elite

I would think these cards would be updated shift to shift, if needed. I am assuming this is in a nursing home, so a lot of the info wouldn't change that frequently. And any med changes (or other changes) that you would need to know about should be communicated to you by the nurse anyways and then you can just add it to the card. Therefore it wouldn't be nessessary for a weekly review/update. The info is a need to know. But don't you go into each of the resident's charts anyway to do your charting? I don't believe this is out of a CNAs SOP. If ther are CNAs that can't be trusted to look into the residents chart for info YOU DO NEED to know about, then those CNAs shouldn't be working with residents to begin with!! In general, I believe that the issue could be solved (and many others) by the CNAs and RNs, at the beginning of their shift, have a quick report -go over anything from the previous shift and then again at the end of each shift in case there. Any updates to cards could be done then. I mean, we are not talking about a full plan of care review, just of a diet or med change etc. You wouldn't have to go through each resident, only the ones with any changes. And again, the nurse should be updating you throughout the shift if any changes are made. Honestly, that is only good nursing practice. A lot of the changes you would know away. Ex: if the resident went from using a cane to a walker. Or if they needed more help feeding themselves.

Working on a cardiac unit isn't much different than any other unit is a hospital (unless it is post cardiac surgery). Here are a couple of very important hints; 1)Always make sure your I&Os are up to date, accurate and daily weights are done. This is most important for the CHF patients if not all cardiac patients. The MDs will be looking at this for fluid retention. You and the RN want to make sure that the intake isn't more that the output. This is probably the #1 complaint from MDs - I&Os not being accurate. 2) make sure you check with the RN before you remove the tele monitor off of the patient. Don't be afraid of the monitors! They are just another tool to help you take care of your patient. 3) some MDs are big on letting there patients sleep at night. Sometimes you might want to check with the RN to coordinate your care (ex: she gives the meds and you check the BP at the same time) go into the patient together so you don't disturb the patient as much. A lot of CNAs are more nervous about going onto a cardiac unit than a reg med-surg unit. Just think, if you are taking care of a cardiac patient, they are monitored - you will know if there is something wrong (cardiac related). All the bell and whistles will go off. If you are on a med-surg floor taking care of a post appy patient usually the only equipment you have the patient on is the auto BP cuff (every 15 min). That's not going to tell you that something is wrong (only after 15 min when the BP cuff goes off and the BP is either high or low). I'm more nervous on a med-surg floor where there aren't any monitors to tell me what's going on!!! There is a lot to learn but is is one of the best units I've ever worked on!:redbeathe Good luck!

Also, you can work as a PCA, PCT, etc., what ever title the facility chooses to give you and do tasks that CNAs can't do because you are not working under the "CNA" title. Some facilities may want you to have CNA experience when they hire but that is only for your care experience and it is that basic training that they don't have to show you. So. if you are working under a CNA title then you have to work within your scope of practice and with proper training. If you are working under PCA, PCT titles, etc. there is no scope of practice but you do have to have proper training for tasks you perform.

Depends on your state and facility. Some CNAs can insert/remove straight catheters (not an indwelling foley) and remove IV med locks. Though some state and facility rules vary. Just because the state OKs it - the facility may not. You will come up against things you were not taught in CNA class. It may be within your scope to do some things that you were not taught as long as you get proper training. It would be best to check with your state's board of nursing/dept of health (or whom ever governs over your CNA license) to see what your scope of practice is in that state.

If you work 80hrs/pp you don't have to pick up on call time. 72hrs/pp it is about 3 4hr blocks in the 6 week schedule, 68hrs/pp 4 4hr blocks, etc. As far as low census on call is concerned, it rotates through all of the staff. You can either be put on call or called off, depending on how low census is, that decision is made by the CRN (inpatient supervisor). If you are called off then you don't have to wait around to be called in-you are free. If you are put on call, then called in any time after your shift started you get paid time and 1/2. Trust me, by the time it is your turn for it, you want it!! The other plus of Exeter is the fact that the managers and scheduler really try to make your schedule work for you.

I wouldn't bother with a med term class. As a CNA you probably know a lot of it. A lot of facilities hire CNAs or nursing students as UCs and do OTJT. In my experience, the Unit Coordinator keeps in close communication with all of the RNs and CNAs on the unit- especially the charge RN. To have a good UC means a unit that run smoothly. You have to have good critical thinking and very be organized. It is not just a job "sitting behind the desk, answering the phone". Of course, answering the phone is part of it. It is also entering MD orders, transcribing med orders, coordinating the patient exams and making sure patients have appropriate preps for the exams, staff scheduling, supply ordering, environmental safety of nursing unit, etc. UC duties can vary depending where you work. I love being a UC. As the UC you kind of have your hands in every part of the unit. You become a big resource for the RNs and MDs. I am still amazed at how much they rely on me. I retain my CNA so I can help out on the unit with phleb or lifting a patient in bed. I can't help out with the CNAs too much because I'm usually too busy at the desk. Though, I help out when I can.

A lot of facilities will train CNAs to do phleb. Then, depending on the certification provider, you can apply for certification. Where I received my cert through I had to have verification of doing phleb for 5 years, pay their fee, take and pass the test- this is for national certification.Though, you need to make sure it is within your scope of practice which ever state you live in.

Just to give you a bit of positive feed back on Exeter! Exeter doesn't solely staff with new grads and travelers. Yes, there are quite a few new grads (as there are in most hospitals because of the great number of retiring RNs), and there are a few travelers (not as many as in some hospitals) - but there are also, many RNs (and other staff) who have worked at Exeter for many years. The RN:patient ratio is pretty comparable, if not, a little better, with the other Seacoast hospitals. As for the pay diff., it could be better. It goes by % of base pay; evening/noc diff. is 20% (max $4.50/hr), w/e diff. is 7% (max $1.25/hr). There is mandatory on call time to pick up but it depends on how many hr/pp you work. Also, there is standby for low census that is only $2.50/hr but you can use your earned time to make it up-that does suck. Lately, low census is so infrequent that the RNs and LNAs welcome the call at 530am to stay home until needed-and if you want to come in there is always someone else that will take the standby! If you have worked at any of the Mass. east coast hospitals you would probably find that little Exeter Hospital is quite nice to work at. In my many years of nursing I have only worked in the Seacoast area(Ports.Reg.Hosp. , Went.Doug.Hosp.)Exeter Hospital has been the best hospital I have worked at. Of course, Exeter has it's problems (what hospital doesn't??)but not at the magnitude of other hospitals. The Seacoast area hospitals don't pay as well as Mass. but considering travel time and gas?? Hope this helps.