It's not sunshine and roses at all

IEDave, ASN, CNA, LVN · May 29, 2012

Had my first CNA clinical day. I read here so much, so I've been a bit open minded and willing to embrace all challenges. Our instructor has been saying up to this point that the residents will absolutely love us, and they are always so excited to see the students come through. She painted a picture of sunshine and roses, and I bought it.
It was not sunshine and roses. It was quite honestly a very hard day. One day on the floor and I can tell you for sure, I do not have it in me to do LTC. They most definitely were not happy to see us. We got cussed at. We got told to go away. We had 3 people who didn't care either way that we were there, but the rest of the residents were angry, frustrated, and just generally not wanting to be bothered.
Frankly, I don't blame them for feeling that way. It's a hard situation that I'm sure most didn't choose to be in. I don't say all of this to complain, but more to say this is so hard. For those of you who are in LTC and handling the abuse, the mood swings, and other less dignified challenges day to day, I solute you. I don't know how you do it, but there is a world of people who depend on you who thank you for your strength and dedication.
Hoping for a better day tomorrow. And as hard as the day was for a first clinical experience ever, I'm thankful it didn't start with, "Be prepared to do postmortem care this afternoon," as two of my classmates were warned.

Welcome to the real world of LTC! :bugeyes:

You may be surprised to hear this, but it does get a bit easier with practice. Part of what you ran into is that elderly residents don't adapt well to change, and a whole new set of student CNA's just bugs 'em. Once they get used to you, it gets easier. I went through this when I first started working as a CNA in LTC "for real" - spent I don't know how many hours fighting with the residents before they finally figured out I was trying to help 'em. Still have to rassle some of 'em, but they know who I am for the most part.

Far as postmortem care? Well...at least you're getting a heads-up; when you're doing it as a pro, oftentimes the only warning you get is that your resident looks a little pallid and they don't respond to your touch - in addition to being cool & not breathing, with perhaps a bit o' fetid smell to brighten your day. Truthfully, as with most things LTC it's not as bad as you'd like to believe - like changing briefs, cleaning up mucus and vomit, etc. with time you just get used to it.

And, yep - it's hard work. Needed, but hard. But - it's doable.

Best of all - you get to do it some more tomorrow! :devil:

----- Dave

Twinkle007, LVN, RN · May 30, 2012

omg I love allnurses.com ......

I finally signed up for CNA class in L.A. and will see whats next ;D

white8tiger6 · May 30, 2012

I'm right there with you!! I just passed my basic CNA in April and I am not fond of LTC it is doable and it does get easier but its very hard to tolerate I do not know how people do it everyday for years!!! I am only dealing with it because 1. I need the job to live, 2. I'm trained so why not do what I am going to school for, 3. it will give me strength and knowledge as a nurse to move forward in my career and I've heard it really does make you a better nurse.

Other professionals can tell the difference between a Nurse that has done CNA work and a Nurse that has not. It does get easier and to be fair I didn't do post mortem care in my clinicals, I didn't do nail care, I didn't get shower experience, so do as much as possible because I am so green to CNA care. Once get some experience look for Home Health or get your Advanced CNA and get on in a hospital that's my next move. From one newbie to another good luck!

ixchel · Jun 2, 2012

I am very sure there is a huge difference between a nurse whose done CNA first and one who hasn't. Even just in basic hands on stuff-- I still feel like I might break someone every time I touch them. Yesterday was day 4. This has been so hugely eye-opening.

I'm considering advocating for patient/staffing ratios. My week has ended much better than it began, but I still feel so heavy in my heart. Is is absolutely not possible to care for 8 (and sometimes more) residents fully. The place I was working does not call someone in if someone called out. They just divvy up the residents so it becomes 10-1. Twice I had residents wheeled away from me when I'd been with them a very long time for feeding. It took them awhile to start eating, but I finally got them to eat, and they were wheeled away. One of them, the GNA said to me, "it's okay- she's on her way out anyway." it's not okay!!!!

My husband was working opposite me all week Until yesterday, when he was off. Last night I gave the kids video games to play together in their rooms, and hubby and I talked. I just cried for a half hour. I was trying to tell him how important it is that we make living wills now, while we're lucid, so we can plan for situations in case we face the possibility of dependent care. He didn't understand why I felt so strongly about it.

What's harder- he didn't understand why LTC facilities might be a bad choice. It was then that I realized that this isn't something you can just tell someone about and expect them to "get". Seeing it day in and day out is what changes you. Seeing it first hand is what makes you realize how terrible it can be. I have a feeling my sobbing through stories may have made an impact on him. I'm not a cryer in sadness. Not normally, anyway. I'm a happy cryer, generally. This week has touched my heart that deeply. It has left profound sadness.

So my state has CNA and GNA testing separately. I've decided not to get GNA because it's only use would be LTC, and I can't handle LTC. I've been scoping the hospital's listings and I'll probably apply at doctor's offices. It's complicated because I'll be dialing back my hours so much when school starts. This experience has truly been far more eye-opening than I ever imagined. I'm glad for all I've learned, and I can honestly say I have grown through this a lot. (Which sounds crazy when I've only done 4 days of clinical, but it doesn't take much.)

Anyway, if you're still reading this long-winded novel, thank you. It feels good to have a place to share this kind of stuff where people will understand.

Esme12, ASN, BSN, RN · Jun 2, 2012

The reality is so much more brutal than you can ever imagine. Back in the prehistoric times when I went to school(1977)

.....before all these regulating bodies. There was the private pay wing. The medicare wing. The medicaid wing that lead to the indigent wing. The staffing changed accordingly. Student were mostly placed in the medicare wing after one week with the paying patients. I always thought it was to keep us from running screaming from the building.

Once in the medicaid wing I was appalled and heartbroken for these poor people. Alone, ignored with bedsores you could put 2 fists into.....crushed and broken with feces caked beneath their nails. I wanted to quit and never return. I was done. You say that you will plan...that it will never happen to you, but life gets in the way. Childrens college, braces, unexpected illness, bills. In the US we don't take very good care of our elderly and our soldiers.

Sad really.... :sniff:

cdargavel1 · Jun 2, 2012

I work in a LTC facility and I love my work and residents :) I do pt time shifts in an Alzheimers/Dementia unit and Pallitive care. I found my clinical trying at best, but once in a routine and after getting to know the persons and families , I cannot imagine doing anything else