A Day in the Life of a CNA

Certified Nursing Assistants, or CNAs, have a hard job.

Physically, we lift, turn, assist, carry, bend, push, and pull all day long. Our patients may be ambulatory and need little or no help with moving around, or they may be completely dependent, quadriplegic, unable to help us move them in any way.

Mentally, we are often abused by patients (or their family members) with sharp tongues, some of whom cannot help the things that they say, but also by many others who are fully aware of their thoughts. We are surrounded by RNs and doctors with degrees, some of whom look down on CNAs as lesser, uneducated people. Some of the nurses treat us as grunt workers. It can be very frustrating.

Emotionally, we are exhausted, going through a string of emotions from humor to grief, anger, relief, thankfulness, and disgust. All in a span of a few hours during one shift. Despise is not too strong a word for how I feel about my job on some days.

No one I know would choose to endure what I do on a daily basis.

The job title is Certified Nursing Assistant (although in my state, WA, it is Nursing Assistant-Certified, NAC). We assist the nurses. This means that when a patient has a need, it is firstly the RNs job and we are there to assist the RN. So if a nurse is working with a patient and he asks for ice water, and she is right there available to do it, she should.

Calling me from toileting a patient in another room, or doing my first round of vitals to run and get someone ice water wastes a lot of time.  I will do it when I’m done with my current task, or you, RN, can take the 2 minutes and do it yourself… unless you’d rather do the vitals.

Am I jaded? Maybe just a little.

Don’t get me wrong. I work with some AMAZING nurses.

The level of respect that I have for them (and they for ME) is enormous. We work as a team. There are one or two who could use a refresher course in respect for others but for the most part, I love all of my coworkers.

In one typical month, I have done all of the following:

• Cared for around 120 patients.
• Cleaned up floods of urine from the floor and several beds, multiple times.
• Changed dozens of incontinent briefs.
• Called Respiratory Therapy a dozen times for de-satting patients.
• Given dozens of showers and bed baths.
• Emptied too many urinals, bedside commodes and catheter bags to count.
• Emptied several colostomy and enterostomy bags.
• Collected lab urine specimens.
• Changed dressings on wounds.
• Cared for and watched a very sweet patient pass away, and then bagged his body.
• Been called a “f*cking bitch” a “stupid c*nt”, “useless”, “horrible person” and been accused of “trying to kill me!” Most of these were from the same patient on different days.
• Stepped in (and tracked across the floor) poop, which I then had to also clean up.
• Filled somewhere in the neighborhood of 150 cups and 60 pitchers with ice water.
• Had three patients cough–right in my face–without warning. Or a mask. I work on the respiratory floor so this could be a problem.
• Educated several RNs who have never been CNAs on how to provide certain cares.
• Retrieved five bags of “missing” personal items from other floors.
• Stopped an IV drug user’s significant other from entering his room, because we suspected she was delivering drugs.
• Removed a Foley catheter from a deceased patient.
• Taught an elderly patient how to answer her cell phone.
• Had my scrub top and (gloved) hand peed on.
• Talked Autism and parenting teens with one patient who has a son like mine.
• Reasoned with a dozen patients who either had dementia or were dealing with temporary confusion issues, to understand what we need them to do to get better.
• Cared for 2 patients in excess of 450 pounds who were bed bound, unable to walk.
• Carried many stool samples down to the lab for processing.
• Was asked for a blowjob.
• Assisted an RN in the insertion of Foley catheters on several patients.
• Had my foot peed on.
• Held a tracheostomy cannula in place, which the patient had managed to pull out halfway, until RT came to fix it.
• Averaged 5-13 miles of walking/speed walking during each 8-hour shift.
• Had to call Staff Assist and physically restrain an agitated patient.
• Backed up other nursing staff with patients who “staff split” to manipulate us.
• Had my rear end fondled by a patient.
• Repeated “I’m sorry that you feel that way, but this is what we have” umpteen times to a patient who did nothing but complain about everything from the food to size of the bathroom.
• Bitten my tongue rather than giving an older RN my thoughts on how she really should consider retirement. Now.
• Suctioned nasty secretions from the mouths and trach collars of several patients.
• Completed 8 online trainings. All mandatory.
• Was spit on.
• Tripped over a bedside table base, sending a whole pitcher of water crashing to the floor, scaring the patient in the process.
• Eaten way too many brownies. One of our nurses brings them at least once a week.
• Bit my tongue again when a patient ranted about “that horrible nurse who needs to retire”, in complete agreement with the patient but successfully pulling off a poker face until I left the room.
• Attended two staff training meetings on my day off.
• Spent one very busy night as a sitter, putting an Alzheimer’s patient back into bed every 15 minutes. All night long.
• Precepted a new CNA, teaching her the ropes of our unit.
• Signed a condolence card for the family of a patient who was with us for months.

I have also heard “Thanks for the care.”

As well as “Thank you so much for taking the time”, “You are the nicest one I’ve met here”, and “Dawn, you’re the best!” (this, from a nurse). I was also told “You’re my favorite bartender here,” from a man with dementia who was on our unit for several months. It’s probably my favorite compliment of all time.

I wish these were the norm, but I think most people don’t realize that a kind word can make the day of a CNA, and they just don’t say them out loud even if they ARE appreciative of the things we do.

We work SO HARD.

I hate my job.

That phrase runs through my head frequently when I’m working. I hate my job but I am good at it. I am always looking for ways to improve, strategies to work with my patients to help their mobility, or to explain something to them that they don’t understand. I am good at what I do, I just really don’t like it very much.

I like most of my patients, but it only takes that ONE to make my job so hard and stressful. I still serve them the same as I do everyone else, with as much patience and compassion as I can muster and if I can’t, I am pretty good at faking it.

After midnight, I come home to a quiet and peaceful house.

I try, really try, to leave work at work. Some nights it’s easy. Other nights, it haunts me, for days at a time even. Some things are difficult to shake from my mind, so when you ask me about work, know that my hesitation to answer means I’m deciding whether or not you can handle hearing about it.