What was your 1st day of (non-orientation) CNA work like?

KB24 · Sep 15, 2010

Sink or swim.

The CNA's at our facility are left on their own after they're done with orientation and the CNA's that have been there a while don't have time to help out the new CNA's.

I felt lost and confused on my first day alone because I was still learning the routine and wanted to make sure I did not drop a resident.

lavette112 · Sep 15, 2010

I just wanted to say congratulations I am a current cna student, and I start clinicals next week. Good luck on your budding career.

fuzzywuzzy, CNA · Sep 15, 2010

Sink or swim.
The CNA's at our facility are left on their own after they're done with orientation and the CNA's that have been there a while don't have time to help out the new CNA's.
I felt lost and confused on my first day alone because I was still learning the routine and wanted to make sure I did not drop a resident.

same. It's easy when you're being trained to follow someone around or do what they tell you. After you get off training, you have to figure out what to do next by yourself. I've trained a couple people and they always follow me around after they're supposed to be on their own, asking me "what now?" You just get in that mode. It helps if you're given a sequence for the whole night right off the bat, and you can write it down.

Not only did people not have time to help, but a lot of them were unwilling. Despite having been trained, I didn't know all the little ins and outs. There's always a resident who's really picky about her care and gets upset when you're "not doing it right" but won't tell you what she wants. It will take you 40 minutes to get out of her room, not 20 like everyone else. That'll make you late for your next picky resident, who then gives you a hard time and wants you to get one of the other CNAs instead. You waste a half hour trying to appease her because none of the other CNAs will help. Then a nurse yells at you because So-and-So is sopping wet and should already be in bed. And you're thinking, "I didn't get a chance!" When someone rings, you won't automatically know to grab a brief and a towel, or a blanket or an ice cream, so you'll have to make 2 trips. The other CNAs will probably already know what that person needs because they ask for the same thing every night. And there's like a hundred other scenarios like that. Learning all that takes time. But a lot of CNAs forget. I would ask for help and people would either ignore me or give me an attitude. And I'm pretty sure everyone was talking behind my back. They'd do things like, only take down their own beds and do all the vitals except on my residents, when normally one person just does them all. Then at the end of the night I'd be getting hassled about not having my vitals done. When people are crabby to me, I get flustered, and then I'm even more useless. So the first few weeks were pretty awful. I was a nervous wreck 24-7. But then things got dramatically better.

Your experience might not be so... traumatic (I admit that I'm a sissy), but it's still probably going to suck for a little while. Little light bulbs will go off in your head as you get used to the residents and routine, and then one day you realize it's not a struggle anymore.

I would definitely ask another CNA: Who do I have? In what order do I care for them? Are there any special tricks that I need to know? Who are my baths? Do I need to get any vitals or weights?

canigraduate · Sep 15, 2010

It really depends on whether you're in LTC or in the hospital. At an LTC, be prepared to be completely overwhelmed. It's OK. Just make sure that you ask for help from the more experienced CNAs. Don't ask for help from other new CNAs, they'll just slow you down and get you and them farther behind. The more experienced ones also can help with your time management.

Make sure you go in with a schedule in mind. For example, I worked 2nd shift. Here was my general schedule:

1445 - Get report

1500 - Distribute ice water and cups, check on residents, straighten up rooms

1515 - Get first shower and bed change out of the way

1530 - Start 1600 rounds, get all residents cleaned, dressed, prettied up, and in WCs, and 2nd shift vitals started

1630 - Track down residents that need blood sugars checked, deliver them to the nurse, then take everyone else to the dining room, keep working on VS, take out soiled linen and trash

1645 - Start passing out bibs and trays in the dining room OR get trays passed on the halls

1700 - Get to feeding

1730 - Start picking up trays, take all residents back to rooms, clean DR, note I/Os, start 1800 rounds

1745 - LUNCH!!!! If you have time

1800 - Keep going on 1800 rounds, get 2nd shower and bed change done if it didn't happen earlier, get residents' teeth brushed and bedtime stuff out and ready, take everybody back to BINGO

1900 - Probably still working on 1800 rounds and shower and extra toileting from dinner

1930 - Ditto, but starting on 2000 rounds and getting everyone in bed, catching up on last VS

2000 - Still working on PM ADLs and rounds, getting bedtime snack requests

2030 - Ditto, hopefully passing out snacks

2100 - Finally getting everyone in bed, starting to chart

2130 - Starting on 2200 rounds, finishing up charting

2215 - Get all charting finished, linen carts restocked, trash taken out

2230 - Report to 3rd

2245 - OUT!

