Starting as a CNA

So, I have made a calculated risk and accepted working as a CNA while simultaneously finishing up my last term in my nursing program, before starting the nurse residency program after I pass my NCLEX.  While this will certainly increase my allostatic load during my final term, I'm incredibly excited to start getting experience, begin working with patients, fully understand the complexities of the role of a nurse tech, understand where to find hospital resources, iron out the "normal" mechanics like clocking in/out, and otherwise getting a true feel for Carle Bromenn as an employee rather than as a student.  Plus, I have my own locker where I can leave my hospital shoes at the hospital.  I also keep my emergency ostomy change there.

At this point, I've gone through all of my pre-shift trainings, the general "Welcome to our Organization!" meeting, and three official shifts with a coach.  Now I'm able to pick up shifts wherever I can pick them up, set free to fly solo.  It's already been quite the adventure!

Here are some of the things I've learned so far:

• Highlighters are hella useful, as I start to set up my own patterns for what I want to do in the day--specifically, my tasks as a CNA include vital signs, assisting to the bathroom (or cleaning up after), assisting with bathing and other hygiene activities, assisting with eating, changing the batteries on heart monitors, measuring blood sugar levels, and otherwise communicating with the nurse for other needs.  Not everyone needs all of these tasks (aside from vital signs).  So I spend the first few minutes gathering my bearings on who might need what over the course of the day.  I don't have a complete system yet, so I'm starting to play with color coding, at least starting the day cleanly.  
• My organization system usually collapses by 1300, as situations change or patients are either added or discharged.  This is part of the process, rolling with the punches.
• Ingenuity is an essential skill.  Need to cover someone's IV before they go into the shower?  Find a plastic bag and some tape and get creative.  Only able to find one "leg" for the wheelchair?  Find another to steal or get creative.  Confused, fall-risk patient not inclined to stay in bed?  Have them help fold towels (and then refold after you accidently move them) or print out some crosswords or get creative.  There isn't always a band-aid that fits perfectly; every patient is their own person; the situation is going to keep changing.
• I get a LOT of steps in on the day, moving from one piece to the next to the next, more even than my clinical days as a nurse.  So far, I've left each of these days (twelve hour shifts, mind you) on the floor physically tired but spiritually very full.
  

  
  

• I'm ironing out parts of my script, trying to find what questions I should ask everyone in the first interaction to set the tone for my day.  I've already given up the idea of trying to decide which patient I see first, because inevitably someone has already called for my assistance and they are now my starting point, often followed by another call as my second person, and otherwise fitting all of my other pieces in as I go until I've seen everyone.  
• I delight in those moments where I can stop and listen to someone that clearly needs to feel heard.  I can't do this all the time--sometimes my phone will not stop going off when I'm trying to help one patient to the bathroom, and I have three other rooms that have asked for my attention after that.  But sometimes, there are spaces where I can linger and have those human moments.  I cannot be all things to all people; but I will have the opportunity to be different things in some of those in-betweens.  And in places where I cannot show empathy in a long listen, I can still set their arm down with a gentle touch and smile with meaning as I thank them for allowing me to take their temperature.  
• On a different note, I swear I have sweat off about a pound so far working in some of the isolation rooms--in the plastic gown over my scrubs, incubating in my own heat with the added movement, it gets toasty quickly.  
• Sometimes I forget about Melvin in the bustle of everything.  And sometimes, Melvin helps me remember to stop, take care of the bag, pee, and get some water, just another small but insistent reminder to pause and tend to myself, too.  
• I'm starting to network with some of my teammates--when I can grab something for one of the other techs or I follow-up with a nurse when I said I would do so, I'm establishing myself as part of the team a bit at a time and also making space for that reciprocity already and in the future.  I feel that I'm contributing.

So, yes, I've dealt with pee, poop, sputum, blood, and whatever else already.  I've talked with patients who were counting the seconds until I left the room.  And I'm finding purposeful, meaningful work.  I know that once courses kick up for the condensed summer term and all of the different clinicals therein, it's going to be a very busy period of time, but I'm also excited and ready for that final stretch of the endurance race.  

And I'm sure there will be many more stories along the way.