New CNA at LTC - already frustrated

mvm2 · Jun 26, 2013

I am so sorry that you are having such a hard time. LTC work is the hardest work I feel a CNA has to go through.

Just to give you a little of a perspective ofwhat Home care is like, I am a CNA working in Home Care, and I love it!!! I am working with one client at a time. I am never rushed but can do my duties and feel I can really help and get to know my clients. You can have a great range of people and what their needs are. You will sometimes have to do house work which some CNAs take offense to because they say I did not take CNA classes to be a house keeper. But the way I see it they can't do these things and they have to be done if they are going to stay at their homes. So I don't mind at all. My company is great as well. We put in our times that we can work a month ahead of time. I can decide what days I work and when I have to take off. I never have to miss a birthday or a school function because of work. We also can say what shifts work best for us. As a mother of young kids it feels perfect for me.

You just have to decide what is best for you. Sometimes if you give yourself time things can start to go smoother and you can get use to LTC, and then you will learn to love it. But Home Care is also a good option for you especially if you are going to school you may be able to tailer your working shift around your schooling and it won't be to stressful. Big Hugs and I hope things can get better for you

TurtleCat · Jun 26, 2013

I know how you feel. I'm working in LTC and relatively new myself, and it really is a stressful and demanding job. I'm also working on getting my speed down, and there's times when I feel like I'm making good time but then there'll always be some distraction -- like call lights going off, residents giving me a hard time and asking for this or that, etc. The other CNAs seem to fly through their work and I just don't know how they do it. Then again the other aides I've seen seem to half-do their job so I guess that's how.

I think what eats at me the most is some of the emotional and verbal abuse I have to deal with from residents. Last night, I had a lady (one that's in her right mind) throw a fit and go off on me because I didn't shower her right after dinner. She told me I didn't know what I was doing and was unfit to be in the medical field. This really stung at me, especially since I'm still fairly new and struggling to keep up. This may seem silly to ask, but I was wondering if anyone else here has been told by an AOx3 resident that they were "an idiot and didn't know what they were doing" or if it's just me that's incompetent. I admit that I have a problem with taking things too personally sometimes. A demented patient can hit, scratch, grab, etc. at me all day long, and it won't even phase me, partially because I know they're just confused and there's no intent in it, but an AOx3 patient berating me and telling me I don't know how to do my job is something that gets to me. All my previous jobs, I worked hard and took pride in a job well done. This job, I always feel like I'm falling short.

There are parts of the job I do like. I love it when they assign me to work in the lock-down Alzheimer's/special-care unit, it's a lot different and also less hectic and stressful back there. For every difficult and hateful resident, there's several sweet, cute and lovable grandma or grandpa types that makes me look forward to going to work everyday. And also... I think there's something to be said for sticking it out in a hard, demanding job and pushing through... I think it helps build character and emotional strength.

Part of the problem, I think, is that I may also be overworking myself. I have a fast food job that I work during the daytime, and doing that only to go work at the nursing home in the evenings really takes a toll on me sometimes, physically and emotionally. I need the money and experience but it's draining me... I find myself a crabapple a lot of the time and I hate that, because I'm the type of person that tries to be nice and kind to everyone. But I'm just not sure what to do when I have two different employers pulling me in every direction, I have a hard time saying no because I worry it looks bad.

boogalina, ADN, ASN, BSN, MSN, LPN · Jun 26, 2013

Plan on things feeling like this for the first 3 months or so. . .it's a big adjustment to go from being something else, to a CNA in LTC. Remember that you are new and some things will take 3x longer (or just feel more tiring) because you are having to think through them from the ground up. You are getting to know two teams. . .your coworkers (CNAs, nurses and other professionals) and your residents. It takes a while to get the knack, but it will come.

The time management, people management and physical skills you will learn as a CNA will enrich your ability to not only competently care for people, but also feel confident doing so. As a new graduate nurse, with just now having 2 years of CNA experience (5 months LTC, 1 year 10 months acute care ICU), I really feel that working has helped me be sure that this is the right path for me, that I can hack it physicially, and given me experiences that just aren't available in nursing school.

So, tough it out, learn from your more experienced coworkers, listen to your residents, and you'll find your way. In about 2.5 months you'll drown less and swim more. You can do it! Don't give up!

