I'm not the CNA I wanted to be.


I have done direct care for 20 yrs and this is my 1st CNA job in a nursing home.

I've heard all the stories about neglect etc. Even when in training in clinicals we (as student CNA's)would talk about the regular CNA's and how "that resident hasn't been repositioned in 4 hours!"

I was going to be different! Every resident would be repositioned every 2 hours, briefs changed or at least checked Q2hours etc.

I honestly try and I give it everything I have. I take shortcuts (armpits, and groin are sometimes all I can get washed etc), but honestly and truely with all my efforts, there are the residents who go 4/5 hours without being changed or even repositioned because I JUST CAN'T get to them. Now I understand what I saw while in clinicals.

It really bothers me. I'm not sure what I'm looking for, but, is there anyone in LTC, with 10 residents, who CAN get it ALL done? :unsure:

10 residents on which shift? Yes, LTC is hard. That's why I will never work it again. It's possible to get all of it done, but you have to have teamwork. Big hugs


52 Posts

I'm on my second week at a ltc yesterday I was assigned 6 residents which I was pleased with however after providing care for 2 I was reassigned to another floor because 2 cna called out. On the new floor I was assigned 11 more residents with 30 minutes until breakfast. It took me a long time to provide care for them I was still giving baths after lunch. I'm not sure i'm cut out for ltc or maybe its just the day shift. The other cna had 11 residents of her own and the nurse was not helpful. I requested help with the hoyer lift and was told go ask my peers for help. I asked the cna and she told me she had her own assignment to do. Ugh I think about throwing in the towel all the time.

allnurses Guide

Hygiene Queen

2,232 Posts

It can be done. You learn to rush between residents but you slow down when you are with them.

It takes time to get a routine down.

It's okay to be slow in the beginning because you are new.

Sure, you'll hear aides say, "Oh, I can get 20 residents in bed in 2 hours!"

Well, so what?

What was the quality of the work?

Quality over quantity.

You will also, as you catch on, be able to sneak in a quick position change (and still do it gently and with care) and you will learn how to respectfully inform some residents that they will have to wait while you provide care for someone with a greater need for your assistance.

You grow more efficient with tasks and more savvy with residents as time goes on.

You need team work, so the best way to foster that is to be available to the other aides. You can even help them out without waiting to be told. You lead by example and, hopefully, when you are in a pickle, the favor will be returned.

This all doesn't happen overnight and it requires you to stick with it.

If you are working in a reasonably healthy atmosphere, you can eventually thrive.

However, I know this is not always the case and that some facilities do nothing to foster team work and healthy attitudes.

I don't what type of place you are in, so what I have said is the best advice I can offer you.

Take care.


366 Posts

Specializes in None.

When I got pulled to the LTC unit I had 16 residents one day. I know how you feel. It's not a matter of being cut out for it. To do your job effectively (bathing, changing, repositioning, feeding) I think 6 would be a perfect amount. Because of that one day I got pulled I have been applying to other jobs and pray I do not have to go back there again. Hugs to you. It's especially hard if you have coworkers that don't work together as I experienced that day.


32 Posts

That's exactly how I felt during clinicals. One of the CNAs told me that some of what I learned in class/clinicals is inapplicable to the real-world. Time management is extremely important, deadlines must be met, and the responsibility is overwhelming.

What is the CNA:resident ratio like at your facility? For the facility I work at...

AM shift- 1:5 or 6

PM shift- 1:8 or 9

noc shift- 1:15 or 16

I like working noc shift because all I do is change briefs and reposition---very low-key and I work at my own pace. After three weeks on the job, I was called in for a PM shift and quickly became overwhelmed. I don't even want to think about what the AM shift goes through.


51 Posts

I work 2nd shift with a ratio of 1:10 but at least once a week there is a call out and we end up with 1:14 or 15. With most residents being a fall risk and with dementia.

We are a great team and we all try to help each other, which is a bonus and I know not every facility is like this one.

I think it is more difficult when you don't know the residents (as when staff calls out and I get more residents added on). Nurse's don't help out other than to respond to chair alarms, but they are always respectful and supportive with any questions or concerns we have.

Thanks for the support and encouragement. I will give myself more time to get the hang of it.

I've worked all three shifts: 1:8-10 am, 1:11-14 pm, 14-20 nights . Above poster I wish I had that low of a ratio all the time when I worked LTC. Day shift was the hardest. I felt like I was on a three ring circus. Nights were the easiest. Good luck. You will be fine. I survived all three shifts u can too.


184 Posts

I can completely relate as I told myself the same thing. Sometimes I can get all my residents checked and changed before dinner time (when I do work 2nd shift) when my ratio is 1:10 (that's the usual load on 1st and 2nd shift at my facility with the exception of the dementia/Alzheimer's Unit). Most of the time, I just focus the most intense of my energy on the ones who need the most help with their ADLs. And of course, it all depends on my residents' state of mind that day. There are days that hardly anyone rings; the next day, you're barely turning one light off before the next one hops on their call light.

The rule of thumb I operate by anymore when I work the floor is hands, butts, faces. I make sure they are at least toileted and clean in dry briefs or pull-ups, and their hands and faces are clean. I especially focus on that when we're short because people don't show up or call in.