Small Hospital, Only One CNA

Nursing Students CNA/MA

Published

So I have a question for the CNA's that work in a hospital setting, or I guess anybody that could give me some insight. I am currently finishing up my first year in a BSN program and I am also working 20 hours per week as a CNA. I work at a pretty small hospital. The floor that I work on has about 20 beds or so I think. I LOVE my job! I love the people I work with, I love the experience that I am getting, and I love working with the patients. The only problem is that we only staff one CNA per shift. I feel like it gets so overwhelming sometimes and that I might not have my day organized the best to complete everything that needs to get done. Does anybody have any tips? I'll list what my usual day is like below.

I start my shift at 0600 and I get my report on my patients. I am responsible for all of the patients on the floor so depending on the day, my report can be anywhere from 5 minutes to about 10 or 15 minutes. Then I get my glucometer and take the blood sugars that need to be done. Lately, I have also been taking my patient's vitals at 0600 and their weight if that needs to be done as well so it is one less thing the nurses need to do when they get there.

After the accuchecks are done, I help patients order their breakfast trays and use the bathroom and freshen up a bit in the morning. I usually change their sheets right away and ask them if they would like to take a shower or a whirlpool bath at some point during the day. The patients that I usually offer showers or baths to are the patients that have been there for more than one day. I also answer call lights at this time since this is when the day shift is coming on and getting their report from overnights.

After breakfast, I usually start on some showers or baths and do this until about 11, as well as answer call lights. I do my lunch time blood sugars and help patients order their meals.

After lunch, I usually continue with more showers and baths until the end of my shift. I also answer call lights along the way and help the nurses do things such as repositioning, help with 2-assists, etc.

On a normal day, I usually give around 6 or 7 showers or baths. What is your routine like? How do you organize your day?

Wow. We have 23 beds total for observation, acute, skilled, and long term care at our hospital and we staff 3 CNAs for first shift, 2 for second, and one for 3rd. There are always three RNs on staff until 2400, then there are 2 until 0645.

I work 1st shift, and I typically clock in at 0615. I check vitals on acute, obs, and skilled patients, put them in the computer, and sit in on report. Then, we start getting people up for breakfast; trays come out around 0730, and we pick them up around 0815 or 0830. We start our baths and showers around that time and we go until 1100. The first person takes lunch break at 1100 while one gets people up for lunch, and I do any q4 vital signs. The second person goes to lunch at 1115, and the third at 1130. Lunch trays come out at 1200 and we pick them up at 1245 or 1300. We lay down those who need to be laid down, pick up trash and stray laundry, do snack pass and fill ice water at 1400, start charting at 1415 or 1430, and I am supposed to clock out at 1445. That doesn't always happen. In between all this, we answer call lights, complete admits and discharges, make up empty rooms, and transport patients to appointments at the attached medical clinic. We don't check blood sugars; the RNs do that.

Our census has run anywhere between 14 to 19 patients the last two weeks and we often work short one CNA and it gets hectic and overwhelming. We try to do as much as we can on our 2x assists until we can get help. We sometimes pick up a patient from someone else's assignment to help them out. Teamwork is key.

Thank you for your input! :-) It sounds like you guys have a really good system set up. You're right though...teamwork is the key! The last few weeks our census has usually been around 15-17 patients but we still only have one CNA on per shift. Would you say you give baths only in the morning? I feel like that's such a huge focus of my day that I don't get to do some of the other things that I should be doing, yet most of the nurses tell their patients that I will give them a shower or a bath. Almost like it's just a given that I will be able to get everyone bathed in one eight hour shift.

If census is low, we usually can get everyone done before lunch. Our long term care patients are on a bath schedule, but we have to work in the obs, acutes, and skilled ones, too, and with only one tub room and one shower, it gets to be hectic and stressful.

It is to the point that we have at least one, if not two or three baths after lunch. If we can talk a temporary patient into a bed bath instead of a tub bath, we can cut down on the amount of time we spend bathing patients. It would be nice if 2nd shift would do some for us, but their work ethic is totally different from ours on 1st shift and if they have to set up a shower or bathe an exceptionally unclean patient who is admitted on their shift, they get cranky. Our DON has been hesitant to ask them to take on some of that responsibility so we soldier on.

I do my best to make sure all my patients get bathed before lunch, but if I have to do one after lunch, I try to make sure it's one of my acute or skilled patients so that if one of my long term care patients happens to have family come in to see them or take them out for an outing, they look and smell presentable.

It has been trial and error for me finding a rhythm that works. I have incorporated things I have learned from co workers and tips and tricks I learned working in a nursing home, and things I have found on my own that work.

+ Add a Comment