I am a CNA that has worked with the mentally handicapped, hospice, done in home care, worked in facilities and currently with memory care AMA!

Why are there so many CNA's that actually don't give a shit about their patients and do the most minimum work necessary?

Under paid, over worked and poor management. Unfortunately, like most jobs, there are bad people in that field that shouldn’t be doing that work who over shadow the ones who do good. Most facilities are understaffed and aren’t managed well. You want to take the time with each resident and make their day and find a special connection but if you dont get x y and z done then your written up and now your going to be yelled at and might lose hours. CNA’s have a high turn over rate because we don’t make much at all. I have to travel 45 mins to work because the town I live in doesn’t have much and what they do have I didn’t want to work at. Also, and sad as this is, when your under staffed and have residents that have behaviors and the facility isn’t qualified to handle them it leaves the others in the dust. Not all places are bad and not all CNA’s are horrible as well. There are good ones out there.

Yes! I've been working in human services (group homes, in home services, youth crisis homes, and youth behavioral group homes) for 10 years. Most places (for and non profit and state ran) pay absolute shit. It's understaffed and management just wants bodies so they can bill for more service hours. So they end up hiring people who barely qualify for the position.

The employees get shit training that isn't really applicable to many situations they will be in, and they aren't taught about the quality of care that they should be giving or why it's important. So these new employees get thrown into a shark tank that's swirling with other crappy and untrained employees. Combine that with the real truth of group homes, which is usually violent mentally ill children and adults who have been getting neglected by their staff, along with the high turnover (causing the clients to test new people) AND the shitty pay...You've got yourself a molotov cocktail.

But management needs those people. So they don't fire anyone and just keep holding quarterly staff meetings reminding everyone to please complete the paperwork, meanwhile your overnight relief hasn't shown up 3 days in a row meaning YOU have to stay overnight. Your supervisor won't answer the phone when you call at 11 at night to try to have someone else do the shift, and FOR GODS SAKE JESSICA JUST GO TO BED. LORRY, STOP PUNCHING OUT THE WINDOWS.

Needless to say, turnover is high for a reason. When your company hasn't given a raise to anyone in 4 years and another company offers $9.50 rather than $9.10, you make the switch and hope to god they treat you better. You hope to god you can afford their insurance plan, and you hope to god your car doesn't break down again because your dad won't lend you any more money. And you're still waiting for your mileage check from 4 months ago.

That's why the quality of care is so low sometimes. Because the staff are overworked, underpaid, and feel like there's no where else to go.

But for the lifers, like me, they push past that shit because they care. In the past, I've been told to spend more time filling out paperwork and less time with my clients. I can do paperwork when I get home. I wanna make sure my client is fucking ok. It took me a while to realize that what I said above isn't normal. It's common, but not normal. When I realized this, I spent 6 months at almost every company in town (there aren't a lot of companies where I'm at, probably 10, that do the developmentally disabled thing) back to back. I went to each one trying to find the right place, and i found it. We're small, under 40 employees, non profit, and we pay the second best in town (soon to be the best once our board approves the next round of raises). When we hire, we select with great care. We check references (many places dont), we do extensive 3 part interviews and put employees on a 6 month trial before they're given a raise with a permanent position. We train extensively, and do continuous training as new research and methods come out. They encourage their more knowledgeable employees to create specialized training and they provide quarterly feedback about our performance. I feel like my company gives the best care in our state. I can say this because our state is dominated by "chain" care facilities. And because we've been told we're the best.

Tldr: You got a kid, sibling, parent etc with a mental disability and you want the best care possible? Find out how much the company pays and how often they train. It says a lot about how much they value their employees. A valued employee is probably a good caretaker.

Thank you for the insight from your own experiences. Im glad you finally found a place!

This particular post doesn't have nearly enough upvotes. I was a cook in a couple nursing homes for about 3 years. Shittiest time of my life(I quit a few weeks ago because shitty pay that is higher than minimum wage isn't worth me failing out of school), working in poorly managed facilities with the working poor not having a way out, but not being able to make the bills happen without their CNA pay. Its sad, you can visibly see the new aids come in all bright-eyed and bushy-tailed, and then the lights leave their eyes, they hate their job and their life.

