New CNA Job

Becky718 · Dec 17, 2005

I just want to say thank you to all of you who have responded for the great advice you are giving me. The more I work this job, the more I see what you are talking about. Most of these CNAs I work with really don't seem to care if they do the job right. Their goal for the day seems to be to try to get by with doing as little as possible and get paid for it. There are some good ones who I enjoy working with, of course. But the others are lazy and just plain rude. I am not letting their habits rub off on me, though, and the residents really appreciate it. They are the only reason I still enjoy the job and are the only reason I can imagine wanting to continue doing this. I'm about to leave for work right now actually. I am keeping in mind all of the things you all are telling me, too. I look forward to reading more posts. Thank you all!

Harleyhead · Dec 17, 2005

You are doing a wonderful job and speed will come the more you do it. The one thing to be careful with is feeding. Pts can get choked a aspirate. If you are required to pass meds be careful the wrong med can kill. Just keep doing the best that you can and apply to a nursing school we need your kind. Good Luck:balloons:

Megsd, BSN, RN · Dec 18, 2005

I was hired a a CNA in July and am really enjoying the job, although it is very physically, mentally and emotionally draining. I am getting to the point where I feel confident in my position, but it took me a while. My advice to you would be to try to stay organized and manage your time as best you can. I work first shift, so all my examples may not apply to you, but hopefully they will help.

When I first got out of training, I knew I was slower than everyone else and it took me about 30 minutes to get someone up and do ADLs. Since I only had an hour between start time and breakfast, this meant I could only get up 2 people. So I asked the nurse who absolutely HAD to eat in the dining room for health reasons, and who I could leave in bed until after breakfast. Then I prioritized, and got those who had to eat in the DR up first. Now it only takes me 15-20 minutes to get someone up and ready, so I can do 3-4 people in the morning instead of just two. It was important for me to recognize my limitations in order to work within them.

You may also want to consider asking other CNAs or your nurses for advice on how to get things done more efficiently. A lot of them know little tricks that can save you a little extra time. Another thing I would recommend is to find out who you can depend on to help you with transfers or anything else requiring a second person. Often I will make a deal that "If you help me take Mary to the bathroom I'll go help you with Pam next", which saves both of us the trouble of calling for, and waiting for, help later on.

Trust me: with time you will get more efficient at your duties, which has many benefits. The other CNAs and nurses will trust your judgment, which means you get rid of a lot of nagging reminders. Plus, you'll have time to get to know your residents better, which I think is the most rewarding part of my job. These people have seen and done so much, and they love to share their experiences.

Best of luck to you, and hang in there!

cdsable · Dec 21, 2005

Hi. I am 24 and I just got out of a 10-day CNA program and passed the state exams...skills and written. I was hired at an LTC facility and started working there on Dec. 2nd. This is my first job working in the healthcare field. So obviously, I am very nervous about what to expect. I've worked there for 4 days now and am slowly getting the hang of it. I want to know if someone could give me some advice. What are the most important things for me to be aware of while I'm working as a CNA? I am so worried about doing the slightest thing wrong because there are so many things I am still learning, and I don't know what I should focus on the most. I hope I am making myself clear. For example, I seem to take longer than most of the CNAs when I change a patient or put them to bed because I always try to make sure before I leave a patient's room that I have done everything perfectly, to the last detail. I feel like I am missing the big picture b/c I'm too focused on details. I know it's good to focus on details, but when I compare my work to the others around me, I can see that I get a little TOO obsessive. In fact, the CNA who trained me told me I need to be in the "get her done" mentality to do this job. Just do it and don't worry too much about little things. That really goes against my nature, but hopefully, with time I will stop worrying so much about minor things and be able to get things done more quickly.
Can you tell me what you would look for in a CNA to decide if they were giving the best patient care possible? Thanks a lot. I appreciate any advice I can get.

What I look for in good work from CNA'S are they do their required care of the patients. AM care, mouth care, turning and drying as needed and every 2 hrs., making sure their call lights are in reach, feeding or prompting them to eat as needed. Get their vital signs as assigned. Documentation daily on your patients is very important, if not documented it was not done. Notify charge nurse of any unusual finding of the patient, such as skin tears, falls, frequent cough, vomiting, diarrhea, constipation, not eating, crying, anything not ordinary. You will get more the hang of it and better at everything the longer you do it. You will also get faster and less nervous about your work. God bless you for your care.

Nikki69 · Dec 31, 2005

Becky-How is everything going? Are you a little bit more comfortable now? I am a CNA too. I know what you mean about the aides that don't seem to care. I am fortunate enough to work at a great place that usually gets rid of the ones who don't. I have orientated alot of new aides, and i can tell within the first half an hour which ones are keepers and which ones aren't. You sound like a keeper. I always make sure my residents look nice, are clean at all times, no food on face, clothes, etc. The one thing that I am obsessive about is taking the residents to the bathroom as much as possible. In this job, there is no reason to be taking a break unless its your break time because somebody is always going to need to go potty, or at least be cleaned and changed. Make sure you always apply protective ointment after every incontinent episode. While in the residents rooms with them, I talk about my life, or the weather, or just something goofy with the residents who are upset all the time, or who just plain don't talk at all because it seems to make them more comfortable. I always smile and try to take the focus off them while doing care, and tell them what I'm doing and going to do before and as I'm doing it. Also, even when I'm working with the less desirable aides, I answer their call lights too. Not just my own. I hope you continue to enjoy the way you make a difference in these people's lives because these places need more aides like us in them!

