Published Jul 16, 2010
Serendipity, PCT
187 Posts
just landed my first job as a cna in a nursing home/rehab
this is a very exciting time for me as i have been waiting since last year when i passed the boards to land a cna job. all this time i have been working as a chha in home health.
my question is: what are the do's and don'ts for new cna's in orientation? what can i expect and how can i best prepare? the orientation begins this monday and i was told it could last for 1 week depending on how "proficient" i am.
i would particularly like current cna's who have had to train/orient new staff at their facilities to answer as well as rn's/lpn's if you are searching this board. i'm hoping for the best . as i've stated, my previous experience is in home health so transitioning to facility work is going to be a lot different; i was told i could have up to 20 pt's depending on what shift i work. supposedly, i will be working 7am- 3pm for orientation, but will be staffed on 3pm- 11pm. those of you who work these shifts, feel free to tell me a little about what to expect as well. .
this can be a continuous thread for new cna's as a reference as well as to share our orientation experience :redbeathe:nurse: congrats to all who have just passed the boards and/or are beginning their first jobs!!!
CoffeemateCNA
903 Posts
At least for the first few months, do a lot more LISTENING and OBSERVING than you do TALKING. Get the "lay of the land" before you start making comments to others. I was with another CNA on my first day of orientation, called one of the nurses a VERY rude name to the other CNA. Turns out it was her aunt.
Don't get upset or offended if the CNA(s) that are precepting you are not exactly warm and welcoming. Know that they have to train a LOT of people, very few of which end up staying at the facility. They sometimes feel like they are "wasting" their time.
Ask questions, but don't bombard people with them every 3 seconds. If it's something that you can look up, then do so. If you must ask, try to "spread" your questions around on other people so that one person isn't bearing the brunt of it.
NEVER tell your preceptor, "Well, that's not how we learned how to do it in class!" He/she will hate you.
Bring your lunch on your first day. You never know how much time you will have for a break, and you don't want to have to go driving around town looking for a restaurant and rushing to eat and get back.
Know that you will never be able to get everything done. As a CNA in a nursing home, you will have to "triage" your residents and get to the most urgent tasks first. Unfortunately, there is seldom time for the small details.
Don't wait until the end of your shift to get your paperwork done. Do it all as you go along.
at least for the first few months, do a lot more listening and observing than you do talking. get the "lay of the land" before you start making comments to others. i was with another cna on my first day of orientation, called one of the nurses a very rude name to the other cna. turns out it was her aunt. don't get upset or offended if the cna(s) that are precepting you are not exactly warm and welcoming. know that they have to train a lot of people, very few of which end up staying at the facility. they sometimes feel like they are "wasting" their time.ask questions, but don't bombard people with them every 3 seconds. if it's something that you can look up, then do so. if you must ask, try to "spread" your questions around on other people so that one person isn't bearing the brunt of it.never tell your preceptor, "well, that's not how we learned how to do it in class!" he/she will hate you.bring your lunch on your first day. you never know how much time you will have for a break, and you don't want to have to go driving around town looking for a restaurant and rushing to eat and get back.know that you will never be able to get everything done. as a cna in a nursing home, you will have to "triage" your residents and get to the most urgent tasks first. unfortunately, there is seldom time for the small details.don't wait until the end of your shift to get your paperwork done. do it all as you go along.
don't get upset or offended if the cna(s) that are precepting you are not exactly warm and welcoming. know that they have to train a lot of people, very few of which end up staying at the facility. they sometimes feel like they are "wasting" their time.
ask questions, but don't bombard people with them every 3 seconds. if it's something that you can look up, then do so. if you must ask, try to "spread" your questions around on other people so that one person isn't bearing the brunt of it.
never tell your preceptor, "well, that's not how we learned how to do it in class!" he/she will hate you.
bring your lunch on your first day. you never know how much time you will have for a break, and you don't want to have to go driving around town looking for a restaurant and rushing to eat and get back.
know that you will never be able to get everything done. as a cna in a nursing home, you will have to "triage" your residents and get to the most urgent tasks first. unfortunately, there is seldom time for the small details.
