Autymnfyres

I always wonder about the efficacy of washing ones hands IN the patients room? Its good to see comments by other healthcare staff in this thread. The light switches, many of which are not automatic/faucets and/or sink are used in various ways throughout a shift, by several personnel and there is no cleaning going on throughout the shift of the faucet/sink. I am not super germ-phobic, but I try to go and rewash my hands in another employee sink, after assisting with various patients on contact precautions. I also wash my hands with non-anti-bacterial liquid soap after two to three uses of the in/out alcohol-based sanitizer pumps, which per our facility policy, we must use.

Venting. Love the actual skills I am doing and learning and the interaction with the patients at my hospital CNA position. However, I'm thinking after 6 more months I'd rather ask to transfer to a department that has fewer CNA's maybe. I'll be in my last pre-req classes in the fall before applying to several RN programs in my state. Working in one of the general med floors, there are 30-ish CNA's. Sooooo many type-A personality's unleashed! Its awesome to know someone is sharp and knows what they are doing, is efficient and responsible. What isn't so great is having to hear about it throughout the shift etc. Where I've worked before when you have a tough patient load, or especially unstable patient care you of course vent a little or ask for more help from other CNA's, but you get the job done, get it done right, focus on the patient care etc. However here, so many of them make a big verbal to do, flouncing around, acting like they are sweating, verbalizing every little task they do and how BUSY they are etc. At first when I started being irritated by it, I watched the RN's on the floor to note their reaction...but they seem to not think its wrong and offer sympathy. LoL, guess its cause I'm former military, or older or something. I've certainly had some pretty tough jobs in life, and while this job is super busy and many days you run your legs off, it is not like that every single shift, nor is it that crazy difficult on average. I guess I'm just venting. I keep my thoughts to myself and my facial expression neutral, but it happens a LOT; seems to be part of the culture here. Having a can-do attitude and moving on past the difficult moment is not anywhere in the expectation usually. Maybe I should later apply for a transfer to one of the departments that have fewer CNA's, ie on Mother-Baby, there is only one per shift a lot of the time. Guess I'm hoping maybe the work environment is different for CNA's say, in other departments. I love working in the hospital and have really enjoyed being able to do more skills than I did while working at LTC's, in home health or Assisted Living. Just finding it difficult to find a comfortable working mental place I guess. Thanks so much for reading and any tips or experiences shared would be great.

I hope you get some really great informative replies and will be watching the thread as well. I specifically have a BSN as my goal, but have had to adjust my plan A and B with regards to achieving it as a second career adult. I wanted to mention to you that unless that community college is where you got those pre-req's etc, it gets somewhat complicated. Every two-year program near me (*northern U.S.) has some sort of minimum amount of credits you need to have taken from that specific college. I.e., they do accept transfer credits of course, but have a requirement that you take for example, a minimum of 25% of the credits within two consecutive prior semesters for whatever major/program you are working on from THEIR college, or other similar requirements. So you may want to check into that for the community college majors in your area while you are thinking about applying to any two-year RN programs, to see aside from their generally posted transfer requirements, what others might be in the fine print. Another issue I've come across may have to do with living in an area where there are a limited number of colleges available within a reasonable driving distance. But, the two well-respected state colleges/4-year programs here are most definitely set up with a focus on candidates just recently graduated from high school/are just beginning a college path. After doing 21 credits worth of gen eds at the local community college I transferred to the university and completed two semesters to obtain the additional science classes I'd need and a couple more electives before planning to apply for the BSN program. I found that was not a very viable plan, even though I had a 3.95 gpa in my prereqs, and an overall 3.89 gpa. They restrict the already competitive openings to just 4 seats for any 'transfer' applicants. Additionally, those transfer applicants are to have no more than 12 semester hours accrued when applying. They do have a small cohort for the bridge program offered there which is on-campus and not online, which is of course directed at RN's/two-year AN degree holders. /rant-on Overall I was super irritated and realize it basically comes down to money as they want you to spend yours at their university, regardless of your academic worthiness or their supposed commitment to 'encourage' and support all to further their education. /rant-off. I certainly hope you live in a more metro area with a good number of programs to choose among, from which you can find a solid path going forward into your nursing career!