Becky718 · Jan 1, 2006

Thanks for asking. Everything is going better in some ways and worse in others. I know how to do more things now, but I am getting more anxious instead of less as time goes by. It's mainly because I feel like since I've been there for a month now I should be as fast as the other workers, but I'm still not feeling very confident in my work. One of the reasons is because I cannot lift most of the patients on my hall and constantly have to ask for help lifting them. Everyone else can lift them without any help from anyone. It makes me feel so useless. I'm only 5'3" and about 110 pounds with really thin arms, and I feel very uncomfortable even when I am just helping to lift someone.

Also, I work the 3-11 shift, and I always do bed checks with the other CNA about 45 minutes before the next shift comes in. The 11-7 person always expects everything to be perfect when they come on duty. I do the best I can getting everyone changed and making sure their sheets are clean, but most of the time a few of them will wet the bed again right when I am done with bed checks and just as the next shift is coming in. It makes it look like I did a half-ass job when I didn't. I know that since I am new, they are all scrutinzing me and are making their judgments of me and it makes me so anxious. I always leave feeling like a failure even when I have done nothing wrong.

I know I can't help it that I am not physically strong, but it's embarrassing being the only one who needs help lifting people. I like to be independent and to be able to do my work without help, and in this job, that is not an option. I always have to get help. Sometimes I can't even turn the person or roll them over to change their diaper without getting help. Is that unusual for a CNA to be that weak?

If it weren't for that problem along with the anxiety it causes me at work, I would say things are better. I enjoy taking care of the residents, and they are the only ones who appreciate my hard work anyway. Without their feedback, I would not know I was doing a good job. It's easy to focus on only what you're doing wrong in a job like this b/c there is more to do than there is time to do it. I am going to focus on managing my time more efficiently since that is something that I can control. I cannot control my physical strength (unless I start working out) so I'll just have to get help in that area.

Well, thanks so much for listening and for the advice. If you have some to give about lifting patients, I would love to hear it. Thanks again and have a Happy New Year!

Marylou1102 · Jan 1, 2006

Hi Becky, congrats on your new profession. You sound like a caring and loving individual, so stop beating yourself up. You will become more adept at your job with time. Stop comparing yourself to the CNAs who have been doing this a lot longer than you. Others have made some valuable suggestions about time management, you will eventually find what works best for you.

As far as not being strong enough, wait. You will build the strength and stamina you need. The The problem I run into are the aids who won't wait for help with transfers or resident care and end up hurting themselves or the patient/resident. This is why families sue and nursing staff has such a high injury rate. Never be afraid to ask for help.

And finally, avoid the "get her done" mentality. People with attitudes like that are only there for a paycheck. They aren't concerned with the care they give and never see the patient/resident as a human being. It is a job and each resident is a task to be completed.

So good luck and hang in there. You sound like a great asset to the nursing profession.

cdsable · Jan 1, 2006

Thanks for asking. Everything is going better in some ways and worse in others. I know how to do more things now, but I am getting more anxious instead of less as time goes by. It's mainly because I feel like since I've been there for a month now I should be as fast as the other workers, but I'm still not feeling very confident in my work. One of the reasons is because I cannot lift most of the patients on my hall and constantly have to ask for help lifting them. Everyone else can lift them without any help from anyone. It makes me feel so useless. I'm only 5'3" and about 110 pounds with really thin arms, and I feel very uncomfortable even when I am just helping to lift someone.
Also, I work the 3-11 shift, and I always do bed checks with the other CNA about 45 minutes before the next shift comes in. The 11-7 person always expects everything to be perfect when they come on duty. I do the best I can getting everyone changed and making sure their sheets are clean, but most of the time a few of them will wet the bed again right when I am done with bed checks and just as the next shift is coming in. It makes it look like I did a half-ass job when I didn't. I know that since I am new, they are all scrutinzing me and are making their judgments of me and it makes me so anxious. I always leave feeling like a failure even when I have done nothing wrong.
I know I can't help it that I am not physically strong, but it's embarrassing being the only one who needs help lifting people. I like to be independent and to be able to do my work without help, and in this job, that is not an option. I always have to get help. Sometimes I can't even turn the person or roll them over to change their diaper without getting help. Is that unusual for a CNA to be that weak?
If it weren't for that problem along with the anxiety it causes me at work, I would say things are better. I enjoy taking care of the residents, and they are the only ones who appreciate my hard work anyway. Without their feedback, I would not know I was doing a good job. It's easy to focus on only what you're doing wrong in a job like this b/c there is more to do than there is time to do it. I am going to focus on managing my time more efficiently since that is something that I can control. I cannot control my physical strength (unless I start working out) so I'll just have to get help in that area.
Well, thanks so much for listening and for the advice. If you have some to give about lifting patients, I would love to hear it. Thanks again and have a Happy New Year!

