Things you wish you knew before clinicals?

Ytellu · Jun 3, 2011

You can pretty much bet that you can out run any resident that chases you :)

I wish someone told me that putting Vicks under my nose would help with the smells that I wasn't use to.

Good Luck.

fuzzywuzzy, CNA · Jun 3, 2011

I wish I'd known how busy the place is. I expected things to be more structured and to get more mentoring from the CNAs, but they didn't have time for us. So if there was a skill I wanted to practice, most of the time they'd be 8 steps ahead of me and by the time I tried asking if I could give a shower (or whatever) they would all be done.

I felt like I had to do all the skills we learned in class to get the most out of my clinical. But looking back I wish I had instead focused more on paying attention to how a nursing home runs, rather than freaking out because I missed my chance to give a bed bath to a quad with a feeding tube. I don't want to trivialize that kind of experience because it IS comforting to practice doing care on someone in the "real world." But really, the point of the class is to pass the state test. For our state test, we performed the skills on each other. As long as you knew how to do them on a classmate, it didn't matter what you got to do in clinicals. The real hard stuff comes once you pass the test and get a job where you have to take care of 10+ residents and figure out a routine... why things are done and when. I don't think they teach enough time management in the class.

msmo · Jun 5, 2011

I know this will probably sound silly, but I actually found feeding a little tricky. Not the mechanics, but drawing the line between encouraging and pushing against their wishes to eat or drink more when you know they need it. The classes make such a strong point of residents rights to choose or refuse care, etc. Feeding the ones who don't have speech or cognitive function where they can really communicate that they are full or do or don't want any more presented questions too. When there was one handy, I would ask the staff CNAs that know the residents about them. If not, I was just guessing, trying to read reactions.

Also, be prepared for the fact that some residents will make noises like you're hurting them, when you're really just doing their basic care, turns, etc. Of course, ask them what's the matter, in case it's something other than they don't like to be moved, etc., (like they rolled onto the call light or something), but just let them know you'll be as quick as you can and try not to sweat it too much (like I did).

I only saw a couple of bed sores at the facility where I did my clinical and they seemed well cared for, clean and not nearly as gross as I've heard they can be. I am glad for those residents, but I almost wish I'd seen some bad ones just to know what they really are like, but I'm sure I will see them in time.

We didn't have anybody chasing CNA students, so I can't speak to that one other than that I would use my "teacher/dog training" voice and say: "Hey! That is not allowed. You need to stop, now." and see how that worked.

The thing I wasn't really prepared for was that instead of being appreciative for the extra hands or even courteously friendly, most of the staff either ignored us or were "chilly" toward us. I had trouble with a code on a door one day and the LPN (the only person around) acted like she was reallllly being put upon to walk the four feet over to the door to help me out with it (although in her defense, it may have been the first chance she'd had to sit down in hours...) There were a couple of friendly CNAs but the rest pretty much acted like we were bothering them if we asked where the clean linens were moved to, or "how do you know when M. is done eating?" Once, the three of us CNA students were feeding residents in the dining room and realized all the nursing home staff were all gone, nowhere to be seen. We were looking at each other like "...is this even legal?" (And I don't know the answer to that one, but I do know it was not cool...what if a resident had choked or had a CVA or something? That facility doesn't even allow CNAs - much less students - to do CPR, nurses have to.)

On the bright side, I was surprised to find I loved working with the residents themselves who had some awareness and were able to interact. (Surprised because I had at one time a near-phobia of nursing homes and used to panic if I was in one for more than about 20 minutes.) Two of them were real crackups and we had a good time getting to know each other. I learned that while it might be awkward to ME to be changing their briefs and wiping up their privates etc, they are all so used to it they don't even blink no matter who is doing the task.

M.

Little Miss Coffee · Jun 5, 2011

These were mine...

Things in the facility worked pretty differently from the step-by-step, formulaic way we learned them. Perhaps this is not the case in every state, but for us each task was spelled out in carefully organized steps.

According to our classroom learning, giving a bed bath would require so many towels, washcloths, a pad, a draw sheet, etc...do you think the nursing home had or used all these supplies every time? No! We were lucky to get ANY supplies without walking down to the laundry room Every facility has its own way of doing things.