If you don't know what your schedule should be, ASK. One of the other CNAs will be happy to tell you. Oh, and don't expect to follow the schedule exactly. It NEVER happens. Something always comes up, so you learn to be flexible.

Having said all that, just remember that you CAN do it. Every time you start to feel overwhelmed, take a deep breath and ask the first coworker you see for help. Also, reciprocate. The more help you give, the more likely you are to get help back.

Good luck!!

fuzzywuzzy, CNA · Sep 16, 2010

^That's a solid schedule, but a new CNA isn't getting a shower and bed change done in 15 minutes. They are not doing any of that stuff as fast. And there's the problem! I wonder if the transition from orientation to independence should be more graduated.

Anyway, OP, keep the timeline in mind and try to shoot for that. Look at the clock constantly. If you spend 15 minutes on each resident you can get 4 of them done in an hour. Be aware of how much time you're spending with each resident. You also need to account for time spent waiting for help, time spent helping others, and call lightd. Some residents are picky and want to get ready at a certain time, in a certain way. Others can be thrown in bed quickly and washed later. Then for the rest of the night you can check and change those people easily by yourself, and you won't be at the mercy of your coworkers.

And when you're looking for help, make sure everything is prepped before you bring the other CNA in because they're not going to be pleased if they have to waste a lot of time getting the hoyer or or take down the bed or whatever. If you're asking well in advance let them know. Say, "I need help getting Catherine in bed- I'm gonna go grab a hoyer sling. Can you meet me in there?" Then if they don't show up right away you can brush Catherine's teeth or straighten up her room. If the other CNA does show up right away, you can just do those things after they help you transfer her. The point is, don't waste a single minute of your time (or anybody else's).

LuvCinci · Sep 17, 2010

After my first day (12 hr shift) I came home, zombie look on my face, walked in the door, and burst into tears when my boyfriend asked how it went.

Just finished my fourth day yesterday, and was all smiles! It gets better each day. Being new is so overwhelming, and expect that you are going to feel a little dumb, because you are new- but don't be too hard on yourself! The fact that you care shows that you will be just fine :)

KB24 · Sep 27, 2010

Another thing I had trouble with is learning the residents names because they moved us around to different units. Really hard to remember people's names when you only see them once every 3-4 weeks.

Tamimac · Nov 3, 2010

My First Day: I work at an Agency and got a client 32 hours per week. I started on a Saturday 10-6 and wanted to do my best to impress! The lady I work for lives alone. I followed the Care Plan which included swiffer/mop/dust hardwood floors- dining room, living room, and extended hallway and vacuuming 3 rooms. I got the entire floor plan covered-done! My arms were almost too sore to ambulate the lady around the block! Ha! Of course, I plan to lighten up- but the family noticed it!!! Also, I do shampoo/shower the little lady too, etc... It turned out great for me because my DON said I did a "great job" and gave me a big hug! And, yes- they both thank me often- usually every day!!

volcomcna · Nov 4, 2010

My first day after orientation, I didn't feel ready so I had an extra day of shadowing but of course I work Noc shift and my co-worker just explained and explained everything so thoroughly so it really depends. I guess I was lucky I didn't get thrown to the sharks right away but after working alone you will catch on! good luck!

blessedinscrubs · Nov 4, 2010

It was pretty terrifying for me. I had four days of orientation, but the first two didn't help me much. I got put with CNAs whom I couldn't understand because their foreign accents were so thick. I have since come to understand them and other CNAs with accents much better (with time), but it really made my first two days of orientating tough. I was lucky if I caught 1 out of every 10 words they spoke, and I had lots and lots of questions. I remember after the first day of orienting, I went home and laid in bed and just bawled my eyes out, I was so frusterated and confused.

I was lucky, though, because on the third day of orientating, I was put with a really experienced CNA who took me under her wing and even went to bat for me when the nurses gave me heck. Once I was on my own, she would come to check on me several times throughout the shift to see if I needed help or guidance. I try to remember how much that meant to me. I can recall actually wondering if she was angel sent from heaven for me, lol. And so, when there is a new CNA fresh out of school coming to work for the LTC facility I work at, I will try my best to find time to check on them and make sure they get to take a break, etc. The nursing field needs more kindness and understanding between it's coworkers. That's what I think, anyway :nurse: