Tips for a New Cna!!!

RJay25 · Mar 13, 2013

You will soon learn "ten is nothing" most days I have 12+ and the other night I had 21. All that stuff you learnt about in class is nothing like the real world. Yes at times you will have to cut corners especially when you work morning shift imo.

funtimes · Mar 13, 2013

A lot depends on the residents you have, what shift this is, and how the facility is set up. If this is day shift and everyone is required to be washed, dressed in regular clothes, and in the dining room with breakfast eaten by 10:30, and these are residents who are two person transfers and feeders and almost all incontent, then you will have to cut corners.

If this is evening shift its a lot more doable, and overnight shift 10 is nothing, probably half to 1/3 of a normal workload.

Either way you will learn shortcuts that arent necessarily cutting corners as time goes by.

JDZ344 · Mar 14, 2013

Actually ten is a good ratio. Most places will have you take 14-18 or even more.

Depending on the residents, 10 may be manageable. If they are all total care, it will be difficult.

Cutting corners is fine, as long as the residents are safe and you don't skip on their care. Rush in between them, not with them.

Prairienurse1989 · Mar 14, 2013

I don't know where you guys work but 10 to one sounds ridiculous to me. I have no idea how you can have ten residents properly washed, lotions applied, mouth care done, hair brushed, and shaved, and down for breakfast which usually starts around 8-830. Factor in the full lifts and feeds, that just sounds downright unsafe.

mskrisCNA2bRN · Mar 14, 2013

I'm a new CNA as well and the LTC that I'm employed with the ratio of patients is supposed to be 10-1 and depending on whether or not we're properly staffed sometimes you can end up taking on 20-35 patients on your own. I myself for the past 3 weeks that I've been employed have taken on at least 25 patients on my own at least 4 times. Thank goodness I work the 11-7 shift where a majority of my patients are sleeping however most of them are incontinent and the changing takes work. It seems like by the time rounds and charting are done its time to start again. Usually I leave work and go to classes right after so god help me I'm exhausted. I think a 10-1 ratio is awesome for you and I wish you the best of luck.

allnurses Guide · Mar 14, 2013

I don't know where you guys work but 10 to one sounds ridiculous to me. I have no idea how you can have ten residents properly washed, lotions applied, mouth care done, hair brushed, and shaved, and down for breakfast which usually starts around 8-830. Factor in the full lifts and feeds, that just sounds downright unsafe.

It absolutely can be done... but it takes time to build yourself up to a degree of efficiency.

Like KatieP86 said, you rush between residents and slow down when you are actually working on them.

You also learn how to prioritize the order in which you care for you residents and learn how to respectfully inform certain residents that they will have to wait a bit (and what quick little things you can do for them to satisfy them in the meanwhile).

Rush taking the trash out, rush brushing dentures, rush making a bed, rush running for the lift, but by golly! Slow down when it's time to interact with your resident!

We all were expected to provide full quality care and we all managed to do it.

If you are working with a great team, anything is possible.

Is it unsafe?

Only if you don't slow down and use your common sense or seek help when you need it.

Just remember, that it is far far better to be slow or get behind and do a thorough quality job than it is to race through and do inferior care just to stay on schedule.

With trial and error, experience and savvy, you can both give the best care possible and stay on schedule...

But it takes time.

JDZ344 · Mar 14, 2013

I don't know where you guys work but 10 to one sounds ridiculous to me. I have no idea how you can have ten residents properly washed, lotions applied, mouth care done, hair brushed, and shaved, and down for breakfast which usually starts around 8-830. Factor in the full lifts and feeds, that just sounds downright unsafe.