TurtleCat · Jun 26, 2013

I would also like to add, I think that I would love to do home care... I think it'd be a better fit for me, as I do better with jobs that are slower-paced and less stressful... and I like the idea of one-on-one care. I don't like the fact that in LTC, your time is so limited that you can really only give the bare minimum to your residents. I think they deserve better than that, these are their last few years after all... I'd love to have the chance to spoil these souls and go above and beyond for them, but can't due to understaffing and time constraints. Only issue is I don't have my own car, and that's one job where you're pretty much required to have one, no way around it. My plan right now is to try and get my experience in LTC, then hopefully get my license and car and work in home health/private duty. Either that, or go back to school to be a veterinary technician instead. I thought about doing RN, but ehh... with how stressful CNA work is for me I just don't know how well I'd handle RN, with 10x the responsibility and liability.

The difference between CNA and LPN/RN, or at least how I look at it, is that as a CNA, you have to REALLY screw up for someone to get seriously injured or die. However, as an LPN/RN, the patient's life is literally in your hands and a mistake as simple as a small miscalculation can end someone's life. I just don't know if I could deal with that level of responsibility.

Glycerine82, LPN · Jun 26, 2013

I was wondering if anyone else here has been told by an AOx3 resident that they were "an idiot and didn't know what they were doing"

On more than one occasion. It isn't easy, its certainly not "right" but hear what I'm saying.....it took me a long time and many many nights of reflection to get here...........

What I try to remember, is that these people are in the middle of possibly the worst time in their lives. They have control over very, very little. They aren't with us when we run around all night, and some just don't "see" how hard we work. They are sick, they need help and 30 minutes can feel like hours. A lot of times they are bitter, angry, scared, confused etc. They don't look at it like we have 13+ patients--nor should they. All they know is dinner is over, they want to go to bed and its going to take at least an hour for her hair to air dry. "Where is my shower!!" That is "literally" all they have control over. When to request a shower. Can you imagine letting other people control almost every single aspect of your life? When you take medicine and what you take, when visitors can come, weather you can go outside for a smoke or not. They don't get to go grocery shopping, or cook dinner for their families. They don't get to have a friend over for coffee or watch movies with their spouse. I try to remember this and really think about what It would be like to be in their shoes. Really think about it. Usually the pt has no medical knowledge and has no idea what a day is like for us. I try to "kill them with kindness" and usually I have the pt. won over by the end of the task at hand. Some patients will tell you to go finish with everyone else, usually they are old nurses or people who have worked in healthcare. These patients are so refreshing and awesome to care for. I just try to remember I am there for them, and I get to go home to my family at night. They'll likely never go home again, so I let it slide and smile and apologize. My favorite saying is "perception is reality".

This doesn't mean its not hard to hear that kind of stuff, and abuse shouldn't be tolerated, but snarky comments do happen and I just try to see the reasons behind them. Straight out abuse though, from an alert and oriented patient needs to be reported and shouldn't be tolerated.

Glycerine82, LPN · Jun 27, 2013

So it has been about two weeks at my new job and I already see why people run from LTC. I am working the 3-11 shift five days a week. I have been floating between halls a lot which makes things hectic. Especially since I am not super familiar with all the patients. I am trying really hard and I am absolutely exhausted when I get home. I feel like I can't keep up! The CNAs are way over worked. Most of them don't even have a second CNA for their hall. I know I need to work on my speed but it really bothers me to take short cuts I feel like I am having to sacrifice patient care in order to gain speed... Is this something I just have to get used to?
I have another job opportunity with home health but I feel like I will be giving up and I hate that. I absolutely love my patients even the needy ones... I just wish I had more time for each of them.
This job is one of the most mentally and physically demanding jobs and the nurses don't help at all. I have so much respect for CNAs. I am going to RN school in the fall and I just don't know if I can handle both... Home health might be a lot easier with school.
Any advice or thoughts would be appreciated. It feels good just to talk about it because I haven't told anyone. I feel ashamed of being so stressed and seeking other options after only two weeks

OP-- You will get there. Read my other post about lucid people who are being jerks.

You are only one person, you can not do it all. You don't have to "cut corners" to get better with time management. I promise, it will come. You will learn tricks along the way.

I will put a resident on the commode and have them put thier pajamas on while they are sitting there. Pants off, sit down, pull up/brief on, pajama pants on, up and in chair. I save steps by not having them get up and down multiple times. Doesn't seem like a big deal, but all those minutes add up. Then, If they are alert and oriented enough to sit in front of the sink alone I will let them put their top on and brush their teeth while I move on to the next person and get them on the commode....while the next person is on the commode (provided they can be left alone) I will go back to the first person who should then be ready to get in bed and tuck them in. Then back to person 2 and so on and so forth. Usually I try to put my max assists to bed all at once with help and round on them through the night.

