Wonderlost

I don't think we're overstaffed anywhere, that was just a response to the previous comment above mine. I get how bad it is. I was a tech for about 5.5 years, & every year it seemed I had to take more patients for the same pay and worse benefits, and it was even harder on the nurses. It's why I decided against nursing school myself. It isn't sustainable though, especially now that more and more people are getting sick of it...

Thanks for getting back to me! Just to clarify, I know that the teach back programs are effective, I was just curious if anyone knew of any particular models that they've had good results with. The last hospital I worked in used "Ask me 3 Teachback" which I didn't see great results with, but that could also be because of other factors... I do like the idea of sharing the data with all the staff. I'm not sure if they are already doing that, I don't actually work for them, but it would be nice to get the HCAHP scores & readmission rates out there just to encourage transparency...

That's really interesting that we are overstaffed in comparison. Makes me think about how much time is wasted on the customer service focus that we have now & the HCAHP scores rather than providing quality care/education. All the documentation & necessary C.Y.A is also time consuming...

I've worked for a few places as a CNA, & short staffing was always an issue. I also felt helpless to do anything about it as a CNA. You're expected to provide top notch care and with minimal resources since the only thing the company cares about is the bottom line (money). I think social work is a good choice if you want to try to make an impact and really advocate for the wellness of the employees. Happy nurses = happy patients and more money in the long run. Really though, it is something that needs to change at the system level. "Streamlining" aka "cutting corners" to save money is common practice these days all over the US. The accountants that run hospitals and LTC facilities do not care about the patients, they care about the money, and as long as that status quo remains I do not think there is much individuals can do. If you want to make a difference at the organization you work for, then my suggestion would be to research data on how having more nurses and CNA's can lead to better reimbursement and better patient outcomes. Just saying "we need more nurses" to admin is not enough, at least in my experience, but if you can show them numbers you may be able to get some results. A good fix with a lot of these issues would be for employers to actually value their staff... Good luck with that, though.

Hi everyone, I am currently serving as an AmeriCorps VISTA with a public health coalition in Alaska. I work with a few community groups, and the main one that I work with is at the local hospital and the goal of this group is to reduce hospital readmission rates. Before this, I worked as a CNA in an ortho hospital & on a psych unit for a bit so I have some experience in the field. The group consists of a few administrators (DoN, ER manager, QI director), & care coordinators from outside clinics. We've been talking about the issues, reviewing HCAHP scores, and will soon be identifying some clear measurable goals/objectives. One idea that was brought up at the last meeting was implementing a teach back method to try to increase education prior to discharge, tracking this in the HCAHP survey, as well as developing a tool to assess patient readiness to discharge. I am happy to see members of hospital administration & staff from outlying clinics in the same room to discuss these issues, but at the same time I can't help but think we are trying to solve a problem from the top down. Just going by my experience back home, trying to solve issues like this never worked. Nursing staff was never involved & no matter what the administration tried to do, their solutions never worked because the nurses just weren't involved & there was zero transparency and I am scared that is what will happen here. My questions are: 1. How can I convince the administration that we need to get direct care staff buy in? & 2. Does anyone have any suggestions for teach back programs? I'm familiar with ask me 3 teach back but it did not seem very effective. Thanks everyone! Any advice is appreciated. Looking forward to finishing my VISTA year in August & getting back home to finally do nursing school, but I'd like to leave knowing I made some impact with this hospital group, lol.

No complaints! Went from orthopedics to a behavioral health unit, stayed there for a few months up until graduation last month (BS in health promotion) and accepted a VISTA position with AmeriCorps to work in public health. Off to LA tomorrow, then I will be spending the next year in Alaska :) Planning on using the education award so I can pay for the RN program next year. It's been a very hot summer, so looking forward to the change in climate..

I thought my credits from my current BS would contribute towards entering as an officer? I was hoping to do that, and then use the GI bill to go in to nursing school and work my way up to NP.I will have to see if I can find a healthcare officer recruiter around here next week.

I stopped by the office today but I didn't see anyone inside =/ I am thinking that at the end of my AmeriCorps service, I will just use my education grant to get my ADN from a community college and see if that will help me anymore with joining. Thanks for the tips, though!

