New CNAs have questions or need encouragement?

[azcna]

I have been reading a couple of threads here lately about CNAs who are discouraged, need support, or have questions about their new job (or on how to GET that first job). This saddens me, because I remember my first day, and all the stress of being a new aide. I have been on this forum since before I ever signed up for a CNA class, and it has always been very helpful to me. So now that I have almost two years experience I would like to offer as much advise and encouragement as I can. Although I don't have a ton of experience I have worked in both LTC and a few different hospital specialties.

On behalf of myself and all of the other experienced or semi-experienced aides on this forum, I want this to be a thread to answer new CNAs questions and get encouragement when they are feeling like the world (or at least the DON or all other aides and nurses) is against them.

To all the newbies, just remember that EVERY aide has been in the situation that you are in. Most of us come into this career wanting to better peoples lives. When we find out how terribly people are treated in nursing homes it breaks our hearts :redbeathe

[LaterAlligator]

Oooh! I'm not really new anymore, but I have a question: anyone have tips for brushing the teeth of someone who's too confused to rinse and spit? I've tried wetting a washcloth to at least wipe out most of the toothpaste (although sometimes they just bite down on it and then it's useless) or going over the teeth again with the toothbrush with just water on it.

Any ideas? I just hate the idea of sending them off to breakfast with toothpaste in their mouths!

[azcna]

The only solution I can think of would be using a toothbrush with only a little water on it to scrub the teeth, or to use those mouth swabs if you have them. I don't like putting liquids in peoples mouths who are confused. I would be too afraid that they would aspirate.

[CoffeemateCNA]

Oooh! I'm not really new anymore, but I have a question: anyone have tips for brushing the teeth of someone who's too confused to rinse and spit? I've tried wetting a washcloth to at least wipe out most of the toothpaste (although sometimes they just bite down on it and then it's useless) or going over the teeth again with the toothbrush with just water on it.

Any ideas? I just hate the idea of sending them off to breakfast with toothpaste in their mouths!

For those residents, I don't usually use toothpaste. Does your facility have disposable swabs/toothettes? Those seem to work best for those types of residents. I dip them (or a toothbrush) in diluted mouthwash and scrub away. That way I don't have to worry about trying to get the toothpaste off.

[PDXnursing]

What is the easiest method for checking a resident after bedtime who is sometimes incontinent but wears pullups?

Also, when you have a resident whose family is there for hours each day, what is the most tactful/respectful way to get them to leave the room so that you can check the resident's brief? I don't like actually saying that "I need to check her brief" or "I need to change her" as I think that it is kind of disrespectful to say in front of the whole family. "I need to provide personal care"?

[fuzzywuzzy, CNA]

I use a toothette or a wet washcloth to wipe toothpaste out of people's mouths, unless I'm afraid I'm going to get bit, and with people like that, where is the toothpaste going anyway? Those people won't open their mouths so you only get the outsides of the teeth and so there aren't many "suds (I can't think of the right word)" to begin with.

For checking residents with pull-ups: isn't there a stripe that changes color when wet? If not, pinch the brief a little bit and see if it feels squishy.

As for telling the family you need to check her, just say you'd like to take her to the bathroom. That way you're not mentioning incontinence, you get privacy for her, and she has a chance to go on the toilet.

[CoffeemateCNA]

Also, when you have a resident whose family is there for hours each day, what is the most tactful/respectful way to get them to leave the room so that you can check the resident's brief? I don't like actually saying that "I need to check her brief" or "I need to change her" as I think that it is kind of disrespectful to say in front of the whole family. "I need to provide personal care"?

If you are feeling nice: "Why don't you go get a cup of coffee and some fresh air while I take care of your [insert relationship here]?"

If they can't take a hint: "Can all of you step out into the hall for a few minutes?"

If that still doesn't work, spout something about it being against facility policy or whatnot. I don't know whether it truly is or not, but since 99% of all other things seem to be against policy, what's one more to add to the long list?

[azcna]

"since 99% of all other things seem to be against policy, what's one more to add to the long list?"

Haha! So true! I'm glad more people don't question the "policies"

I usually say something like "Could you step out for a moment please while I take your mother to the restroom?" And if the family says "She can't walk, how are you going to take her to the bathroom?", they are pretty much inviting you to respond by telling them exactly what you plan on doing. I find that most family members are grateful for what you do, and won't question you when you want to initiate some sort of care.

[yousoldtheworld]

For those residents, I don't usually use toothpaste. Does your facility have disposable swabs/toothettes? Those seem to work best for those types of residents. I dip them (or a toothbrush) in diluted mouthwash and scrub away. That way I don't have to worry about trying to get the toothpaste off.

This is exactly what I do. The majority of my residents on my usual group are NPO, tube fed, and have trachs. I scrub their teeth with water and mouthwash.

[LaterAlligator]

Good tips on the oral care, thank you everyone!

My facility mostly doesn't have swabs/toothettes unless someone is NPO (rare) but most residents have their own toothbrush and toothpaste. A lot of mine are cooperative enough to open their mouths for brushing but not able to understand "rinse and spit" and will just drink the water if I give it to them or are on thickened liquids so I'm afraid to give them any to rinse with in case they aspirate.

Thanks to your tips I've been trying watered-down mouthwash if they have it, a tiny bit of toothpaste if appropriate, and just plain water in a pinch. So far the wet washcloth wipe-out works pretty well for the cooperative ones, and I just go over the mouth again with plain water on the toothbrush if they won't let me wipe their mouth out with a cloth.

Whew!

[daimere]

If they are there all day,they probably know what you will be doing and probably know the schedule and might excuse themselves. Also there are some residents families that will want to stay there during care (and sometimes help).

[BeezRN]

How to give a proper bed bath is one of my main conerns... I know how the book describes it but most of the time (since I'm new working about 3 weeks) I'm pretty slow and I can't take forever with one resident. I end up taking forever regardless and miss my breaks but at least I want to get it done. I don't know if i do it properly: i use two washclothes. One for soaping up and the other for rinsing off the soap and stuff using clean water. of course i start with the cleaner areas first then move on to the private parts last. Can some one give me a step by step process for this. because I'm pretty sure I'm doing it improperly and would hate to hear a complaint about it. I try to get them clean at least tho so they're "areas" don't smell. What about the hair what would be a quick way to wash with out taking too long.