What's it like to work in a hospital?

LovelyInPink · Dec 9, 2016

Every hospital is a bit different in terms of what CNA's are allowed to do and what the typical day involves but I can give you my point of view. I have been a CNA for 10 years - the first 4 years I worked in long term care facilities and the past 6 have been on a busy Telemetry/Med Surg floor in a hospital.

For one, the length of shifts are different. In the nursing homes I worked 8 hour shifts but in the hospital I do 12 hour shifts, so, 3 days a week is considered full time.

Also different are the tasks I am allowed to perform. I remember when I worked in the nursing home they wouldn't even allow the CNA's to apply medicated creams and powders such as Nystatin; we also weren't allowed to take part in CPR which, looking back, seems pretty crazy to me. In the hospital I can check blood sugars, remove foley catheters, remove IV's, apply telemetry monitors, perform non-sterile dressing changes, empty drains, check vital signs, and perform CPR along with other tasks.

All in all, I highly prefer the hospital environment to the long term care environment. I start nursing school next month and I believe it will be a bit easier to make the connections among certain concepts because you see such a wide variety of patients working in a hospital. There also is a lot of interaction between you as the CNA and the nurses and even the doctors, physical therapists, speech pathologists, laboratory technicians, etc. In the nursing homes where I worked, the nurses treated us like we were the scum of the earth. In the hospital teamwork is a lot better. You certainly will feel like you are back at a nursing home at times with your patient load but the good thing is that it doesn't last forever and often times you will get to meet new patients every time you work and even during the duration of your shift.

I'm sure I forgot to mention some things but just feel free to ask if you have any questions!

CNA1012 · Dec 9, 2016

"Also different are the tasks I am allowed to perform. I remember when I worked in the nursing home they wouldn't even allow the CNA's to apply medicated creams and powders such as Nystatin; we also weren't allowed to take part in CPR which, looking back, seems pretty crazy to me. In the hospital I can check blood sugars, remove foley catheters, remove IV's, apply telemetry monitors, perform non-sterile dressing changes, empty drains, check vital signs, and perform CPR along with other tasks.

All in all, I highly prefer the hospital environment to the long term care environment. I start nursing school next month and I believe it will be a bit easier to make the connections among certain concepts because you see such a wide variety of patients working in a hospital. There also is a lot of interaction between you as the CNA and the nurses and even the doctors, physical therapists, speech pathologists, laboratory technicians, etc. In the nursing homes where I worked, the nurses treated us like we were the scum of the earth. In the hospital teamwork is a lot better. You certainly will feel like you are back at a nursing home at times with your patient load but the good thing is that it doesn't last forever and often times you will get to meet new patients every time you work and even during the duration of your shift."

this stood out to me a lot, thank you for taking the time to reply! I honestly went home crying because of how the nurses and some of the other aides treated me. I did everything in my power to try and do my best and try to make the work load for everyone a little easier. One of the nurses ******* me out because I had a patient who needed to use the bathroom but their nurse was nowhere to be found, so I flushed her NG tube, just how I was trained to do. I was trained by my CNA instructor when I took the course, another nurse at the care center, and all the other aides flushed tubes that the patients had. But her nurse was so infuriated with me she made my boss send me home. Another time a nurse made me go on lunch while we were doing rounds, and my "partner-aide" was so mad when I told her the nurse told me to go on lunch she complained to my boss and almost got me fired. Those are two of the instances that made me second-think being a CNA. I'm glad I stuck it out and now I absolutely love where I'm at. Mostly because I either babysit (in pediatrics) and do care when needed (ADLs, (feeding, changing, etc)) other than that I sit and chart and/or wait when I'm needed. When I was in the carecenter, the work load didn't usually bother me as much as the staff did.

Id love to learn to do those things. When they emailed me they asked which unit I'd be comfortable in and I told them medical telemetry was a big interest for me. Knowing that you can do that stuff, hopefully that's how it is at this hospital because then I'll be trained to do those procedures even before nursing school, which I think is a big privilege/advantage for those who want to go to nursing school. I like keeping busy because in homecare I can get bored sitting and waiting around. Thank you for replying!

justSara · Dec 14, 2016

First of all, congrats on possibly landing your first hospital gig! I'm currently a PCT at a hospital in South Florida so I'll give you a detailed view of what my job is like and a little background on myself. I've been doing this for 3 months! Hopefully you find this useful. Warning: This will be very long, lol!

I'm almost 21 years old, I've spent the last few years slowly working away at my pre-reqs for nursing school. In the meantime, I was working in retail. This past summer I spent 3 months taking an intensive course to get my PCT certifications. I got my HHA cert, CNA license, EKG cert, and Phlebotomy certification. I initially had a hard time finding a hospital job due to my lack of experience. So I applied for CNA positions with various home health agencies and lied to them all about my experience, and found work with what I thought was a decent agency. I stayed for about a month and then got pretty tired of it, and realized the agency wasn't so great after all. So I again started applying for PCT positions online and got 3 interviews to my surprise. (I got these interviews by lying about my experience again. I said I had two years of Home Health experience instead of a month, LOL). I was offered all 3 positions and negotiated salaries, and ended up with a full time (daytime) PCT position in a hospital for $12.79 an hour plus benefits. Which is low in general but very decent for the area I live in. I don't think I could get any higher in South Florida.