It is so sad but very true. There have been a couple of places i’ve seen like that. You want to try and help and change the facility and you go in thinking your fresh eyes and perspective might help only to be met with a dead end. It’s horrifying for the residents, especially when they dont really have any family involved or they can’t afford anything else. I had to leave my last company because of that.

Those are valid reasons to find a new job, not to neglect patients.

Im not condoning it just answering your quesiton but I agree. Most people who are CNA’s are very young and just starting out in the real world.

Thanks for doing this AMA. I am someone whose mother is in the early stages of dementia. How do I provide the best care for her? What home care company is the most reputable? And how can I spot a bad nurse when I see one?

It is a very difficult thing to watch your loved one slip away a little at a time. The best thing you can do is be patient and understand. Understand that your mother doesn’t mean it when she says something hurtful or forgets and upsets you. Be patient with yourself. It’s ok to be mad and hurt. There are going to be bad days there are also going to be great ones. Understand that right now your mom can do all these things but adapt when she no longer can. I think the most important thing is to go along with them, if they progress to the stage where their “talking nonsense” i.e babbling or make an off hand comment continue the conversation. Let it flow. It’s not an easy process and my thoughts are with you and your family. I suggest finding a support group as well. I know good care company’s in Idaho but for other states I would talk to some friends that are in the health field. They can usually recommend a great facility. When you walk into a facility you want it to feel like a place you would want to live. Does it look and smell like a hospital, do the patients seem out of it? Look at their activities calendar. If the workers are smiling and encouraging the residents to go to activities that’s a good first step. Go at different times so you can get a feel for how it’s run. Go during meals and during activities to watch how the workers engage the residents. If you notice a nurse doesn’t have good communication with their staff or with you that can be a red flag. It’s hard to determine, the care facility I work at the nurses aren’t as hands on as the CNA’s are. A good caring nurse is someone who will take the time to answer your questions and reassure you. Someone who you feel comfortable asking questions with and who will give you an honest answer. You can tell by the way they speak to your mother. If they treat her as an equal and make eye contact/get on her level then you know you’ve got a good one.

6 years is a long time to be a CNA. What's stopped you from becoming a nurse or doctor?

I have plans to do EMT/Paramedic next then nursing. When I first stared I imagined I would go straight into nursing but life had a different plan. I feel that you can’t be a good nurse until you’ve been a good CNA first and i’ve enjoyed all the experience it has taught me. Right now my husband and I are trying for a family so after a break i’ll go back to school for my EMT and work my way to nursing

Why not just take the prerequisites for RN school? EMTs generally make less than CNAs do. Especially if a CNA works as a patient care tech in a hospital. Plus, its easier to get a job when you already work in the hospital.

I don’t want to do just nursing. I love the medical field and want to do it all so to speak. My long term goal is to be a nurse but i’m in no rush to get there. I wanted to do CNA work and i’ve always wanted to work with paramedics. When I was in high school I did a ride along program with the EMT’s at our local fire station and that kind of sealed it for me. As contrary as it sounds I never really wanted to work in a hospital as a CNA.

I wasn't a CNA before I became an RN. I do 1:1 patient care as an RN including all CNA duties. Anyway, I think you should look into becoming an RN. Much higher pay than paramedics, better job stability.

I will. I wanted to do CNA EMT then nursing.

When interacting with people (especially kids) who are mentally handicapped, is there anything I can do to make them feel more comfortable while speaking to me or make them feel better about themselves?

Talk and interact with them like you would any other child. You might have to approach them differently based on their needs. One thing I learned was to not care what others would think or how they would sometimes stare. If it made my client happy to break out into a random song and dance in the middle of the store then so be it. I’d broadway it right there in aisle three. Be patient. Take your time. Let them figure it out and do it the way they need to, not the way we think it needs to be done.

if I had gold to give, you would be receiving a lot of it. Particularly for the broadway number :)

Lol thanks!

Would you mind spelling out the acronym CNA at least once, so those of us with little connection to your field can have an idea about what your job is?

Certified Nursing Assistant

Are you able to don't let the destinies of your patients get close to you? If yes, how? I'm just a little bit worried about you because of your username. :)

There’s always a patient that gets close to you. I love each and everyone of my residents but I also understand that death is a part of life. I look at it like I can help them and their families when that time comes. I can help provide some type of comfort. I can care for their bodies as they make that transition. Sometime’s it’s hard but I have an understanding and my faith helps as well.

