Which job should I choose while in nursing school? CNA in hospital vs. nursing home?

klone, MSN, RN · Jun 5, 2020

What's your priority - experience, or a paycheck to pay your bills?

vanessa123yaa · Jun 5, 2020

8 minutes ago, klone said:
What's your priority - experience, or a paycheck to pay your bills?

experience right now

klone, MSN, RN · Jun 5, 2020

Then there's your answer

Long Term Care Columnist / Guide · Jun 6, 2020

I was a casual CNA in a small hospital when I was going through nursing school, and I learned a LOT. In addition to taking vitals and performing ADLs, I was encouraged by the nurses to listen to lungs and bellies, assist with procedures like NG tube insertion to the limits of my scope of practice, check blood sugars and discontinue Foleys and IVs. I loved it and got plenty of hours. It was a great experience and I would recommend it to anyone.

Sour Lemon · Jun 6, 2020

18 hours ago, vanessa123yaa said:
So I've currently been working as a PSW (American equivalent to CNA in Canada) in Long term care and to be honest, I HATE it. I'm not learning anything! I don't do vitals or anything remotely nursing just help with ADLs....thats it. I know this is part of the job, but I feel like I could be using my knowledge and skills more as a BScN student entering my final year in September. I tried to talk about this with my manager and all she replied with is "so you're not happy with your job". like im not going to tell her I hate my job so I remained silent. The residents are abusive and the workload is too heavy. I'm working with a bunch of middle aged women and I just don't feel like I belong.
I got a job offer in the resource team at a hospital which I would be super happy to accept, but here's the catch it's "unscheduled" which I think means my hours are not guaranteed. anyone know what an "unscheduled" psw/cna is? the position is also temporarily and is suppose to end in September (can be shortened or lengthened based on the hospital's needs).
I want to choose the hospital position based on the learning opportunity and possibly doing something I enjoy. but at the same time, I want a stable job where I'll get hours and really dont want to be in the position of looking for a new job when the contract ends. WHAT SHOULD I DO?
pros/cons of hospital job
-learning, doing more skills
-"unscheduled" worker
-contract ends in couple months
pros/cons of long term care job
-hate the work
-not learning, literally JUST ADLs
-stable, get hours

It's important that you realize the difference between school and work. As a nursing assistant, you'll be there to assist nurses with work- not for them to assist you with school.

I enjoy students and teaching, but rarely have time to teach nursing assistants while we're both busy at work. Those occasions are icing on the cake, but should not be an expectation.

If you need a stable income, you should probably keep the job with stable hours that doesn't expire. And don't discount the value of being experienced with ADLs. You'll be doing plenty of them as a nurse, and they slow you down in a horrible way if you're not experienced.

SilverBells, BSN · Jun 6, 2020

In some ways, I agree that you probably would see/do a little more in the hospital setting. With that said, is it possible that opportunities are presenting themselves in the long term care setting that you haven't realized? Are you not allowed to take vital signs or have you not been given the opportunity to do so? If permissible, maybe offer to take some vital signs for the nurses. Nurses are busy and may not realize that you are looking for more tasks to complete, but I am sure that many of them would not mind if you wanted to help take vital signs if it is not against facility policy (unsure why it would be; vitals are taught in CNA school). Since you are completing ADLS, this could give you an opportunity to learn how to evaluate skin and when an issue should/should not be reported. Obviously, if there are any concerns the nurse would need to address them, but you could possibly gain assessment skills, especially with pressure wounds, by doing so. Is there a chance you could become a TMA in the facility? Some facilities will train CNAs to pass (basic) medications and may give you the opportunity to take blood sugars. You would likely not be allowed to administer insulin or IV medications however. With that said, medication pass could assist you with learning different medications, how to evaluate a resident for signs of pain, possibly identify parameters on which to hold certain medications (however, the nurse would ultimately be responsible for this, and you would be required to consult with one prior to holding any medication) Again, this would be specific to your facility. Also, are you in a truly LTC facility or does your facility ever take short-term rehab patients? If so, perhaps offering to float to that unit could help increase your skills. Many short-term rehab patients are actually medically unstable and depend on nursing assistants' reports to nurses with any concerns. If your facility does not accept these patients, is there one nearby that you could work at that may be more willing to provide you a more stable schedule? I am not trying to downplay your concerns at all, nor am I trying to discourage you from the hospital, as hospitals are also valuable experiences. Certainly, you would see different things in the hospital. Just trying to throw some other options out there that could gain you both experience and a steady income.

vanessa123yaa · Jun 6, 2020

14 minutes ago, SilverBells said:
In some ways, I agree that you probably would see/do a little more in the hospital setting. With that said, is it possible that opportunities are presenting themselves in the long term care setting that you haven't realized? Are you not allowed to take vital signs or have you not been given the opportunity to do so? If permissible, maybe offer to take some vital signs for the nurses. Nurses are busy and may not realize that you are looking for more tasks to complete, but I am sure that many of them would not mind if you wanted to help take vital signs if it is not against facility policy (unsure why it would be; vitals are taught in CNA school). Since you are completing ADLS, this could give you an opportunity to learn how to evaluate skin and when an issue should/should not be reported. Obviously, if there are any concerns the nurse would need to address them, but you could possibly gain assessment skills, especially with pressure wounds, by doing so. Is there a chance you could become a TMA in the facility? Some facilities will train CNAs to pass (basic) medications and may give you the opportunity to take blood sugars. You would likely not be allowed to administer insulin or IV medications however. With that said, medication pass could assist you with learning different medications, how to evaluate a resident for signs of pain, possibly identify parameters on which to hold certain medications (however, the nurse would ultimately be responsible for this, and you would be required to consult with one prior to holding any medication) Again, this would be specific to your facility. Also, are you in a truly LTC facility or does your facility ever take short-term rehab patients? If so, perhaps offering to float to that unit could help increase your skills. Many short-term rehab patients are actually medically unstable and depend on nursing assistants' reports to nurses with any concerns. If your facility does not accept these patients, is there one nearby that you could work at that may be more willing to provide you a more stable schedule? I am not trying to downplay your concerns at all, nor am I trying to discourage you from the hospital, as hospitals are also valuable experiences. Certainly, you would see different things in the hospital. Just trying to throw some other options out there that could gain you both experience and a steady income.

Thank you for your comprehensive response! but unfortunately even if there are opportunities for me to practice more skills (I.e. vital signs), there certainly isn't any time for it. I barely get time for a 30 minute break in my 8 hour shift. theres so much diaper changes, showers, etc. etc., the workload is super heavy. I dont know what a TMA is and pretty sure it doesn't in Canada. I never see any other PSWs (CNA equivalent in canada) doing any med administration and im pretty sure its not allowed where I work.

SilverBells, BSN · Jun 6, 2020

51 minutes ago, vanessa123yaa said:
Thank you for your comprehensive response! but unfortunately even if there are opportunities for me to practice more skills (I.e. vital signs), there certainly isn't any time for it. I barely get time for a 30 minute break in my 8 hour shift. theres so much diaper changes, showers, etc. etc., the workload is super heavy. I dont know what a TMA is and pretty sure it doesn't in Canada. I never see any other PSWs (CNA equivalent in canada) doing any med administration and im pretty sure its not allowed where I work.

TMA = Trained Medication Aide. I am not sure what or if the equivalent in Canada would be

Also, I can relate to barely having time for breaks as well as my own job. I'm a nurse manager in a SNF, worked the floor for 3 years prior and am very busy myself. I can also attest to the fact that the nursing assistants are very busy and have difficulties making time for their breaks as well. Good luck with whatever you decide!