Thank you for your post BostonFNP; very considerate and erudite. As to the middle part where you said, "it's just the evidence-based practice is not what you want them to tell you..." I disagree since I do not want to really have an innate need to be told this. I hope to hear whatever the truth is wherein evidence-based practice is included and which can guide professionals and families to make the best decisions regarding this issue. It is true we feel a bit beat-up that the general masses do not support parents making this medical decision yet uphold parents on other medical decisions made for their children. I try to find reasonable statements to describe my stance and I diligently follow-up on many articles and resources which address the vaccination issue. I sincerely want an answer for my now-teen children (*all of whom completed the entire suggested vaccination series), so that they will have a solid core of information available to them about even choosing to have children. Focusing on genetics is really, really important. One thing (*although not new) I have bookmarked was interesting in continuing research about the study of genes and that link to Autism prevention: http://www.cnn.com/2014/10/30/health/autism-genes-studies/ I support responsibility in making medical decisions, and I know there are ramifications and consequences. A lesser part of those actually is the way I am treated by persons who are very passionately 'pro-vaccine' as a matter of fact. I am glad we live in a country where we do have the right to exercise medical choice. I too see the repercussions which could occur if a large percentage of the U.S. population declines all vaccinations. But I do think the right to make proactive decisions in medical choices is super important. The virtual toilet-papering of an online poster's opposition stance or comments on an issue, as has occurred in parts of this thread is disrespectful and distasteful. I'm glad for moderation on our forums also; thank you. I am no propagandist, and I'm not a poster-waving anti-vax screamer marching up and down in front of medical clinics who provide basic vaccinations free-of-charge. I am a devoted mom taking a quiet, firm stance and trying my absolute best to make the good decisions. I do admit to an ever-growing *bookmark/favorites list of online and hard-copy vaccination articles, studies and resources, both pro and con. I hope to share that information with my own family about decisions they need to make in their future, not to ever dis-inform others or use heavy-handed techniques to convince them. I think it is a grave issue, not one to be taken lightly nor to simply check off a selection box on, and go on merrily about one's life. Thanks very much.

JenRNWI, I would like to thank you for your very thoughtful and engaging post. I appreciate some of the points you made, and feel motivated to search further about some information you pointed out. I have wondered as I read through this thread why there seems to be such a black/white slant to the topic even here in an active forum of the healthcare profession? Why don't more nurses accept that perhaps with that covered up research, more studies might have been initiated, more paths of research could have already been forged so that choices related to delaying vaccines/changing the timeline of vaccinating at the very least would be considered? Everyone affected by Autism is not a radical, emotionally-charged idjit who cares nothing for the rest of the human race. Many of us in fact marched along lock, stock and barrel with all of our children, trusting our medical providers when they told us unequivocally that was the best we could do for our children. No one told us that we were going to be the "other guys", the ones who were just a little too unfortunate to eventually have a child be diagnosed with Autism. Nope. And to this day I see we are still being told that the greater good should be foremost on our minds as opposed to our own family and parental decisions about our kids. Funny thing is, I haven't met too many people who actually have Autism touch their families that feel martyr-like and thankful they have saved ever so many other children's lives by doing the standard vax series. Most often we are explicitly told we are "just widely varying anecdotal data." I hope and pray there are scientists, and evidence-based practitioners interested in studying the issue who go forward with continued work which will soon provide answers. And I stand up for families who are living with this life-changing disorder, extending them compassion as they search for anything which will provide answers. Yes, a healthy balanced outlook to just make progress going forward after diagnosis is a positive thing. That's what we tried our best to do. Heck, at first we didn't really even have time to eat or sleep, let alone focus on "why." But eventually for many, that soul-sucking, emotionally-crushing black void finds its way into hearts and minds. The questions are many, the answers almost non-existent. Our son did have immediate detrimental reaction to his 15 month series appointment. We have documented evidence of 'normal' developmental progression until the 48 hours after his MMR booster. We have medical records, we have video's, we have family journaling of activities and milestones until that fateful week. He was our sunny, water-loving, toddling all-over the place, really happy 14 month-old. Then everything changed. Extended fever, prolonged crying, lost progression walking/even crawling, no further eye contact, loss of his budding vocabulary, reacting as if in severe pain whenever water touched him, wide variations in appetite and sleeping patterns...the list is long. When you hear these stories, please refrain from thinking "my" thinking is somehow misty, foggy not factual. I know these to be absolute truths and differences from his 14 months of life prior to the 48 hours after those 15 month booster shots. I am not 'remembering wrong' nor am I creating false memories or any other ridiculous excuses while feeling sorry for myself. We extend the appropriate respect to parents on many decision-making choices about their children in the west, why depart so vastly in regards to parental choice in medical decisions such as this? What is more - many families were not told about accessing anything related to the vaccine injury path. I know it seems more widely known now, but that was not so in the late 1990's. We got immediate symptom response for our child of course by our health provider. Then after six more peds doctor appointments with our growing alarmed list of changes in our child, we were given a referral to the nearest Autism Research facility. Thankfully, once there (*which took 8 weeks to even get an initial appointment), we received awesome support and began to ferret out any and everything connected to therapy and how our child's life could be most productive going forward. We have always been hopeful that research would continue to be conducted and that human beings sometime in the future wouldn't have to face what our child lives with...you know, prevention. However we continue to be looked at as suspicious zealots when the topic of decision-based vaccinations comes up. Our path is set and we deal with it in as positive a way as possible, loving our child 110% just like his siblings, none of whom have any spectrum affectations or symptoms. But still, we wonder. As for those who hold the greater good of the general public up as most important justification for the complete suggested vaccination path, I juxtapose the greater good of all future families who hope to finally have solid information and a credible way to make choices which will absolutely protect their children from this horrific disorder. I salute all who have had to make choices for special needs children, Autistic or not. It is not a life of martydom at all. Love and peace and thanks to JenRNWI for her thinking post here today.

Re: "he's not even allowed to drive me to my job..." Pretty sure she meant her company disallows friends or family driving one to client appointments. That is a standard policy in Home Health/Hospice organizations.

**It's all about critical thinking baby!** Soooo many interesting posts in this thread; thank you all! Of course these type of questions about whether certain academic programs are more or less difficult to endure or succeed at receive answers which are very subjective, I know. I am really curious about the 'critical thinking' component tbh. When I first started seeing and hearing this phrase in conjunction with the nursing industry and careers, I pretty much understood it to be all about what was often mentioned - i.e. finding potentially the 'most right' or 'best' answer to a given challenge. The stakes are completely different within a field in which a person is making a decision where the result affects another human of course! I do get a little puzzled sometimes. Critical thinking processes are highly valued in a lot of other jobs; and in the main, required to be among the most effective, even if its not verbalized as such. It is emphasized and respected in many spheres of life. The simplest form is often generally accepted as how one responds to a situation with logic, instead of emotional fuzziness, and often its about adaptability under extreme time pressure etc. The reason I feel puzzled often though, is that 'critical thinking' which is focused on in most nursing programs is discussed by students and nursing veterans alike as if it is something that is alien to a vast majority of people in or coming from other professions. Is that generally true or is it mentioned so often because nursing programs are primarily designed with younger students in mind, for instance those right out of high school, where one might not expect a more developed exposure yet to what critical thinking is all about? Thanks for any comments delving deeper into the 'critical thinking' requirement in nursing which seems to be presented as unique in comparison to other professional paths. Comments about this often-raised point would be helpful for those interested in becoming a nurse, who would like to delineate between their current life and career experience and what will be expected within nursing academic programs as well as once they have the responsibilities of working as a nurse in a professional position after obtaining their license.

Looking at recent job openings, there are some part time and one ft CNA position at a huge AL, about 45 minutes drive one way from where I live, and one opening at a very close by hospital on Med/Surg with three overnight 12 hr shifts per week. I have liked working in home health and some agency temp jobs for a couple years now, but would like to expand my skill set and also work a more regular amount of hours. (*I will be going on to an associate nursing degree program, but that will be a full two + years from now.) Hospital openings in my area are few and far between. This one pays several dollars less ph but has benefits, plus I think more training possibilities. The AL opening pays more ph, but has only a few available benefits. Anyone else been this route and have helpful comments about what they do or do not like about their positions as a CNA in hospitals compared to large AL's? Any details will help-thanks very much.