Hey there! Congrats on the job :) I'm not a RN yet, but I worked in an orthopaedic hospital for a year as a CNA, mainly on the total joint replacement unit, but I also had to go to the spine unit as well. I can offer a few tips from my perspective as a CNA, I hope it helps you out! Watching a surgery is a great idea, I got to watch a total knee replacement and it really puts into perspective the kind of pain these patients are in. In my opinion, it is not an easy unit to work on bc the patients are always calling out to be turned and get pain meds, and just seeing the surgery helped me to understand that they weren't always being a little dramatic. A lot of patients will get confused after the surgery just because of the drugs, which I guess is true for all surgeries, but it's worse on the ortho unit since they have really limited mobility and are high fall risks. Make sure you learn how to use the alarms on the beds, picking up a several hundred pound knee replacement patient off the ground is no fun. I once had a guy leap out of the bed and try to strangle me because he thought I was robbing his apartment, and he moved so fast that you wouldn't be able to tell he had surgery a day before but he was so unsteady he would of fallen over had he not grabbed onto me, lol. Carrying on with the confusion thing, I don't know what it was about this particular hospital, but we would have a ton of people withdrawing from alcohol. I guess they were embarrassed to admit it to the admitting nurse before their surgery, and they'd end up withdrawing. A little trick I learned from my house supervisor was to ask them what they wanted to drink, and often times they would say things like Pabst Blue Ribbon or wine. Personally I think it's helpful, you can be kind of preemptive and get them started on CIWAS or whatever protocol the hospital uses for alcohol withdrawals. A lot of times the patients will have drains in their sites (we called them hemovacs) and I noticed that the tubing can get pulled out from the actual vacuum container really easily, so putting some tape around it is a huge help so you don't find a bed full of blood on a 2 hour round. Also, and this is something I didn't know until recently, but the tubing can get clogged and you may think they are done draining but when you go to pull them out (I did not do this as a CNA, it was the RN's duty) it will end up shooting blood across the bed and floor so always be wary. Spine patients were my least favorite, they complained way more and seemed to have the most post op issues. They can never get comfortable and seem to call out more for meds, and we usually had to reinsert catheters on them more often than the joint replacement patients. Just be prepared to be turning these people all night long, and definitely utilize ice packs with them. Probably the best advice I can give is to be friendly to your CNA's and be prepared for a lot of physical work. Orthopedics is very physically demanding for the RN's and CNA's and they are very needy patients. A typical night for me was taking Q4 vital signs on 8-12 patients a night, walking people to the bathroom all night long, turning people, placing and removing catheters, emptying drains as needed, I was constantly moving for 12 hours. The nurses were doing full body assessments changing dressings and removing drains, constantly giving medicines (esp pain meds), sometimes they would have to report to dr's how the patients were doing depending on which doc did the surgery, and always be prepared for an admit from the ED. You will get a lot of little old ladies with fractured hips, esp from nursing homes. The night was always so much smoother when the nurse and the CNA support each other. Don't be scared to delegate to your CNA's. In my state, I am able to place and remove catheters, remove IV's, do some wound care if the wound is over 48 hours old, and a few other nursing procedures. It will make your load easier and it is good experience for a CNA going to nursing school. In exchange, just help out with taking patients to the bathroom and taking vital signs, and other things that the CNA normally does. If you're busy, walk them to the bedside commode and tell the CNA you put them there and we can take them off. I hope this helps you some! Let me know if you have any other questions and I will answer them as best I can. There are a lot of precautions you will need to know for the different types of hip replacements and knee replacements, as well as precautions for spine patients, but I think it is best to learn those on the unit so you can actually see what needs to be done. The physical therapists should be able to show and explain all of them to you, and PT will give you a ton of tips on how to move patients around and ways you can kinda "test" to see if they have the strength to get out of bed before moving them. Good luck!

Hi all, I just have a question or two about joining the air force and going into nursing, and I was hoping you guys could help me! I have been a CNA for the past few years, and I just graduated with a BS in health promotion and I have accepted a position with AmeriCorps to go work in Alaska for a year in public health. I went for a BS in health promotion bc I have always enjoyed the opportunities you get to educate patients in acute care settings, and I was thinking of getting certified as a health education specialist but I am scared that would take me away from the bedside. I was wondering if my degree would help me out when joining the air force, and if it is possible to go all the way to nurse practitioner? I'd love to work as a NP in med/surg. Any advice or information you guys have for me is much appreciated. Thanks! Also, sorry if this is not the appropriate board, I wasn't sure where else to turn. My mind has been racing with all I am going to be doing the next year, and it helps me to have a game plan in advance. Lol.

No, I did not do any volunteer work. I got my CNA in November 2010, & then a job in January 2011 so I didn't really need to, & was employed for a year. Now, I simply can't afford to drive anywhere to do volunteer work even if I wanted to. I don't know what CNA's do whenever they volunteer at places, I doubt they are allowed to do any clinical work at all d/t liability issues.

I am going to go back to school & get my CNA2, until I find a good enough job that I can pay for school myself Nursing market is flooded right now, especially here in NC, it is hard to find anything for us as CNA's aside from home healthcare -_- Try dialysis clinics, it would be good experience bc they train their techs to use the machines, at least the one I interviewed at does. You might want to get your med tech certification as well

DOC is the prison, things will be different there. I am in NC too, I worked inside of the Gaston county jail. I've also applied to the DOC CNA jobs but have yet to hear a response lol. I got lucky when I got the jail job, but I only took it for the money. I wish I hadn't, even though I learned a lot, it doesn't matter that I know what I know bc I'm a just a CNA -_- I would try a nursing home, & then after a few months, apply at hospitals.

That was just in my specific county jail. I knew the vice president of the company, and she was contracted to work in that jail alone, so she set the rate of pay for the techs & the nurses. It sounds nice, but when I started there, they had me working full time hours with no benefits, & by the time I was let go, I was working maybe 2-3 days a week & only 6 hour shifts, so I could of made more with a full time job making 10$ an hour probably. Don't do it for just the money lol, if you decide to leave & get a new job, it can be hard

I got in trouble at my last job for using an ammonia inhalant to wake someone up who had taken a lot of klonopin when I had to take their vitals & I couldn't get them up, before I used it though i didn't try a sternal rub, & they said that I went outside of my scope, so since then I've always been really cautious & paranoid about things lol. Thanks for the answer though. I doubt I will work with them again anyways. Travel job that doesn't compensate for gas, so no point in it right now lol