing your job.

well i think i have said enough . pardon the rant i had a wicked, dirty, ugly weekend at work.....i wish you the best with your studies...you will make a great cna

if i was your assigned cna, what would you expect from me? what could i do to really make your job easier and provide for patient care?
i am basing this question on the assumption that this is how it works, the cna gets assigned to an rn or lpn.
i am in the cna program right now, and i want to make sure that i am actually going to benifit my coworkers and patients. i don't want to just be a useless body getting a paycheck.
misslo

misslo · Jan 21, 2008

Wow, alot of the responses feel like a big warm group hug! Thank you for all of your responses and well wishes!

I am planning to hopefully start nursing school next winter semester. I decided to do the CNA for a few reasons, one, that I want to learn by personal experience how to nourish and care for the patients/residents. I feel that starting as a CNA, from the bottom up, will give me much of that experience. Also, I love to help people. My whole life (thank you mom and dad) revolved around helping others in need. What better way to help than become a part of a nursing team?!?! I also think, that for myself, skipping the CNA step and going straight to nursing could be overwhelming (for me). I don't want to miss out on a good thing because I skipped some important steps. I also want to develop a good habit of TLC and nurturing before I learn the other important tasks. Am I making any sense? I don't want to ever, EVER, become crass and uncaring and I think that going the CNA route will help me to achieve that.

In becoming a CNA, I also want to set a good standard for other assistants. I know, a big task, but if learning what the RN's and LPN's need from me, and being able to pass that on will provide relief to them and provide better care for patients and residents, then I am up for the task. One of the things that I have learned so far in my CNA class is that nursing assistants are part of a team. All it takes is for one bad team member and the team can fall apart. I don't want to be the one responsible for my "team" falling apart. I want to do what I am training to do and I want to be the best darn CNA that I can be. All of the advice I have gotten on here thus far is helping me along the way.

Sorry for the long response, I am just on a mission and I want it to be a successful one!

MissLo

calliesue · Jan 21, 2008

Thanks for asking!

First be pleasant, to me to pts and to staff.

I'll be nice too . Understand that I will have to ask you to do things and am not trying to tell you how to do your job, but am trying to communicate what needs to be done.

Let me know when your going to leave the floor so I don't have to search for you if I need you.

Never tell me thats not my patient, cause if I am asking you for help with a patient I need help. Plus they are all our pts.

Understand how important you are to patients and the facility where you will work. Especially in long term care .

You will be the person who sees the pt the most and will notice subtle changes that I might not notice.

Know that even if other nurses don't respect what you do I will.

Your work is hard and it is important.

Also don't Get into it with families or tell them about problems. Refer them to me, and I will take their ration of crap so you don't have to.

If you see blood. I need to see it .

If you see skin issues don't assume I already know tell me so I can check it out.

Never pick one of my pts up off the floor without getting me to asses them first and help.

Just the fact that you have asked the question tells me you are going to be great. once more Thanks for asking, and to turn it around what do you expect from your nurse?