I am a new-ish CNA. I have been working at my first CNA job since July 12, so I just had my 90 day review, which went fine. I work in a long term care facility. I am feeling pretty conflicted about whether or not I want to stay at this job. If you have time, please read this post and share any opinions/advice you have for me. Here is what is stressing me out at work. I have no problem with any of the things we do for residents - "poop", "pee" and "wiping butts" do not bother me in the least, as I know these folks need help and I hope one day, if I need it, someone will help me!!! I also don't mind working hard. I am not lazy, and I want to do the best job I can. HOWEVER.... I do NOT enjoy the general atmosphere of "hurry, hurry, HURRY!!!!" that exists in my workplace.
Apparently I am still too slow at my job, and my coworkers frequently voice their frustrations to me. I understand that they might be stressed because me being slow makes "more work for them." I work 1st shift and the morning get-ups are the worst part of my day. We have 26 residents on our wing, and we are supposed to have them all up for breakfast by 7:45am. Right now, we have maybe 4 who are "independent," but we also have 15 who are an assist of 2, so you can't just do them by yourself. We are supposed to have 3 aids and a bath aid, who usually gets up about 3 people, as they get their baths before breakfast. Anyhow, I have been told to make it a goal to spend only 15 minutes getting a resident up, washed and dressed for breakfast. I am down to 15 minutes once they are on the "potty chair", but then it takes a few minutes to clean up the bathroom and get to the next room... and that doesn't include the time actually getting them up out of bed. In reality, it is taking me about 20 minutes per resident. I am working to improve my speed, but I refuse to forgo the gait belt (which many of my coworkers do) or the basin, because I think it is silly to have one way to do things when State is in the building and another when they are not. I want to do my job so that State could walk in at any minute and they would think it was just fine. Even with starting at 6:15am, the most people I have had up and done by 7:45 was 4 people.
It seems there is a double standard going on here. The DON and ADON, and also the nurse on our hall, have told me they appreciate my thoroughness and that I should do my job right and not worry about the "hurrying" factor. My fellow CNA's, however, will poke their heads into a room where I am helping someone and stand there and say "Let's go!! Get a move on here!" Which does not help, by the way, as it just stresses me out and makes me fumble things. I feel like there is some sort of weird conspiracy where the administration tells you to do things the right way, but really wants you to cut corners as long as you don't get caught. That is what most of my coworkers do, and they get mad at me because I won't do it.
OK - I am sort of rambling here. I guess what I am wondering is this - is there an environment where a CNA could work where patience and thoroughness are valued more than speed? I have applied at the two local hospitals, but I feel kind of guilty about it, like I am a quitter or a traitor. I do not look down on LTC - I applied there because I wanted to care for older people who need help. But this environment feels toxic for me. I just can't spend my days hurrying and being yelled at. I also will not hurry a 95 year old woman as she is getting out of bed. Is this what I will always find in LTC? Would hospital work be any different? I don't personally know anyone who works as a CNA at a hospital, so I don't have anyone to ask.
I would appreciate any feedback. Please know that it is not the work that bothers me - body fluids and messes are no problem for me, it is life and folks need help with it. I just hate to hurry all day long and feel like a loser when I am not the fastest one in the bunch. I hope I don't get burned too much for this...
I hear you. The thing about administration saying they don't want you to cut corners, but giving you so much work that you have no CHOICE about it, and looking the other way until state comes in? Pretty sure that's everywhere. It took me forever to get used to my job, and I blame my coworkers! Most of them were super judgmental about how slow I was, and that only made me nervous enough to freeze up and start fumbling around. Plus they would work together and help each other out and I was pretty much ignored, so I'd have to spend time looking for someone when i needed help with a transfer. It takes time to build up your speed and no matter what job you have, if you're working with other people you're going to have coworkers that yell and complain. I've never worked in a hospital but I imagine it's probably even worse because you have different patients every day.
Now that I'm used to the job I actually LIKE the "go go go" aspect of it. It makes the day go by faster. I've always liked fast-paced jobs... once I get used to them.
Personally I would try to adapt my routine to fit that of my coworkers, at least until you "prove yourself" and they stop nagging you to be faster. Then you can start doing things your way. When I first started my rooms were always sloppy. I would never leave them like that now (in fact I start twitching if things aren't orderly), but at least a bag of laundry left sitting under the bed for a few hours isn't going to get a bedsore. I would rather cut corners on things like that than patient care. That said, my patient care was bad when I first started too. I was overwhelmed and I forgot stuff all the time, like brushing teeth, repositioning, peri care after incontinence, etc. It didn't help that most of my coworkers flat out don't bother with that stuff.
I've been on day shift 2 years now and I really like working with another CNA and always being in the same room with them and tag-teaming. You can pace each other and there's no waiting for someone to come and help you. Whoever finishes washing their person first can start making the other person's bed or something.