don't wait until the end of your shift to get your paperwork done. do it all as you go along.
thank you so much for your response!! you made some great points. the one that sticks out the most is when you suggested that i listen more than i talk; i will definitely take that to heart because i am very prone to be a talker - which isn't always good. i'm going to heed your advice and scope out the scene first!!
also, it's been a while since i completed clinicals and it slipped my mind to bring a notebook, so thank you for saving me once again, lmao i'm not going to go all out and buy extra supplies right now. what i'm going to do is work for about a week, observe the other cna's and i will eventually buy things i need along the way. . do you bring a "cna bag"? if so: what's in it if you don't mind my asking. .
anywho, great advice nevertheless and i can't wait to see what advice others have. those who are new or orienting should post here as well to share experiences. i've been working in direct care for a year and it really takes a special person to stick with this long term. it's easy to start, but as they say, not many finish. regardless, if anyone is blessed enough to have the experience of a cna/ direct care personnel, you will definitely take something with you and learn something from each pt :redbeathe:redbeathe
Do you bring a "CNA Bag"? If so: What's in it if you don't mind my asking. .
I have a lot of stuff in my bag, and the contents are always changing, but here's what's in it now:
-stethoscope
-blood pressure cuff
-pulse oximeter
-Post-it notes
-pens
-cough drops
-pocket drug reference book (for when I'm passing meds)
-lotion
-Band-Aids
-Shout wipes
-individual pockets of Tylenol
-ID badge
-lanyard
-gait belt
-tea
-candy
-Sharpie
-alcohol swabs
-scissors
-water bottle
You won't need most of that stuff -- I just like to be prepared for everything.
You are definitely well prepared !!! From what i've gathered so far you seem to be an amazing CNA. .Cool, you get to pass meds?!
I had the opportunity to work in a NH yesterday. My HH agency also staffs HHAs in NHs to be sitters, etc. From what I saw, NOTHING is the way we learned in class. In fact, there was only ONE bath basin instead of two for a complete bed bath. Is this normal? Lol. No soap.. just pre-soaped disposable cloths. ONE towel for the bath etc. Let me just say that i'm glad I saw that first hand yesterday so that when I start orientation tomorrow I don't look like such a NOOB,
What got to me though is how rough some of them were with the PT's especially the hospice PT's. When the CNA went to bring her to the top of the bed she yanked her so hard that the PT hit her head! It's like they had that "they gonna die anyway" attitude. The bed bound hospice PT was begging for food while mobile PT's were in the dining room and no one seemed to bring her anything. . hmm Right before that the PT's family left and seemed pleased swearing up and down their loved one was receiving good care. .
All in all I enjoyed myself yesterday. But I only had one PT - Tomorrow will be a different story when I start orientation on 7AM-3PM. I gotta wear white scrubs so I bought beige panties, a little notebook, im gonna bring a pen, watch, and polish my white nursing shoes and bring my lunch. Hopefully things run smoothly Thanks for all your advice!
You are definitely well prepared !!! From what i've gathered so far you seem to be an amazing CNA. .Cool, you get to pass meds?!I had the opportunity to work in a NH yesterday. My HH agency also staffs HHAs in NHs to be sitters, etc. From what I saw, NOTHING is the way we learned in class. In fact, there was only ONE bath basin instead of two for a complete bed bath. Is this normal? Lol. No soap.. just pre-soaped disposable cloths. ONE towel for the bath etc. Let me just say that i'm glad I saw that first hand yesterday so that when I start orientation tomorrow I don't look like such a NOOB, What got to me though is how rough some of them were with the PT's especially the hospice PT's. When the CNA went to bring her to the top of the bed she yanked her so hard that the PT hit her head! It's like they had that "they gonna die anyway" attitude. The bed bound hospice PT was begging for food while mobile PT's were in the dining room and no one seemed to bring her anything. . hmm Right before that the PT's family left and seemed pleased swearing up and down their loved one was receiving good care. . All in all I enjoyed myself yesterday. But I only had one PT - Tomorrow will be a different story when I start orientation on 7AM-3PM. I gotta wear white scrubs so I bought beige panties, a little notebook, im gonna bring a pen, watch, and polish my white nursing shoes and bring my lunch. Hopefully things run smoothly Thanks for all your advice!