Its stuff like that you will learn as you go. It will also help as you learn all of the residents and their little quirks. It can take a long time at first. Once you know that Mrs. S. likes her toothpaste set up a certain way and wants to use 3 paper towels, it will save you time.

Its about multitasking. And approaching things tactfully. I don't just put someone on the hopper and say OK time to put on PJ's. I'll say, "I'm going to have you get your pajamas on while you are on the potty (or insert your word for toilet here) so that you can save your strength. It will take less steps and get you to bed faster." Or something like that.

It will all come in time. Remember you are only one person, try to prioritize. If any of your patients will let you get them in their night clothes before supper--do it. I would try to convince anyone who was going to be eating in their room to get their pajamas on around 4om. I would just let them know I have time right now if you would like or I'll be making bed time rounds around 8pm. They usually opted for 4. It sucks, I wish I could give them all exactly what they want exactly when they want it but I simply can not. Neither can you. Remember that, good luck you are doing great.

evmarie · Jun 27, 2013

I really appreciate everyone's encouragement! I got stuck by myself on a hall tonight. It was pretty stressful but I learned a lot. I still just have a long way to go with speed. I like what the above comment says about getting a routine down. I can't wait to have that because right now I just feel overwhelmed. And as for someone telling me I'm incompetent that happened to me too tonight. Made me feel absolutely awful. We were short on techs so I had to run to another hall to help someone while a lady was on the commode. 15 mins later I got a chewing out. I deserved it I should have waited until she finished and helped out after. It's just hard to figure that out without the experience! I'm learning I guess patients and coworkers will have to bear with me for a bit. I am trying my best and working my tail off. So hopefully I will improve, I don't want to give up but I am thinking about going to part time just to ease up on my stress level and maybe doing some home health on the side so I can compare the two.

chibifloom · Jun 27, 2013

LTC is HARD. There's no getting around it. Personally, I worked in a skilled nursing LTC for 4 months and it seriously makes a difference in how good you will be as an aide/nurse. I started off as slow as they come, but speed will come with time. Cliche, but true. It took awhile for speed to come, shortcuts or not.

I now work in home health (boooooring! compared to the constant running at the SNF) and an assisted living facility (which scooped me up as soon as they heard where I worked and what I did there). I have skills that are desirable to other employers and if you're anything like me, you'll miss the stress. I honestly think about going back to the SNF I was at before because I miss my old residents, I was good at what I did, I always had an adrenaline rush, and my weight was down while working there.

Don't give up! You'll thank yourself later! And good luck in the meantime!!

blwilliams10 · Jun 27, 2013

I work in LTC on a locked psych unit and love it. It is hard, but just remember speed comes with time, everyone was in your shoes at one time, and don't take things personally. I have been working in LTC 3 months now and I am just now getting my routine set and getting fast. The people who are the fastest either have been doing this for a while or they are skipping stuff. Trust me though skipping stuff is NOT good, it causes behaviors, resident morale is lower, infections, and a lot of other issues. I know a lot of people who skip peri and oral care but really it only takes a couple extra minutes and the residents are a lot happier after they get it.

Also remember some residents will be mean to you. I have one resident who will literally punch me, slap, scratch, bite me but as soon as they are up and in there W/C they will take my hand and kiss it. I have had one resident tell me you don't know what you're doing, you just got to roll with the punches and keep going. People get angry when you are violating their personal space and get combative but you can't let it effect you or your care level because once it is done they will be happier.

laurel72 · Jun 28, 2013

I have been working at my facility since January. I am per diem and only worked weekends. I have since begun to work 3 days a week. I can say that the first few months are the worst. It is hard to get to know the routine, residents, staff, and handle the demands and fast pace. Sometimes I hate my job soo much! However, you should keep trying. I feel that all ltc facilities are no walk in the park and we should just make the best of it. I used to have so much anxiety when I knew I would be put on an unfamiliar floor, but as time went on, I got to know the residents and staff and felt more comfortable. I now prefer to be on my floor, but I do not get tense and unable to sleep if I feel that I may have to be on an unfamiliar floor. Practice makes perfect, and as time went on, I walked out of my facility with a smile. I still have to deal with tough situations, drama, and lack of help on a daily basis, but everyday I learn more and become more acclimated. Hang in there and keep trying. It will get better!