I'm a newbie and all of a sudden State's coming in

[TheAwkwardOne]

I'm a newly hired CNA, with no prior CNA experience other than clinicals, and I just got done with four days of training. I went through my first day of work by myself, and that was a total wreck. The rest of the CNAs were picking up my slack, and that was also embarrassing.

Now I've just been told that State should be coming in this week or next week - some time REAL SOON - and my stress level just went back up. I'm brand new, so of course I'm gonna be slower than everyone else. I was given a difficult run my first day of work, and now I've changed groups and have brand new residents. Well, they're not completely brand new, but I've trained with them for ONE day out of my four, so I'm still getting to know them. They said my group's supposed to be easier, but then again, I'm still new to this job...

I'm still learning the ropes to the facility, and I'm literally learning as I go. I'm slow, I'm small, and sometimes I need help turning residents or getting a sling from a lift underneath them; but now that State's coming, I also have to worry about the new "rules" they want us to enforce and I'm not even used to those new rules they're applying such as when we're feeding people.

I was told that it's basically going to be like the CNA test, only it's happening at a real nursing home - and the surveyors are gonna be there watching you. When I took my State test, the rules they had then are a lot more different than the rules they have now. The rules they have now aren't even common sense anymore. It's ridiculous.

I'm stressing out because I don't want my name to show up on the official report saying that I screwed up several things. I don't want people to know that I'm one of the ones that screwed up, and I bet you I will screw up at least SOMETHING because I'm totally new.

Any advice to give to someone who's totally new, still getting used to how everything runs and where everything is, and has State sneaking up on them?

[mrsboots87]

You are over reacting. When state comes in, they are checking out the FACILITY, not testing the aides. Your name does not go into a report to the facility unless they see you using a hoyer by yourself or knocking patients over, or giving thin liquids to a resident who needs nectar thick, as in doing something VERY unsafe. The state surveyors check the facility to make sure it is following state regulations in care. If you spill food on a resident, take a couple extra minutes to clean up a BM or something trivial, they don't care. They also check call light response. If everyone is with a resident when they press a light, that's ok. If they press a call light while there is staff in the floor and no one answers it, that's a problem. Just do your work and do your best.

I can can say though, it is red flag that you have "new rules" specifically for the state survey. I take this to mean that they allow for unsafe practices on a regular basis and only wish to show off for state.

Many facility is far from perfect, but the higher ups don't implement new policies when they suspect state is coming. The most they do is move the newer or the cruddy CNAs to the easier halls and the better CNAs take th difficult or lift heavy halls for the shift.

[hookyarnandblanket]

Do your job as you were trained to do. Try to block out the fact surveyors are there. Make sure you use your gait belt, use 2 people for all 2 person transfers, and if they ask you a question to which you don't know the answer, tell them you don't know the answer but will find someone who can answer it and *follow thought with it.* It is nerve-wracking but you will have to face inspection more than once in this career.

[Missingyou, CNA]

It's probably a good thing that you are new. The "stuff" from training is still fresh in your head and you haven't had time to develop bad habits.

Memorize the answers to things like " What are the types of abuse? & Who do you report suspected abuse to?" Those are the types of things a surveyor will likely ask a CNA.

Just do your job the usual way and all will be well.

[Leonardsmom,LPN]

I have been through many state surveys over the past eight years. As a new aide that hasn't been through one yet it can be nerve wracking, especially since management tends to get stressed at that time and it trickles down. Depending on the shift you are working your exposure to the state surveyors may be limited. Most of the time they are there during day shift hours with a little overlap into afternoons ( usually starting about 8 in the morning until 4 or about 5 in the afternoon). Sometimes they may pop in later in the evening or overnight, but this is not as common.

Questions that a surveyor may ask a CNA would be things such as what are the types of abuse, what do you do if you suspect abuse. What is the Elder Justice act, where can you find information about it in your facility. Where can you find information on the chemicals (cleaning products and such) your facilities MSDS book and where is it located. As another poster said, if you don't know the answer to a question say so, followed by who you can get the info from and follow through.

Before you enter a patient's room make sure you are knocking on the door. Provide privacy for your patients that you are taking care of, closing the door, closing blinds on the window, pulling the curtain if there is one before providing care.

Just remember to do what you have been trained to do and keep yourself busy. If you have any downtime don't stand around in the hallway ( that is an invitation for a state surveyor to come talk to you). Find a room that may need to be stocked or straightened up, provide nail care for a patient that may need it. There is always something that needs to be done.

[Valcorie34, BSN, MSN, RN]

Here are a few tips...

If state asks you a question and you arent sure of the answer, dont guess. Tell them you will double check. Ask your nurse or RCM then tell them. You will never be in trouble for taking the ti,e to be right.

State may check out rooms. So make sure to pick up rooms as you go, dont leave urinals or basins out. Bag then and tie them to rails in bathroom. Make beds, take out trash with used depends, or soiled toileting stuff.

Make sure call lights are near residents. Keep peri care supplies out of site.

Put feet on weelchairs. ( my first staye visit was my first week, I left footrests off and my RCM caught it)

If state ever wants to watch you do a process with a resident like a bedpan or a change just grab a more experienced CNA and two person it.

Its just stuff you would normally do. Just look over room before you leave. You will be fine. Its really not as scary as all the ner pus hyp in the fa ility sounds.

[NurseEmmy]

Shoot when state comes in you typically have better staffing. The DON and ADON will stress. That's not your problem and shouldn't be your concern. They are not there to trip you up. They just want to make sure the residents are getting safe care. Do a good job. Take extra time if you need it. It'll be ok.