ANYWAY. I'll give you a look at my typical day. My shift is 6:30a - 7:00p (12.5 hour shift, with 30 minute lunch break and 15 minute breakfast break). I work on a small unit, only 20 beds. It's a Neuro-Telemetry unit and there is usually only 1 PCT working at a time, unless all of the beds are full.

The perfect amount of patients for me is 8-10. I think 10-12 is still manageable (meaning I can do all my rounds and duties as expected), but anything more than 13 gets hard to juggle. At my hospital I often end up with 14 or 15 patients and I can't even round properly some days. I just run around crazily answering call lights and trying to help everyone in time.

Anyway, first thing in the morning the Charge Nurse prints out a "PCT Handoff Tool" that is a report that gives me a brief summary on each patient explaining what they are being admitted for, any precautions, any wounds, what their activity level is, their diet, any allergies, and things like that. While looking at the assignment board, I jot down notes for each patient on the handoff tool (such as who their nurse is and what phone that nurse has today).

06:30- I arrive and go look at the assignment board at the Nurse's station that tells me what rooms/pts I'll have that day and which phone I will use (we have employee phones and pagers). An example of my assignment may be "Sara: 909, 910, 916-928)" Which means I have those rooms (15 pts for the day).

06:45- I'm ready to receive report on my pts from the nighttime PCT so I go find him/her. We go together to each pt's room and the nighttime PCT will tell me if the pt is "Self", "assist" or "total". "Self" meaning that they are self-sufficient and are in need of minimal assistance. OR the pt may be an "assist" meaning they need my assistance to get up and go to the bathroom and may need help with their ADLs. OR the pt may be a "total" meaning they need total or complete care from me; this pt cannot get up so they will need a bedpan or their catheter/ostomy bag emptied, if they are incontinent they will need me to change the pads on their bed frequently or their diaper if they use them, they will need me to do their ADLs for them, they may need me to feed them, and they will need to be turned every 2 hours by me. We go into each patient's room together and the nighttime PCT tells me what I need to know, I introduce myself to the patient, and then we move on to the next room.

07:00- I have *hopefully* finished getting report on all pts and am ready to work. I am supposed to round on all my pts on the odd hours of the day; so at 07:00, 09:00, 11:00, 13:00, 15:00, and 17:00. And the RN's round on all the even hours of the shift. At the 07:00 round my goal is to change all the dry erase boards to reflect the proper staff names and health goals for the day. I will also perform the accu-cheks on any of my diabetic pts (since it must be done before breakfast comes at 08:00). I will also assist any pts who are awake with brushing their teeth, going to the bathroom, and changing linens if they want me to. Depending on how many patients I have, I may finish with this round anywhere between 07:45 and 09:00! Because of course I am constantly being interrupted with pages to assist pts with using the bathroom, etc.

09:00- This round is usually done pretty quickly. During this round I change linens, bring water, and assist with ADL's for any pts I did not get to during my 07:00 rounds or for the ones who were alseep then. I also change electrodes and batteries for all the tele-monitors since I work on a tele unit. As I go into each room, I greet pt by name, ask how they are feeling and if they are in any pain, see if they want to use the restroom (all pts have bed/chair alarms and must have someone with them EVERY time they are out of bed to prevent falls), I ask if they want to reposition themselves or move from bed to chair etc, make sure all of their belongings are in reach, and then if there is nothing else they need I tell them someone from my team will be in to check on them within the next hour.

09:30-09:45 I usually try to go downstairs to the cafeteria and eat breakfast around this time. My hospital offers one paid 15 minute break and I use it for breakfast. Sometimes I am too busy and have to wait until 10:00 or 11:00, but most days I take it early.

09:45- Back on the floor. At this time of the morning I answer pages and go back and forth helping pts to bathroom, changing incontinent pads, bringing someone more cups/ice/water/pudding/socks, etc. If there is free time I will stock gloves and extra linens in rooms.

10:30- I start my 11:00 round half an hour early because during the 11:00 round I also must take vital signs and do accu-cheks on the diabetics so this round can easily take 60-90 minutes (sometimes longer if we are short staffed and I keep getting interrupted to assist pts to bathroom). So I do normal rounding with everything mentioned early (repositioning, bathroom assist, placement, ask about pain, etc), then I take temp, respirations, b/p, and O2 Sat%, and blood sugar/accu-check. I record all the vital signs on my PCA Handoff Tool (notes).

12:00- *Hopefully* by this time I am finished with the 11:00 round/vitals and I will go to the computer room where I must chart on my pts for a while. I chart the vital signs for each pt, along with the times that I repositioned them, how many times they voided (used the bathroom) today and if it was urine or feces (if urine, must chart the ml if they have a foley catheter or urinal to measure). I also have to chart which pts I assisted in brushing teeth, pericare, bathing, eating (what percentage of meal did they eat at breakfast), etc.

