Reality vs. Classroom

Nursing Students CNA/MA


Hi All!

I just finished the classroom portion of my CNA and had my first day of clinicals at a nursing home. I was absolutely blown away the first day. My CNA was crazy busy, of course, but after all that I had heard in class about the right way to do things, patient rights ect, was stunned when my CNA:

- flung back the covers of her residents to change them, not attempting to keep them covered in any way while they shivered away

- used the same towel to clean perineal and rectal areas (never rectal first though)

-never offered a choice of clothing

-didn't talk to residents about what she was about to do (raise/lower bed, turn them, ect) clearly causing some of them distress

-did several Hoyer lifts by herself

-told a couple of residents that they had big bellies

-discussed a resident while in a different resident's room and in front of that resident

-hid to use her cell phone for texting and talking

So, I'm not SO naive that I think everything goes just like a textbook, but am I just experiencing what reality is like, or did I get a crappy teacher?

I do believe that this CNA cares about her residents. She was at other times comforting to them. They seemed ok with her some of the time too. This facility is a not-for-profit, and it was clear that she had to hustle to take care of her 8 residents.

So what gives?


Specializes in Med/surg, rural CCU.

That'll happen. The shivering- unacceptable. Same towel- normal. As long as it's front to back- it's fine. Do you use two towels to dry your bottom??

Choices, talking, etc.... it depends on the situation. When I worked LTC... I KNEW my residents, and they knew the routine. It would be dumb to talk them through it every day, year after year. ALso- I knew which prefered choices- and which didn't care, and got annoyed when I asked.

Hoyer lift- that could be a safety concern. It depends on the facility. At the NH where i worked we could test out to use them independently- IF the resident's care plan supported it. We did many lifts alone- due to staffing. (and only on alert, cooperative residents)

Talking about other residents- NO

Phone calls on teh floor-NO

Telling residents they ahve a big belly...RUDE.

Ok- if that is the way washing is normally done, there you go. The test for the state has the student use a separate wash cloth for perineal/rectal. So I'll just keep that in mind. no -not two towels for my own bottom. Maybe if it gets any bigger....

I suppose I will just use this experience to help me decide what kind of aide I will be and spin it to the positive. One thing I know for sure is I have a lot still to learn.


um....I think that we were paired with the same CNA for our first day of clinicals! I had the same experience and I ended up crying at the end of the day and wondered if I wanted to have any part of this world. I felt that her actions were borderline abuse and didn't want to continue on. Fortunately for the rest of my clinicals I was paired with amazing CNAs who showed compassion and proper technique. Sure, there is a difference between state exam world and real world, and many CNAs that have been doing this job for years will experience a little bit of burn out. I ended up speaking with my instructor and came to find out that there were several complaints about this certain CNA. She no longer works at the facility. I may not make the bed according to the textbook or hit all 25 steps while giving the bed pan, but the patients are always safe and their privacy and dignity are maintained. Be sure to bring up your experience with your instructor in a professional way, expressing your concerns over the CNAs execution of the skills.

The fact that you noticed and have concern about the patient's well being shows that you will be a great CNA.

hA! That CNA must sure get around. Thanks- I'm gonna do my best. :)

I did make up my mind to speak to the instructor and I will see what she says. This CNA did mention she isn't paid enough (except that's probably true!) and that it is hard work several times. I have no delusions about that though.

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