I second everyone's comments; we're all slow at first. Prioritize. For first shift, your main priority is to get everyone up, dressed, and into the dining room (probably). You can go back through and make beds and do showers after breakfast. Are you allowed to bring people to breakfast in their robes if they're a shower that day? We are at mine, but it's a dementia facility.
Once you get to know your residents, use that to help you decide what order to get them up in. If someone is going to be very grumpy and hard to get up at 0615, save them for last and get them right before breakfast. If someone is very time consuming no matter how early or late, you might want to do them first and get them out of the way. Ask coworkers what order they do things in, get their ideas. If you have to, wait until after breakfast and do oral care as you're toileting and changing your residents for the 2nd time that shift.
I work 2nd shift now, and like it better, but when I worked days, I would get everyone up and in the dining room at 0800, then after breakfast (0900) go back through and make my beds/change bedding as needed. Then usually do one of my showers, and toilet/change about half the people before my break. Come back, do the other half, do my other shower, get everyone in the dining room for lunch from 1200-1300. From 1300-1400, get them all out of the dining room, toileted or changed, and settled where they were going to want to be for the start of next shift.
I'm glad u brought the subject up. Last week was my last week of clinicals and my instructor informed me that i had failed. My instructor said it was because i was to slow and that i needed to hurry up and get things done quicker. Plus I needed help getting a 1:1 lift up. The resident couldn't move her feet very well so my classmate had to help me move her. So its like now i don't even want to go into this field anymore because i don't want to end up hurting a resident.
:eek:I'm shocked you can be failed for being too slow during clinicals. I would raise hell with the school you attend. I can see failing for other reasons but not being slow. Speed is attained through experience, as is confidence in moving a residence on your own.
Your instructor sucks, imo. Don't give up on the nursing field because of this experience.
Good luck and let us know how it turns out for you.
You have described it to a 'T' what every single LTC facility is going to be like. The only alternatives are ones already mentioned, changing to a different hall or a different shift where the pace is slower. Of course, on slower shifts you will correspondingly have less staff, so the pace may be only slightly slower -- however the 'chop-chop' pace will remain a standard no matter what shift you are on. Hospitals may be slightly better in terms of pace, however most require at least a year's experience before they will even interview you. The only realm in which you won't have a whip cracked on your back to hurry up is home health care.
Don't ever feel apologetic about seeking better conditions or a different place to work. It's your right to be happy doing whatever you choose to do. Furthermore, don't feel bad if you decide to change career paths in mid-stream. Half of everyone I know was a CNA once and decided nah.....I don't wanna do this anymore.......
An update - today I worked on a different hall at work, and it was a completely different experience. Much less stressful. We got everything done by 1:30pm, including charting, and then I was actually looking around for something to do. I went and answered a call light on my original hall!! It made me think that just that simple change would be enough to lower my stress level.
But, meanwhile... I got calls from both of the hospitals I applied to. I have an interview at one tomorrow, and the other one called to ask me to take an attitude survey, so I think they may be interested in interviewing me. The position I am interviewing for is an Activities Assistant on a Skilled Nursing Unit, but the job description said CNA required, so I am curious... it might be a good way to use both my new skills as a CNA and some of my former experience as a music teacher. There are 2 positions at the other place that I applied for - Telemetry Tech and Patient Care Tech, Med/Surg. Both of those sound like I could learn a lot from them.
I am going to keep an open mind and just investigate these options. I have a job, so I guess I don't have to leave it if the new opportunities don't sound better in some way. I am actually having some physical issues that have been aggravated by my job - namely, nerve pain in my left arm, and newly diagnosed carpal tunnel syndrome in both wrists. I did not think that I would have any type of physical limitations when I started this job - I consider myself to be pretty healthy!!! So if any of the jobs sound like they may be less physically demanding, that would also be a plus.
Thanks for reading - still dealing with a slight bit of guilt for looking elsewhere when the administrative types at my job have been so kind to me, but I suspect that I may have made a bad impression with my coworkers and maybe a fresh start would be OK, too. I will update for those who have been following this post!
The Activities Assistant sounds really fun!! Many LTC facilities require that some of their activities staff to be CNA's, but the physical demand in such a position will be much less than a floor CNA. Much less transferring and heavy lifting, and a lot more fun and enjoyable duties. The trouble with having any underlying physical issues is that at some point they are going to be greatly exacerbated by the heavy load of physical activity that CNA's do every day. I have a pinched nerve between my lumbar and thoracic spine, and after less than a year of work as a skilled nursing CNA, I would occasionally wake up with very scary and almost debilitating back pain and spasms. I'm in my late 40's and I certainly don't need a disability to come along and prevent me from making a living, that was one of the reasons I retired from ever again working in a LTC facility unless it was in an administrative capacity.