I have additional certification on top of being a CNA, so yes I get to pass meds. I still like "working the floor" primarily, though.
Get used to having no supplies whatsoever. Those bath basins are luxuries -- I don't think I have ever seen someone have 2 for a bed bath before!! In the last several years I have only seen ONE real bed bath done -- the rest were done with those yucky sticky disposable cloths. It's been a long time since I myself have even done any bed bath -- period! Luckily we have hospice companies that are contracted that come in and do such things for their assigned residents.
I wasn't there, so I can't say for sure, but the way those CNAs were treating that resident is pretty "normal" with everyone, not just hospice residents (by the way -- you can prevent conking the resident's head when you move them up in bed by taking their pillow out from under their head and placing it against the headboard).
Are you sure the resident wasn't NPO or receiving parenteral nutrition (ie, G-tube)? Then again, the CNAs might have just been lazy. I've seen them mark down "refused" for residents for eating because they were too lazy to sit down and feed them.
Wow!! I can't believe you have to wear white scrubs to work! I wear white pants on occasion but not a top because of the risk of getting them dirty.
Jhely06182009
45 Posts
Thanks to both of you.I just got a call from a post acute in Atlanta,Ga and i'll start orientation next tuesday from 8am to 3pm.The pay is $ 9.25 and i don't have experience as a CNA.
fuzzywuzzy, CNA
1,816 Posts
The pace is fast... expect to be a lot less thorough than in home health. You will be expected to take shortcuts. And your supplies will probably be lacking. There's not enough of anything to go around. You'll never be perfect and in the beginning, you're gonna suck. No one ever feels ready to come off orientation, and even after that it takes a few months to get comfortable. Also, a lot of the staff is going to be stressed out and less than patient with you. Try to roll with it because the same people who you thought were so nice during orientation might drive you crazy a few months later, and vice versa.
The most important thing in LTC is the routine. I think it's kind of stupid when facilities train people on 1st shift and then throw them on 2nd because second shift has less staff and a completely different routine. Just try to move way faster than you're comfortable with and don't make a production out of everything.
During your orientation everything can be really confusing because there's so much going on and the way things are done varies depending on the staff, the mood of the residents, who is supposed to have a shower that day, etc. Bring a small notebook and write down the routine. Usually you can break the day up into chunks- before breakfast, before lunch, after lunch, whatever. Each chunk of the day has a different objective (like on 3-11 everyone gets up and toileted before supper, then everyone gets washed right after supper, then you spend an hour doing showers, then you do bedchecks). I trained on 3-11 and I remember being really confused because before supper we toileted a big group of people. Then after supper we ONLY took care of the people on our own assignment, and not all those people were the same ones we toileted before. It just all ran together by the end of the day and it didn't make sense to me. But there's a rhyme and a reason for how everything is organized in these places and everything gets a lot easier when you know what you're supposed to be doing. Personally I wish I had focused more on the "whys" than the "hows" when I was training.
Watch how the other CNAs approach the residents, but take it all with a grain of salt. Sometimes you can get good ideas on how to deal with certain residents from watching the other CNAs, and sometimes you learn what NOT to do. When I was orienting, there was this old man who was horrible! He was on the toilet, covered in BM, giving my trainer a hard time when she tried to clean him up. She looked very irritated and kept whining and huffing at him like, "Stopppppp! Don't touch thaaaaaaat! Geeeeeez." Then when I got off training and had to deal with him by myself, I was too afraid of him to say much of anything and he didn't give me any trouble.
One thing I noticed about trainees is that they'll follow you around even after orientation, waiting to be told what to do. Really the only way to learn anything in this job is by doing it a zillion times. Think for yourself and have some common sense because the more you depend on others, the longer it's going to take to get used to the job.
For now,i'm just signing papers.By friday night,i'll get hands on training.Hope everything will be fine.