Point is, the procedural methods were for the tests. Speed and proficiency were for clinical. Of course, what you DID have to remember about the step-by-step instructions - every single time - was safety and cleanliness. You would always wash your hands at the right time, you'd never wipe a face with a towel that has touched a butt, and of course you'd preserve privacy and respect the resident.

Also, I was in that mode where I had to prove myself and was a little afraid to ask for help (unless, obviously, it was a task that required a team, like moving a resident who was a fall risk).

Sometimes a task that usually requires only one person is difficult for some reason you can't control, particularly since you don't already know the residents.

For instance, I had a resident who gave me a really hard time about changing her brief because she just wanted to sleep all day. And changing briefs is very urgent to prevent bedsores. She was not exactly fighting us, though, so when I got a couple partners and my instructor to help out we managed.

CoffeemateCNA · Jun 5, 2011

You can pretty much bet that you can out run any resident that chases you :)

It's those little, "innocent" old ladies that will always surprise you. The more blunt metal objects they are carrying, the faster they seem to run.

blackbird singing · Jun 5, 2011

I pretty much agree with what has been written, but also I was not prepared for how sad it would be. I went home and cried because I felt so bad. I mean, they have 50 to 60 year old pictures of their family sitting in a frame next to the bed, looking beautiful, young, and happy. At one point I was changing a resident's depends and I almost lost it because I looked over and saw that picture, and thought about how sad it was that here she was now, totally contractured and incapacitated, needing her diaper to be changed. It was very sad for me. Aaaand it was Mothers' Day, so that definitely made it even sadder... Women live much longer than men (it's very disproportionate) so the majority of people in nursing homes are women.

But that's something that I know i have to get used to... I had just never been in a nursing home before, and when I had, it was volunteering with the residents that were pretty capable of taking care of themselves.

Not trying to scare you, but I just wish someone had prepared me for the emotional side of the clinicals.

Iridescent Orchid, CNA, LPN · Jun 6, 2011

I pretty much agree with what has been written, but also I was not prepared for how sad it would be. I went home and cried because I felt so bad. I mean, they have 50 to 60 year old pictures of their family sitting in a frame next to the bed, looking beautiful, young, and happy. At one point I was changing a resident's depends and I almost lost it because I looked over and saw that picture, and thought about how sad it was that here she was now, totally contractured and incapacitated, needing her diaper to be changed. It was very sad for me. Aaaand it was Mothers' Day, so that definitely made it even sadder... Women live much longer than men (it's very disproportionate) so the majority of people in nursing homes are women.
But that's something that I know i have to get used to... I had just never been in a nursing home before, and when I had, it was volunteering with the residents that were pretty capable of taking care of themselves.
Not trying to scare you, but I just wish someone had prepared me for the emotional side of the clinicals.

I want to thank you a million times for posting this. I'm just now starting out with my LPN program, I still have one more semester before I start my clinicals. I hope I become more informed on the emotional side of them as well. I'm nervous, but so excited about them at the same time. You posting this brought tears to my eyes, but it also made me think about how I truly need to prepare myself for what is to come with the clinicals as well as the career-choice. I think there comes a point where we'll all learn how to manage our emotions better with our careers, and it starts with the clinicals! Thanks again! :redpinkhe

Sunshyne20 · Jun 8, 2011

So i completed and got my certification last summer. I had know idea what to expect during clinicals. The best advice I would give is:

1. Take your time and make sure you perform your CNA duties the correct way you were taught. I found that many of the CNAs working at the facility that I had my clinicals didn't follow standard precautions or a patients rights such as not providing privacy. So try not to pick up the bad habits that you may see, because for your state testing you will have to do everything perfect and they will be watching your every move.

2. When I did my clinicals and I was assigned a task that I wasn't comfortable doing alone for the first time such as the male peri area, I asked my instructor to do it with me. And that way it made it better and i was less nervous.

3. Remain calm. You will be exposed to situations that you have never dealt with before. I have seen patients hit CNAs or yell and curse at them. Just be prepared! lol

Overall clinicals for me was a great experience and very humbling.

hope this helped,

Raquel