One of the things that may help you get over any residual guilt about improving your situation and leaving some of your co-workers behind is realizing that the only people who won't be happy for you are the ones who really are not your friends. Good luck!!!
2nd shift is gravy where I work. 3p-11p. Show up, 2 hours till dinner, then after dinner, you have the whole evening to get people to bed at your own pace. The few times i've worked it as a call in, its been a yawn fest. Everything done by 8pm so then its just doing 2 hour checks, hanging out with the residents that are up, play a few games with them. But on occasion you'll get the christmas tree of call lights about 10pm.
Other things you might look into is a Therapy Assistant. I was offered a job doing that (they came to me and asked; work hard and people notice). Pretty simple. You go to a patients room with the absolute intention to get them to therapy. Might have to dress/toilet them depending on how the aides in that building work. Then you work with the PT/OT people if they need help. Clean up floor pads. Stuff like that. I passed on it as it was a part time m-f gig and I'm looking for fulltime.
Also could be a staffing coordinator/scheduling. High stress if you dont have a great bunch of PRN people and/or call-in list. But they learn who answers their phones and wants to work.
You know what? Taking care of your residents is NOT a race! Some people work faster than others, some don't. In most nursing homes, there always seems to be a "window" of time that you need to get your residents up out of bed or back to bed in the evening. There's a difference between a CNA that takes his/her time and does the job right and one that rushes just to say that they're "done" with their portion of the assignment (their residents are most likely sitting in soiled briefs)...and offers no help to you when you're drowning in work. I prefer the hospital scene over a nursing home, not only for better pay and benefits, but it's just a different pace. I alone may be responsible for 12-18 patients per shift (depending on staffing), but they're not all "total care" patients like a nursing home resident would be. I think if you choose to stay at some sort of long term care facility, the work load should be divided between CNAs, so nobody can say they had to "pick up your slack". You just have to worry about your assigned residents and your residents only! Let the others work how they want to...and just know that you performed your job correctly.
I work fast. I DO treat it as a race because there is always more to do. My view is, if I fiddle around too long giving AM care right up until lunchtime, then there is no time to toilet/change anyone.
Yep. There's a big difference between working fast because you have so much to do and working fast to sit around. I work as fast as I possibly can to get my residents in bed, because if I take my time like some of the other girls, I don't have time to make sure they are all changed again, the rooms are clean, their mouths are clean, my trash is taken out, and my charting is done - aka, the things many of the other girls don't get done and constantly get griped at for.
Speed DOES matter. The real challenge when it comes to being a good aide is to find a way to balance speed and quality of care. Anyone can do a good job if they move at a snail's pace, and anyone can rush through and slop things...it takes a lot of care to find the right balance.
Ha! I don't know if anyone is reading this anymore....but I heard back that the hospital hired someone internally for the Activities Position. They want to know if I am interested in working as a CNA there. I had decided I would take the Activities Assistant position if offered, but I am still thinking about whether I want to move to the hospital as a CNA. A benefit would be that if I am already working there, I have more chance of getting hired as a new grad nurse (in 3 years!!!) Disadvantage would be that I would be new again. I am getting more comfortable at my current job. Still not that fast, but getting better. However, we are almost always short staffed, which is stressful. Must pray on this decision!! Input is welcome!
fuzzywuzzy, CNA
1,816 Posts
I hear you. The thing about administration saying they don't want you to cut corners, but giving you so much work that you have no CHOICE about it, and looking the other way until state comes in? Pretty sure that's everywhere. It took me forever to get used to my job, and I blame my coworkers! Most of them were super judgmental about how slow I was, and that only made me nervous enough to freeze up and start fumbling around. Plus they would work together and help each other out and I was pretty much ignored, so I'd have to spend time looking for someone when i needed help with a transfer. It takes time to build up your speed and no matter what job you have, if you're working with other people you're going to have coworkers that yell and complain. I've never worked in a hospital but I imagine it's probably even worse because you have different patients every day.
Now that I'm used to the job I actually LIKE the "go go go" aspect of it. It makes the day go by faster. I've always liked fast-paced jobs... once I get used to them.
Personally I would try to adapt my routine to fit that of my coworkers, at least until you "prove yourself" and they stop nagging you to be faster. Then you can start doing things your way. When I first started my rooms were always sloppy. I would never leave them like that now (in fact I start twitching if things aren't orderly), but at least a bag of laundry left sitting under the bed for a few hours isn't going to get a bedsore. I would rather cut corners on things like that than patient care. That said, my patient care was bad when I first started too. I was overwhelmed and I forgot stuff all the time, like brushing teeth, repositioning, peri care after incontinence, etc. It didn't help that most of my coworkers flat out don't bother with that stuff.
I've been on day shift 2 years now and I really like working with another CNA and always being in the same room with them and tag-teaming. You can pace each other and there's no waiting for someone to come and help you. Whoever finishes washing their person first can start making the other person's bed or something.