OP - its awesome you are so focused and aware of where you want to stand on the line between right and wrong. I was SO happy to get the chance to go to CNA school over the summer and thought I'd work weekend overnights to supplement funds while I'm in school full time Mon-Thurs. Rethinking my path now seriously. And btw from other posters here, 20 residents on the midshift, really???? Heh, I can only wish. I'm learning a lot but basically my supposed 'Orientation' was a crazy mesh of different shifts with different people -- almost ALL of whom 'take care' of the residents differently, spread out over two to three weeks. My first overnight shift I was alone on my unit with one other CNA way on the other side and just one nurse. In my opinion about the only consistency is that safety seems to be practiced as a priority; but cleanliness/sanitary conditions? Heh. And 20 residents is definitely NOT the norm here on an overnight shift. I've 37. The floor is divided into three 'units'. For some reason the middle hall section, which has about 17 residents always goes to one of the vets on staff, and I'm told to do the other larger section. I am trying to be proactive, think ahead, grab supplies before I go into rooms, have my pockets stuffed with extra washcloths, a roll of plastic bags, and lots of gloves -- and get done everything I'm supposed to for this shifts responsibilities, but I'm still so slow. I have learned some better time-management, but some things you just cannot 'hurry up', and I find it hard to believe there are not two CNA's that basically could work together on all of the two-assist residents and the hoyer ones. It goes so much faster and you have each other to be able to remind or help additionally when needed. Q-2 turns, at least three or four fall risks who stay up all hours of the night with several who need the bedpan or have bedside commodes three to six times through the shift; one or two regular showers per night shift, wheelchair cleaning, CNA notes and charting ...and really the thing that annoys me the most: no clean laundry. I go early so I can hunt out on two different floors at least enough clean towels and washrags for my 4 or 5 residents I have to do complete care on, dress and get up before the morning crew comes in. It sounds so trivial maybe, but oh crud its not. And yes, of course I have written a request for laundry to be in better supply, and/or for washing machines and dryers to be repaired. The fall risk residents worry me so much when I'm the only one there aside from my Nurse. The nurses usually are very helpful; but they aren't always in the common area/at the nurses station either...they have treatments to take care of in addition to their meds etc. I am not talking a l-o-l who 'might' fall out of her bed onto the floor mattress. I'm talking the 6 ft-plus 275 lb early stage-dementia-oh-dear-shouldn't-he-be-on-the-other-unit? The one who either has a UTI or has had them repeatedly so believes he 'feels' the urge to go to the bathroom literally every 15 to 20 minutes, and who is focused on doing just that whether anyone is nearby to help him be safe or not. And it is never just one fall risk when you go to work. It is bragged about that our facility is a no restraint type. I understand the trend/positive reasons for lessening restraints in LTC's but I'm not yet convinced there is any practical, safe considerations really being looked at from shift to shift and with manpower dictates in relation to making sure our residents are really safe. And as far as falls go, if it doesn't result in 'blood' or contusion, there is such a fluster with everyone that 'now we've had a fall-er' - oh dear we have to do sequential vitals through the shift and fill out 7 pages of paperwork, and most especially really watch the one who fell so they don't fall again...uhm yea, remember: safety first. Eek, I sound scattered I know. But this is SO not what I thought it would be, heh. I've met great staff and such wonderful residents in my month so far, but I just don't see how I can deal with the 'lack-of' needed items to care for people on my shift, the certain LNA's that are so bitter, so 'trapped because I have the insurance and my husband is out of work', so burnt out because they accept 55-60 hours a week in extra call-in shifts. O-P you are obviously very conscientious and I applaud you. This is really tough. And let me explain, I am a 40-something with three careers, including a long while in the military, so I know what hard work is and don't shy away from it. I've lived in many different cultures, consider people-work to be a great thing, and have been wanting to work as an CNA partially as a pay-back for the fabulous care my relative got from a private duty nurse and two CNA's during the two years leading up to her death from cancer. But its kinda hard to really 'help people' when in these circumstances. Maybe I will get a chance to try per diem Home Health or hospital shift work. I keep telling myself to wait another month or three and it'll somehow be better...but I know really, it won't. I don't see how I can get another position yet with being so new though ;o/. And on top of these ambivalent feelings, now our facility hired another student from my CNA class and she's super nice and really motivated but stopped me in the hallway to say she feels confused and isn't really getting orientation etc. I just tried to encourage her and wished her a good shift. But most of the CNA's I work with have worked in other LTC's and they say its a really rare situation to find any LTC that is greatly different from the working conditions in ours.

