For a new CNA, working in a nursing home can be a terrifying experience. The workload can be extremely overwhelming to a newbie and knowing where to start can be difficult to determine. There are meals, bathes, dressings and a whole slew of other job duties that must be taken care of in the course of a shift. The only shift I have ever worked is first, so this is the area in which I can offer some sound advice about how to handle a full patient load in the time allotted to you.
When I come into work at 7am, the first thing that I do is go to the nurses’ station to find out who my patients for the day are. I carry a note pad and pen so I can write down this list. Once that is done, I go to the soiled linen room and pull out my laundry cart. This is the most important accessory that you can have during your shift. I rip out the paper that I have jotted down my patient list on and tape it to the top of my laundry cart.
By doing this I have a clear view of my room numbers and I can cross off the patients whom I have already provided care for. The next thing I do to prepare for the day is get enough towels and wash cloths for all of my patients and lay them in their rooms for later use. By this time it is about 7:15 and I have enough time to provide full care for one patient before the breakfast trays come out. I choose the easiest patient to work with; this is usually one that either A.) Does most of their own self care or B.) Is easy to lift and very cooperative. The meal trays arrive about 7:45 and it is time to feed the patients. Once everyone has eaten and the trays are pushed back to the kitchen, it is about 8:40. Now I have at least 9 more patients to care for before 11:45 when the lunch trays arrive.
The best way that I have found to get such a large amount of work done in the three hours I have to do it in, is choose your patient order carefully. Go for the patients who are easiest to care for first. You will be able to get them washed, dressed and up in their wheelchairs more quickly than the others and this will leave you more time for the more difficult patients. Next on my list are the patients who are immobile. They are not self sufficient but are also not total care. These are the patients who require you to use a lift to get them out of bed. Once they are ready to go, move onto your total care patients. These take the most time because they cannot assist you at all. They also do not get out of bed much so you must take time to ensure that their skin is intact and they are placed just right. You will have to turn them every two hours to ensure their health and safety. After they are all set, the lunch trays are on their way and you get to do it all over again! The good news is that once lunch has passed all you must do is rounds to makes sure that everyone is still doing okay before the next shift comes in. It takes time to get this schedule down pat, but once you do it will seem like second nature to you!
Expert Contribution by Tanya Glover, CNA
She writes candidly about the things she encounters while working as a CNA. Some of her popular articles include Goldilocks and the Three Nursing Assistants and Nursing Home Personalities 101
Thank you for this tidbit of info. I’ve worked in home health and I’m considering going to a nursing home to gain the experience. the thought of all the patients you have to handle has caused some anxiety. worrying that I wouldn’t get everyone taken care of in time.
This was very helpful information. My weakness was time management and organizing my caseload. This is something not taught during cna training.