CNA Endevour

Once I came back from the trip with the others I started CNA(Certified Nurses Assistant) classes at Spoon River College in Canton.  After all, I've graduated high school, its time to start life!  Some people know what they want to do by age 6 while others don't know up to the day till they graduate.  Possibly they never know. 
I've chosen nursing and my parents advised that I take this CNA course to get a taste of the medical field. 
It was a month long very intense course.  By intense I mean 3,4 to 5 chapters a day.  And they were,..well just like regular school pretty much.  Long  in some parts, more exciting in others..  Good information though on basic care of people; mainly on the elderly.  There were 8 in the class.  2 guys,(let me tell you it is good to have men in the medical field.  Because lets face it girls, they have more muscle than us)and 6 girls ages ranging from 17-37.  A great thing about the class was that we got to eat during it.  We didn't have to wait till 11 or 11:30 for lunch.  I, of course took advantage of this:)

The CNA course is divided up into half of lectures and half of clinicals, where we actually work somewhere to be signed off on the skills we learned.  Then afterwards we would have our final exam.  AND THEN.. the state exam in August to be certified.  (I can only work as an Nurses Assistant right now, but I wont be working till after I start classes at ICC to schedule work around that.) 

Now onto the clinicals.  We went to work at a nursing home in Canton.  We had to be there by 6.  Since Canton is an hr away, I had to get up at 4.  I'm by no means a morning person.  But seeing how it was going to be a temporary it was alright.  So I woke up, slipped on my white top(WHITE! I couldn't believe it.  Anything white is like taboo in our house.  Its like asking for something to get spilled on it.  So it couldn't be any better to be working in white.) ,my navy blue pants, my white shoes and strapped on my gait belt and my wrist watch.  Then I slipped my name badge, a pen, a notepad, a piece of paper with the residents names and their room numbers into my pockets ,picked up my bag that had my lunch, stethoscope and blood pressure cup that I would need for the day.

Canton Ho!

Clinicals like I said is where we actually work somewhere to do our skills.  We have to be checked off on them in the time that we are there, and yes we are graded.  We are partnered up with a partner and we work together on residents seeing how most need 2 people to help them.
The nursing home had 3 halls.  1st hall, is a rehab hall.   Those that just need to be there for a little bit. Its almost like a hotel setting.  However, some end up in the 2nd hall which is what you see in regular nursing homes.  The rooms can have up to 3 or 4 residents in there.  The 3rd hall is for those with disabilities.  We mainly worked on the 2nd hall but there were times that'd we help out in another hall.

Once there, we had a quick meeting about things we needed to know for the day then we jumped into action.  The 1st order of business was to look at the shower sheets to see who needed baths for the day.  Which means we get to walk around the rest of the day with wet shoes.  You know, people worry about it being awkward seeing someone naked.  But in all truthfulness, we have to get those people in and out as quickly as we can.  Theres no time to be thinking about those things, and well, as people get older, things don't look the same. 
Some can manage very well on their own to where only 1 person helps them, most need at least 2 people to pretty much do most of the washing, while some are complete care where they are placed on a stretcher and 2-3 people are needed. 

The showers needed to be started at least 10 minutes before you brought the resident in because it took so long to get hot water.  You had to constantly monitor the temperature because it would go cold on you.(There was one day that we couldn't do any shower because it was storming)  Before you brought the person in you had to make sure to grab towels, wash cloths, their clothes and a depend(if they wore one) and.their soap and lotion if they had it. Once in the shower room, you'd transport them from their wheelchair to the shower chair.  By the 5th day of clinicals we had to have a shower done at least in 15 minutes or we would be docked for the day.  Its best to roll up your pant legs otherwise they'll be soaked by the end of the shower.  Especially when someone points the hose right on you.  (This unfortunately happened to me)  Running around in wet shoes and socks can give you blisters on your feet especially on the bottom of them.  (Trust me, I know firsthand or should I say first foot.)

On with order of business.  Its our job to get the residents up and ready for breakfast by 7 so they can start eating by 7:30.  Its very frustrating to not be able to find things to give proper care.  You're searching through drawers and closets, under the bed, the bathroom...Everywhere trying to get this resident only to find they're out of something or its just plain missing.  But you can't dawdle so you got to make do or run up to the nurse's station or the supply closet to get it. 

The morning routine consists of partial baths if they don't get a full, taking them to the bathroom, changing depends,(adult diapers) getting dressed, brushing hair, oral care which may just be popping some dentures in, and then helping them out to the dining hall.  Those with complete care take longer because you must use a hoyer to get them from their bed to their wheel chair.  To do so, you have to roll them many directions, back and forth to try and slide a sling underneath them.  You attach the rings on the edges of the sling to the hoyer; the person is then lifted out of bed and swung over to their chair while someone is watching the head and holding their feet. 