12:30- If there are any pts who need help eating, this is the time I will do it. If there aren't any, I will go on my lunch break at this time (30 mins). Some days I can't eat until 14:00 or 15:00 because it's busy.

13:00- At this time I have to round again and ask all my usual questions (any pain? Reposition? Move from chair to bed? Need to use the bathroom? Make sure all belongings are in reach and tell them someone will be back to check on them in an hour.)

14:00- If I'm done with 13:00 rounds I will go catch up on any leftover charting; such as, which pts have voided since I last charted and how much, which pts needed assistance eating and how much did they eat, etc. If there is no left over charting I will SIT AND BREATHE for the first time that day and just wait to get pages for bathroom assistance of something else.

14:30- I start my 15:00 rounds half an hour early because this round also includes vital signs and therefore it takes much longer than the usual rounds. I ask my usual questions about repositioning and bathroom and blah blah, and then take all vital signs I mentioned earlier, record them on my handoff tool paper and go through all the rooms like that.

16:00- I go to the computer room and chart all my vital signs, who had voided and how much, etc. Usually takes about half an hour.

16:30- I do my last set of accu-cheks (blood sugars) on my diabetic pts before dinner is delivered at 17:00.

17:00- It's time to round again on all pts. I ask my usual rounding questions, and since dinner is being served right about now I am moving a lot of patients out of bed and into the chair so they can sit up and eat. For other patients I am helping them sit up their bed and bringing over their bedside table and adjusting the height and stuff so they can eat. I also get a lot of pages for stuff like pt needs ketchupâ€, pt needs coffeeâ€, etc at this time of the day and I take care of that stuff.

17:30- If any pts need help eating I do that as soon as I'm finished with the 17:00 rounds. If there are no pts who need help eating, this is the time I start cleaning up and getting ready for shift change.

18:00- Start getting ready for shift change: stocking all rooms with gloves, incontinent pads, masks, gowns, stock up the linen cart, stock up the accu-check kits, empty all catheter/ostomy bags one last time, make sure all incontinent patients are on dry pads or in dry diapers, etc. Empty all the trash cans on the unit and bring all bags of soiled linens to laundry room. This usually takes 30 mins to an hour, because I'm still being paged for bathroom assists, etc.

18:30- Nighttime shift arrives

18:45- Start giving report on all patients to the nighttime PCT.

19:00- GO HOME! (Usually, haha) Sometimes I still haven't finished stocking/cleaning the rooms, so I have to stay an extra 15 or 30 minutes to finish. I've never stayed any later than 20:15.

I am also supposed to bathe patients sometime during the day, but my hospital is way too understaffed for me to have time to do that as often as they want me to. Our goal is to bathe each pt every other shift. Luckily most pts are bathed at night, and then I usually have time to bathe one or two. But if there are more than that who need bathing, sadly, it just won't happen during my shift.

Another huge hassel is getting a new admission or discharge. They happen daily, sometimes 5 or 6 in one day, and they take a lot of time to do. And they're unpredictable so that's something that often interrupts my regular duties.

*Additional duties include: putting tele-monitors (heart monitors) on new admission pts and changing the electrodes and batteries daily. I change dressings for simple wounds. I put on condom catheters (not foleys). I remove IVs when the pt is being discharged or when the RN asks me to. I help with orthostatic blood pressure tests. I also try to walk with patients around the hallway when I have free time. While I am certified to draw blood, I never get to because my hospital has the lab techs come and do that, so I just do the finger pricks for the accu-cheks. Of course I can do CPR as well, but I've never had to so far. I also assist with post-mortem care when someone dies on our unit. I feel like there's so much more but that's all I can think of right now!

I like this job a lot, I just wish we could have at least two PCTs on my unit during a shift for an extra set of hands. Also wished I could make a little more money. But overall, it's a decent job to gain experience until I actually become an RN.

Hope this helps! And good luck to you!

ItsMe34 · Dec 15, 2016

Wow @justSara, CNA Thank you for sharing such in depth of information. It was very helpful. I had my face to face interview as a PCT on yesterday. I have to take a assessment, then I have to shadow someone in this position to see how I like it and if I still would want the position and to see what's it like working in the hospital.

Cakelady1 · Jan 1, 2017

I have been a CNA for about 18 months. I decided to try it first before dedicating time and money to nursing school.

I have had two jobs. The first was in a skilled nursing facility. To be completely candid, I hated it. We were constantly short staffed. The nurses didn't respect the CNA staff and vice versa. Back biting, gossip, etc. All I did was wipe butts - I know that is a major part of nursing in general, and we have to expect mess. But I want to learn, be exposed to different facets of nursing, to observe, to DO.

A few months ago, I was hired on as a float pool CNA within a hospital system. I float to four different hospitals. Different floors, different specialties.

I.LOVE.IT.

I have expanded duties. I feel like I'm part of the nursing TEAM. I love my RNs.

The only thing I don't love are 12 hour shifts. They get long and that's taken some getting used to. But, that's reality. I think most nurses and CNAs work twelves. But I only work one day a week. :)