New CNA working in LTC getting depressed...please help!

fuzzywuzzy, CNA · Jan 25, 2012

Here we go, I can feel one of my long posts coming on....

I hate to say it but your coworkers are right. You simply do have to get used to it, and it takes time. It's hard to give you any concrete advice when I don't work at your facility, so I can't tell you something like, "Make sure you do Barbara first, or you'll end up having to change the whole bed, and save Bob for last because once he's OOB he rings constantly.... and make sure you put Emma on the toilet 30 mins before lunch or she'll mess her pants and climb out of her chair in the middle of us trying to feed people." But there are SO many little details like that that you figure out as time goes on. Are you asking your coworkers for *specific* tips on picking up speed? Because it's easier to answer questions like, "does Bob have to be OOB for breakfast?" or, "what order should I do my assignment in?" then "how do I get faster?"

One thing you should ask/think about is who gets up when. There are pros and cons to getting people up early. If you get someone OOB and dressed first thing, then you can make the bed and cross them off your list. BUT if they're assist of 2, it's much harder to toilet them later. Some CNAs are just like "toilet people? hee hee whateverrrr!!!" but that's actually important to me, lol, so I take that into consideration. If you dress everyone and leave them in bed, you can easily change them or put them on the bedpan all by yourself, but then you have a zillion residents to get up before lunch and you have to depend on other people to help you with the transfers and it can turn into a huge waste of time. PERSONALLY if I'm leaving someone in bed, I make sure they are as done as done can be. Meaning they are washed, dressed, briefed, teeth brushed, hoyer sling underneath them, wheelchair outside the door, etc. I put their pants on and pull them up over the knees. That way I can still change the brief as needed and when it's time to get up I literally only have to roll them a couple times to change the brief and get the pants up, then make the bed once they're up. It drives me nuts when someone says a resident is "done" and you go in there to get them up and they are laying there with just a shirt on and you have to put on their pants, shoes, compression stockings (ugggh!), put them on the hoyer sling (after searching for one) AND run and get their chair from the storage area. What seemed like a simple task has now turned into a big production. I work with seasoned CNAs that do this all the time and I just don't get it! And they wait until 10:45 to approach anyone for help, and they have like 6 people to get up, and it takes at least 10 minutes of running around to get each person done and then they get all stressed out wanting to know why they're late for lunch! COMMON SENSE, people!

Also, are you doing everything by the book? Honestly, you might half to do things half-assed for a while. I'm a raging perfectionist but if I'm on a new unit or at my per diem job, which I don't know well, I have to let go of a lot of stuff that I would do for residents I know well. I like to toilet people frequently and change them at least every 2 hours but I work with tons of seasoned CNAs who can't manage to check someone's brief more than twice a day. You might be "slow" because you're actually trying to do more than what the seasoned CNAs are doing. That said, since you ARE new, you're probably actually slow in general and in order to get faster you'll probably have to skip on a lot of stuff and focus on the bare minimum. It sucks but if you continue to be slow and it annoys the other CNAs enough, it's going to be harder to get help when you need it, which will slow you down even more, and they are going to start getting resentful and tattling on your for stuff you didn't do because you're too slow (even if they don't do that stuff either). I've seen it, and it's not fair, but it happens.

Another thing that works for me is getting most of my AM care done before breakfast. If your facility is strict about getting the breakfast trays passed out on time then that might not be an option. I haul ass before breakfast because I know that after it's done, there are more call lights, alarms, and other time-sucking distractions. Plus I just figure if I'm going to be spending time changing someone who is wet, washing the urine off their bottom and either boosting them up in bed or getting them OOB then I may as well go all the way and dress them. Some people are in a hurry to get breakfast done with and they get annoyed when I drag my feet passing them but those are the same people that annoy ME by not having anything done before lunch!

You mentioned that you have a partner. I've found that working in pairs makes everything easier and it's best when they literally stick together all day and go room-to-room. Then whoever finishes first helps the other person finish their stuff instead of just leaving. But since you're slow, this is kinda up to your partner to do that.

nguyency77, CNA · Jan 28, 2012

You have 2 hours and 15 minutes to get everyone up? You are so lucky! I get only 50 minutes, then I have to go pass trays with the other NAs. Just think of other ways to do things. Some people are in long-term care even though they're almost completely independent! For example, if Mr. X likes bedbaths and is relatively independent.... Let him do the bath. There is no sense in standing there while he bathes himself and tells you war stories. You can do something else, and when he's done, he can call you and you can chat with him a little as you help him finish cleaning up. Don't compromise safety, but just remember there is more than one way to do things.

h_kitty, CNA · Jan 28, 2012

Yeah I have about 50 minutes to get everyone up before I start passing out breakfast trays too. Morning shift is a lot faster then PM shift, so if it's your first CNA job and you were thrown in there, (like I was), you'll start getting faster. trust me:). You do charting faster, give showers/bed baths faster...you'll learn tricks. I was the same way when I first started.. so you'll get there. :] I do a lot of different things at the same time so maybe you can do that too. Like say I have to get up 3 men in the morning who are all roommates, in like 15 minutes. I get one up, dressed, to the bathroom first because he likes to be in there for like 10 minutes...while he does that, I'm standing near the door changing his roommate's dipense,(while still watching the other guy in the bathroom) getting him dressed and putting him in his wheelchair. then when the other one in the bathroom is done, get him out, give both of them a wet washcloth and comb (because they can do that for themselves while I get the 3rd one up) ....you know what I mean. Use your time. when you have time, DO CHARTING. Don't save it for last. You're morning shift, so if NOC sometimes get most of your people up who need to be up, use that time to do one of your showers or something before breakfast. you have 2 hours to do stuff, later for you, that will be a lot of time once you start getting faster! Use your time:)

fuzzywuzzy, CNA · Jan 28, 2012

Technically, we have 10 minutes for each pair of CNAs to get 16 people ready for breakfast! We get on the floor at 7am and dietary drops the trays off 10-15 minutes later. Needless to say, our meal trucks sit there for a while before we pass them, except when the state is there and then everyone is on us like white on rice hassling us to pass trays.

A lot of our people have to be OOB to eat, and even if no one did, it still takes more than 10 minutes to change, boost, and give dentures to that many people.