Dressing people can be quite a challenge.  Its our job to help them pick something out.  Most don't really care so we try to pick a couple out for them to choose from.  There was one lady however, that she was simply appalled at what I picked out apparently.  She was just like, "You expect me to wear that?!"  She was a hard one to get ready.  Another lady that was there was a compulsive changer.  She'd change her clothes probably 10 times a day if she could.  So her clothes were kept in the linen closet.  Course, that didn't stop her from wearing her roommates clothes. :D

BREAKFAST! 
Our job is to take trays out to people from the kitchen, and make sure they have everything they need.  If they don't want to eat what they have and want something else then you take it away and you get something else.  It's their right to refuse.  There was one lady there and if she had it her way she'd have macaroni for every meal.  I'm not sure if she did get that for breakfast or not...
Once the trays are served, you'd go to the feeder table.  The feeder table is where those that need complete care are fed as well as those that have trouble eating.  Mainly if they are easily distracted or need constant prompting to eat.  Those that are complete care usually had their food in liquid form.
If you weren't helping at the feeder table, you'd help deliver room trays.  

After breakfast, most of them migrate out either back to their rooms or to the tv room.  Some stayed if there was going to be some kind of activity later on.

After breakfast is when vitals are taken.  There is a list for who's vitals need to be taken. Vitals consist of temperature, blood pressure, respitory and pulse.  For weekly or monthly vitals, everybody's vitals are taken.  It can be pretty intimidating.  Its very easy to get it wrong, and sometimes you can't hear what you need to hear.  Most of the residents are pretty cooperative and will let you take it without a problem.  Course, there are some who will let you take it, but will complain the whole time about it.  Oh well.  They have a right to complain I guess.

If we aren't taking vitals, we are patrolling the hall checking call lights, or making beds if house keeping hasn't gotten to it, or repositioning complete care residents.  Nail care can also be done during this time.  Residents that smoke usually are out around this time for their 9:00 smoke.  Someone has to get their smokes from the nurse's station and take them outside.  There are alarms on the doors by the way for any escapees.

10:00- break for lunch. 

Once back on the floor, we are getting residents back out to the dining hall. Same routine as breakfast. 
By 12:00 we are off the floor.  We are given our daily assessments from our instructor with either praise or it saying that we need to work on something. 

The skills that we had to be marked off at clinicals were:

• Perform Oral Hygiene

Its sad to say, but residents aren't given very good oral care.  Residents in general are better taken care of when students come and work for a bit because they have the time for it and are trying to get checked off on that skill.  It can be so bad that a retainer looking film will form on the roof of their mouth.  When peeled out it looks like plastic.

• Shave a Resident(male or female)

I didn't shave a female.

• Perform Nail Care

The lady informed me that if I hurt her in any way,she'd hurt me right back

• Perform Perineal Care

You definitely want to do this right so they don't get any kind of bladder infections.  Its a smelly job, and their bathrooms don't have good ventilation.

• Give Partial Bath

Sometimes residents wouldn't let you.

• Give a shower or a tub bath

Blisters to prove that I did.;)

• Make Occupied Bed
• Dress a Resident
• Transfer a Resident to Wheelchair using a Gait Belt

 Even though that person looks itty bittty, its dead weight and you are breaking into a sweat sometimes.

• Transfer using a Mechanical Lift

Could only do that when supervised by my instructor.  If you are under 18 you cannot operate a mechanical lift. 

• Ambulate with a Gait Belt
• Feed a Resident
• Calculate Intake and Outake

A lady had a leg bag so got to record its contents when needed.  The bag made it very difficult to dress her.  VERY.  It didn't help that she was stubborn as a mule, complained, and wanted out of her room that VERY moment.  I think that was the only time that I really got mad at a resident.

• Place Resident in a Side Lying Position

Can be a challenge to do, but complete care residents must be repositioned every two hours to encourage circulation and avoid bed sores.  I've seen bed sores, and you do NOT want bed sores.  Looks very painful.

• Passive Range of Motion

A man had a bone disorder and could no longer hold his neck up.  To make sure it didn't worsen you do certain motions to his neck.  Complete care residents receive ROM as well. 

• Take Vitals

The Most nerve racking to me at first.  Its not so bad now.  There was one man who had to have a rectal thermometer to take his temperature.  That was interesting. 

• Move Resident in bed with and without help

Some skills we were only able to do in the lab like CPR.  Course, I had a close encounter with that.  I was feeding a lady at the feeder table and her face just turns red.  I thought for sure she was choking.  Thankfully, she wasn't.  Whew!

Many of the Residents have some form of Dementia.  They can constantly ask you the same question over and over and over and over.  They'll tell you things that aren't true. They can possibly revert back to an earlier time in their life.
Also, you have to be a bit weary on trusting them.  There was one lady that would be all loving to you one minute then the next minute slap you.  Always have to be on your toes. 

So that was my CNA experience.  It could be frustrating, nerve racking, smelly, and a bit strange at times, but its good work with some funny stories with it.