Hi, Happy New Year!! Do you have a hoyer lift where you work? They are very useful and can prevent you from injuring your back or risk hurting a patient with a fall. If they don't have a lift ask them to purchase one for your facility. It is much easier when getting a patient up or returning them to bed. I'm sure someone can instruct you on using it. If nothing else continue to get help, I'm small too so I know what you mean. I have injured my neck and back by trying to lift someone that is too heavy. They will get over it, keep up the good work! Somedays it is very tiring, but rewarding in the long run. Let me know how you do. Bless you!!

Kristyn, RN · Jan 2, 2006

Hi Becky! I'm glad to hear you are sticking with it, we need people like you :)

To reply to some of your sepcific concerns:

Don't feel like you have to keep up with all the others now that you've been there a month. It took me at least six months to get my confidence, and there are still days when I feel like I can't stay on top of things. Besides, when you are doing things that other caregivers may not be, it is going to take you longer. Remember, lots of people cut corners. Don't turn in to one of them.

As far as transfers go, you WILL get stronger doing this job, I promise. Don't ever transfer anyone without help unless you are completely comfortable. It's just not worth the risk. Use a gait belt when you do transfers, even if your coworkers tell you it isn't needed--it will help you feel safer and it really does make lifting easier. Finally, if you are really uncomfortable, have someone at your facility, either a nurse or a physical therapist, review body mechanics with you.

Turning some people in bed can be difficult, especially if they push against you. Use the draw sheet to help get them over there if you can. We have one woman where I work, I swear she is so heavy, I have to get my knees up on the side of the bed to get enough leverage to turn her (I know, infection control!) Proper body mechanics can help with turning too.

You say the night person always wants everything to be perfect when they come on shift. :chuckle Well, don't we all? So what. Unfortunately, that can't always happen. Think about it, do things always look perfect when you show up? Maybe most of the time, but not always. Just keep doing your best. If you know you haven't got to something, tell them what it is. I would much rather hear "Jane hasn't been to the potty in a while" than to assume she has been and find her soaked when I next check on her. Sometimes people will pee again right after you change them--heck, sometimes peole will pee when you are in the middle of changing them. To try to avoid this, I do several things. I offer the bed pan. I get them up and take them to the toilet if possible. I might even gently press on their bladder to see if I can make them pee before I change them if they are completely incontinent. But even then, sometimes people will wet again. If you are really worried about it, you COULD write the time on their brief when you change them, but I don't really recommend this.

I'm glad that you still enjoy your residents, and I'm glad they appreciate your hard work. Just keep at it, I know it will get easier. This might sound stupid, but I don't even really know you and I appreciate your hard work. CNAs that care make us all look better to the public we serve. :)

doddlebuggin · Jan 2, 2006

congrads on the new Job.I was a cna for 2 years while I prepared and went to nursing school and to this day I still work at the same LTC facility.the things that stick out to me now as a nurse are 1) if you can answer the same question the 25th time with the same kind tone as when you answered it the 1st your meant to do this job. 2) If you give the care that you would expect for your parent ,your meant to do this job. 3) and if you consistantly do the little things that wont bring you glory but benifit your resident you are meant to do this job. you have 8 hours to make a bed,bathe,straighten that room but you have a vested interest in the well being of YOUR residents and it shows.You sound like the very person I would want to take care of my parent and altho your peers may look down on the little things I bet your residents dont.Dont let it burn you out be consistant and it will pay off in the end.. Good luck and God Bless...:balloons: :saint:

Snow1278, RN · Jan 4, 2006

Hang in there! It sounds like you are doing great. Lifting takes time, but don't lift by yourself if you aren't comfortable with it. I am little too and lifting bigger people is hard for me. But I am not afraid to ask for help. I work in a really great place we all work together and no one gives anybody a hard time about helping out. I have worked all three shifts and don't expect any assignment I take over to be perfect, I just expect that the previous shift took care of the resident and the room is clean, the resident changed on last rounds,etc. I know when aides do their best and take care of the residents, you can tell. Not every person is going to be dry. Just keep up the good work it sounds like you are trying your best and your heart is in the right place!

Becky718 · Jan 7, 2006

Thank you all so much. I always feel so much better after I read your encouraging responses. I really needed to hear something good.

I experienced my first patient death on Tuesday. :scrying: That was very hard! She was only in her late 40s or early 50s, I think, and had a 20-year-old son...she was the sweetest lady. She was so lively, too....I didn't even realize she was that close to dying so it came as quite a shock to me. I am still kind of in shock. Her eyes were open when she died and she was alone. She was dead for 20 minutes before anyone even knew.. She wasn't on my hall so I didn't see her at all until about 40 minutes after she was dead. I'll never forget how she looked, either. I've never seen a dead body before....it's so creepy. I kept expecting her to just wake up, you know. It really made me start pondering about death and what it's like during the moment you are leaving your body.

Well, anyway, I just wanted to share that. Thanks again for all your advice. It's really helping. I look forward to hearing from you all again.