In an ideal world, 1-10 would be too much; however, in reality, LTC is grossly understaffed. Most LTC places here have maybe 2 NAs for 30+ patients. The nurse will have the whole building to be responsible for. That's just the way it is, unfortunately. 10:1 is not so bad if at least 2 of them can stand with help and feed themselves and are continent. It's a whole lot harder if all ten are hoist transfers, incontinent and need maximum help, but you just have to try your hardest and prioritize.

fuzzywuzzy, CNA · Mar 14, 2013

It gets easier as you get used to it. And you also have to decide what your priorities are. I work day shift and we're supposed to have everyone dressed and out of bed by 11 or 11:30. Some of my coworkers will spend the whole morning just doing AM care. Then there are others like me who focus more on changing/repositioning, so we spend less time on AM care. I like to have everyone dressed by 9:30 so I can go back and change everyone, lay some of them back down for a while, change them again and get them back up. With 10 residents you can't expect do do everything, and at first you will definitely just have to focus on getting the absolute bare minimum done until you're fast enough to add things to your routine. If you have to skip something don't worry about it. Just focus on being safe-- alarms, floor pads, low beds, seat belts, etc.

And of course the thing that makes a huge difference is teamwork. That's not something you always have control over, especially as a new CNA. If you need help with a transfer or something, and no one is jumping to help you, then don't sit there and wait-- find something else to do. When I was a new CNA I found myself being ignored a lot and you have to be assertive. I remember repeatedly asking different people for help with transfers when i was new, and wasting a lot of time waiting for them to show up when I could have been doing something else-- then at the end of the night, I had nothing done and everyone was annoyed with me. The way you approach your coworkers can help with this though. Don't be timid, address them by name, and give more information. If the other person is busy you can't expect them to drop what they're doing and run to help you, but if you step in an help them finish whatever they were doing, it's harder for them to "forget" to go help you afterward. If you feel like you're too strapped for time to do that, then at least tell them where you'll be, ie "Can you help me get Doris into bed when you're done? I already have her hooked up to the lift. If I'm not in there, I will be across the hall in Mary's room." Do not just say "Can you help me with Doris?" and then then wander off the answer call lights when they don't show up right away. And when you ask for help, make sure they don't have to wait for you when they get in there. It's so annoying when someone wastes your time by having you go in to help with a transfer and the person's shoes are not on or the wheelchair is at the end of the hall or the lift isn't even available. If you do that, people will be less likely to help you than if they know they can just run in and run out.

fuzzywuzzy, CNA · Mar 14, 2013

In an ideal world, 1-10 would be too much; however, in reality, LTC is grossly understaffed. Most LTC places here have maybe 2 NAs for 30+ patients. The nurse will have the whole building to be responsible for. That's just the way it is, unfortunately. Imagine how great the care would be if the ratio was like 1:6! But you have to work with what you've got. 10:1 is not so bad if at least 2 of them can stand with help and feed themselves and are continent. It's a whole lot harder if all ten are hoist transfers, incontinent and need maximum help, but you just have to try your hardest and prioritize.

I don't think total care people are that bad... it's the walkie-talkies that MAKE those patients difficult. I work on a unit with a lot of total care people and if it was just them I could go up and down the line providing care, but we also have a number of demanding residents who are able to do a lot for themselves but they ring, and ring, and ring, constantly demanding attention. I can't do anything without being interrupted by one of them.

allnurses Guide · Mar 14, 2013

I don't think total care people are that bad... it's the walkie-talkies that MAKE those patients difficult. I work on a unit with a lot of total care people and if it was just them I could go up and down the line providing care, but we also have a number of demanding residents who are able to do a lot for themselves but they ring, and ring, and ring, constantly demanding attention. I can't do anything without being interrupted by one of them.

So true!

I have always loved my total-care patients and would pour my heart and soul into them.

It was always frustrating to know you had these poor souls who could do absolutely nothing to help themselves, and yet there is the walkie-talkie next door who is a time-suck because they won't pour their own water or the picture on their wall is crooked :arghh:

I used to trade "easy" assignments of all walkie-talkies for an assignment of total-cares and dementias... but, hey, it worked for us because everyone has a certain patient population they work best with.

fuzzywuzzy, CNA · Mar 14, 2013

Yeah! I'm very fond of my total care patients. I feel a connection with them that a lot of my coworkers don't, and caring for them is so satisfying, and almost meditative for me, whereas the walkie/talkies just exhaust me. Then again, I'm a TOTAL introvert with no appreciation for fakey small talk stuff. Some of my coworkers would rather focus their attention on people who are more social and can give them external validation about how they're doing, whereas I just feel like I'm being manipulated when I deal with those people. It's a song and dance I don't enjoy.