Wow, thanks everyone for the info. mvm2 -- I would be fine with staying awake all night. I'm a night owl anyhow, I love working nocs, and that is the shift I'm working at the new job in the LTC, so wouldn't be any difference. Though depending on the client, I might hope to be able to get a little studying in, after or in between care duties and any household stuff I would be expected to do etc. I will definitely keep all this in mind after I get more experience. I'm also not sure if there would be a huge difference with the pay rate. I'll see after I do some more research for my area. Thanks again!

Hi all, I'm just starting CNA work at an LTC soon. I will be attending full time college classes this year- finishing up some health science courses before applying as a junior to a BSN program. The plan right now will be working three eight hour shifts over the weekend, and doing classes Mon - Thurs mornings and/or afternoons. I used to have a friend who was a CNA long ago; and the comparisons she gave me then still come to mind. She had worked for one year in a nursing home, and then one more year at a smallish community hospital while attending college for her BSN. Later she started in an agency doing Hospice and other per diem home health care and she was so rejuvenated! She finished her BSN while working almost full time doing that. She primarily worked with two different patients each week. I was wondering if after I work at this nursing home for a year or so, would it be possible to get overnight shifts for Home Health Care as a CNA? Anyone have experience and/or comparisons they would be willing to share of working at individual clients' homes for overnights? My dh is a little concerned about the 'safety' factor - just as far as unknown neighborhoods, and also access from family members coming and going etc. I am not as worried about that, but I should probably consider it heh. We live in a fairly smallish town (*maybe 35,000 population); some crime of course but nothing like in larger cities. Thanks if anyone has some tips or info to share!

]I so appreciate the experiences and knowledge being shared here at allnurses. Its good to have various sources of information including laymen or anecdotal data. Worth considering while we all try to inform ourselves about the current concerns relating to the spread of Ebola and how possibly aside from re-use of PPE gear - how it was possible for those healthcare workers in Sierra Leone to become infected? From OSHA Fact Sheet which discusses the merit of Surgical Masks and Respirators. https://www.osha.gov/Publications/respirators-vs-surgicalmasks-factsheet.html ] "Surgical masks are used for several different purposes, including the following: Placed on sick people to limit the spread of infectious respiratory secretions to others. Worn by healthcare providers to prevent accidental contamination of patients' wounds by the organisms normally present in mucus and saliva. Worn by workers to protect themselves from splashes or sprays of blood or bodily fluids; they may also keep contaminated fingers/hands away from the mouth and nose. ]Surgical masks are not designed or certified to prevent the inhalation of small airborne contaminants. These particles are not visible to the naked eye but may still be capable of causing infection. Surgical masks are not designed to seal tightly against the user's face. During inhalation, much of the potentially contaminated air can pass through gaps between the face and the surgical mask and not be pulled through the filter material of the mask. Their ability to filter small particles varies significantly based upon the type of material used to make the surgical mask, so they cannot be relied upon to protect workers against airborne infectious agents. Hoping for good information and positive results to become available to the public relating to the two Americans being treated in Georgia.

Oh, very good reminders about the potential fall residents, *nods. Well on the weeks where my three night shifts truly do have the call lights blinking on and off continuously -- I'll just take advantage of that leg work and cut out part of my lower body workout routine that week, *giggles! I do know its true some of the residents literally seem to never sleep or only like every second day when they are really exhausted heh. Thanks so much for the tips everyone, much appreciated!

Thanks so much for replying and giving me examples! Okay, well maybe I can involve myself with holiday happenings they may have at the nursing home occasionally throughout the year and make some connections that way. Maybe I will also do stocking and even help pre-set up for baths etc in the morning before I leave. I want to make sure I learn all I can (within the constraints of the shift obviously). Also, heh, I am not one to stand around; would much rather be helpful and busy. The shift will seem to go by faster that way also probably. Thanks again!

Morning! I've been searching around and haven't found the differences between the actual sorts of duties and exactly what one/an example of a typical nightshift - does in comparison to say, an evening 3 p - 10p duties are. I'd love to see any details in addition to the basics of course. I have two different job offers and am musing a bit. I enjoy working with older adults and especially when there is the opportunity to get to know them a bit now and then, hear their life stories etc. I wonder how much less of a connection I will 'feel' if I accept an overnight position as opposed to the day or afternoon/evening position. Otoh I will be in school full time this fall and was thinking overnights for weekends would work well and allow me to make a little money while adding to my skills etc. Any comparisons from those who have worked both/or all three as an CNA/LNA in an L.T.C. specifically please? Thanks very much!