Three months ago I started I started working as a CNA – Certified Nursing Assistant, on the Cardiac unit at a major hospital here in the city. I thoroughly enjoy being a nursing assistant and have learned so much in these past few months. I wanted to share what a day on the cardiac floor is like from the eyes of a nursing assistant.
I will be the first to say that being a nursing assistant is hard work!!! Our floor is set up where we have forty-two rooms. One side is odd [1-41] numbered and the other is even [2-42] numbered. There are four nursing assistants designated to the floor. Between the four of us, the 42 rooms are divided and we end up with 10 patients each. However, there are many days when there are only three CNA’s, and then we each have fourteen patients each!!! Which can be a good or bad day – depending on your patients.
On our floor we are allowed to clock in at 6:38 a.m. and if you clock in after 6:51 a.m. you are late!!! No Pressure! Ha!
6:38 – 7:00
The first thing I do after putting my bag in my locker and my lunch is my fridge is get report from the outgoing night shift CNA. We walk from room to room, and she gives me updates on my patients. She lets me know if they are diabetic and need to have their sugar checked, and if they are an assist, total or self. An assist means that they will need help to get in and out of bed and to the bathroom if needed. An assist *1 means the patient only needs one CNA or nurse to get them up, an assist *2 means the patient needs two persons to assist them.
A total patient means we do everything for them, hygiene care, feed them, and shift them from side to side every two hours so that air can get under their back. A self, also known as a walkie-talkie means that they are able to do for themselves. They also let me know who is going to have a procedure done that day, and if they need to be prepped or have their bed changed before they go.
7:00 – 8:00
Report ends and I grab my vital sign machine and get my supplies [batteries, gloves, thermometer cover, and an extra pair of blood pressure cuff] for the day and start my vital signs. When I get to a patient’s room, I foam in, put my gloves on, and then I introduced myself, tell them why I am here, and then start checking their vitals. In the morning – every morning- we change the batteries which are in their telemetry box. The telemetry box is a heart monitor that all patients wear when they get on the cardiac unit. This allows us to monitor their heart rate throughout their stay with us. Vital signs entails checking their blood pressure, their temperature, heart rate and their oxygen levels.
I change the date on the board and make sure they don’t need anything before I leave, then I discard my gloves, and foam out and do the same thing for my other 9 or 13 patients, depending on our census. Whenever a patient comes on the floor we give them either a urinal or a hat (females) that goes in the toilet for us to measure their urine. It’s important for us to measure urine on the cardiac floor, as we need to note their input and output in the system for the nurses and doctor, as sometimes the patients are given Lasix and if you don’t note their output in the computer (like I struggled with when I just started), then the doctors won’t know if the medicine is helping.
9:30 – 10:30
After my vitals I run down to the cafeteria and get breakfast and coffee – much needed caffeine. At 10:00 we have our shift huddle in the nurse’s station – this is where the charge nurse tells us anything we need to be updated on, and where the staff shares their concerns.
10:45 – 12:00
It’s now time for a next round of vitals. The only difference here is that we check the glucose levels for all patients who are diabetic. On a good day I will have only two glucose levels to check, on a busy day, I have had up to eleven.
1:30 – 2:00
2:00 – 3:30
We have to make beds every day on the cardiac floor and we have to offer the patients a bath each day as well. I normally do that during this time. A trick I have learned when it comes on to making beds, is to wait so see who will be discharged and that order is usually in the system after lunch, so I don’t make those beds, because EVS will come and clean the room and make up those beds. I am very friendly with our EVS staff on our floor, as they normally know who is getting discharged ahead of us. So, that normally brings it down, to like half the beds. Score!!
With baths, a lot of patients will refuse, some of them are self-care, and will just ask for the supplies to do it themselves. Most times there will be wives and mothers in the rooms, and they will offer to do the baths for their loved ones – yay!! Which will leave me with just the total care patients, and then I knock those out pretty quickly.
On our floor we give out two colored socks, green and yellow. The green socks are for patients who are walkie-talkies. The yellow socks are for fall risk patients. Fall risk patients, are those who are weak, or who stumble when they are walking. We keep bed alarms on for their safety. When they try to get up off at a bed, the alarm goes off – and it is extremely loud, and we all run in the room, because we don’t want a patient to fall and hurt themselves while they are in our care.
I start my final rounds of vitals at around 3:45 and I try to get my glucose checks in before dinner is rolled on the floor around 5:30.
The last thing I do for the day is to pass out ice chips to all my patients so that they’ll have something to drink if they get thirsty in the middle of the night. By now, this CNA is tired!!!
The night shift staff starts rolling in and I give report to the oncoming CNA before ending my day.
Time to clock out!! Exhausted. Goodnight. Home. Shower. Eat. Sleep. Repeat.
We have a steady rotation of patients being discharged and admitted during the day. When the nurses get a call about an admission, they call the CNA’s and give us report and also gender, so we know how to set up the room. By setting up the room I mean getting the essentials that they will need, such as: the telemetry box, a vital sign machine, a scale, a gown, a urinal or hat, toiletries, blood pressure cuff, facial tissue a pitcher with ice chips and water, and a personal effects bag. When the patient comes on the floor, we get their height and weight, take their vital signs, and introduce them to the room – show them how to use the remote, how to call nurses station, how to order food and how to contact me if needed.
When a patient is discharged, I’ll go in there and unhook their telemetry box and also to remove their IV’s. I’ll also help them get dressed and packed up if needed.
Being a CNA is hard work, there are days when we are slammed and I don’t eat lunch until 3:30 or miss it completely, but I wouldn’t change it for anything in the world. What I really want is to be a CNA in an emergency room or an ICU. I haven’t found one that will work with my current schedule, so I will continue my learning experience here at this hospital, until I fulfill my dreams of becoming a trauma nurse!! One day soon!
Are any of you CNA’s or work in the health field, what’s your day like?