Thank you for answering! I think the importance of your personal experience is often not seen by people who are not in the job, so it's nice to have someone tell their story.

Thank your for asking :)

What's your favorite story from working as a CNA?

My favorite would be J. I did 24 hour in home care with J for over a year and loved every minute of it. One day my co worker was walking out of her room when J caught a glimpse of her back tattoo. She goes “what is that? Good girls don’t have tattoos and your a good girl” My co worker explained it was a memorial tattoo for her sister and dad that had passed. My other favorite memory is when J was in the process of passing away we were in her room talking to her and she was laying on her bed looking at the ceiling when she goes “look at that light! It’s so bright and beautiful!” Her son and I looked at each other and smiled. Also, later that day a pastor came in to talk to her and she was talking about her beautiful garden that she was going to and how excited she was. Hands down my favorite memory :)

I'm a CNA myself, let's be real...what's your best poop story?

Lol oh lord where do I start. I think the funniest one was when I was working in the home with mentally handicapped adults. We had this one lady that would not let us change her until bed time. So she walks back to her room and my co worker and I go to change her, we take off her attends and are like where’s the poop? We knew it was there just a second ago where the heck is it. So we’re like maybe we’re crazy? No, it had fallen out in the hallway. That was pretty funny. Also there when we would do showers every night they would wait to have their bowl movements until then so I got the nick name “the poop fairy”

May have been asked before, I haven't looked. But being a CNA for 6 years blows my mind. As in, I have to wonder if you've thought of being a Nurse or a higher paid medical worker during that time? Seems CNA get paid marbles compared to the enormous amount of back-breaking work they do. I couldn't imagine being one for more than 2 years (the time it would take for me to finish nursing school).

Yes I do! I plan on going into EMT then nursing. A lot of people don’t understand why I don’t hurry it up and just go into nursing. I’m taking my time im enjoying the experience and the ride. I can’t believe the joy and pain it’s caused as well as the life lessons i’ve learned. When I was younger I thought i’d just go straight to school but that’s not quite the case when you factor in money and what not. I am grateful for the time i’ve spent doing this work, it will only make me a better nurse when I do get there. A part of me feels like I never will but I know that’s not true. Currently my husband and I are trying to start a family so this is my last CNA job. After this im heading back to school for EMT and then i’ll go back for nursing. Im looking forward to having a small break in-between and being a stay at home mom for a few years.

Oh I see, hey that's your route who's us to knock it! I'm not a CNA yet, but I'm looking into classes now. My plan is to do some volunteering at a hospital I want to work at while I take my CNA classes, so when I complete the CNA test I'll have a small foot in the door (hopefully). Then once I'm a CNA at a hospital, I'll take the nursing prereqs, then head to the ABSN school (hopefully the hosp has tuition reimbursement). Basically, I want to get a CNA job at the hospital I want to be a nurse at. But in NY there's so many hospitals it's driving me nuts how to narrow down :-/ I'm 27 and feel like I'm starting too late so I'm flustered trying to get my life in order right now. I hope to be a nurse by the time I'm 30-31, or at least close to graduating. Just need to get a job at the hospital and I can relax a bit.

Don’t focus so much on what you think you should be doing by a certain age, enjoy it! Working at a hospital as a CNA is probably one of the hardest jobs but like you said you’l already have your foot in the door. Take your time when picking a hospital. Ask around. There’s no rush!

I just completed CNA training and I'm hunting for places to work. Do you have any advice on the type of places I should apply to? And do you have any advice in general as a new aid?

It depends on what type of work you want to do. In home care can be much more personal and one on one but can also be more frustrating depending on the client. With a facility there’s so many options out there there’s independent living, assisted living, memory care. I enjoyed my time with in home care but only with a few clients, it was a lot of added stress and pressure. I really enjoy the facility I work at now, I feel that I connect really well with my memory care patients. My advice is to give yourself time to learn and grow. It all comes at you fast but there’s not a day that goes by where you don’t learn something new. Observe your patients, they will teach you more in a simple gesture or in their body language than a textbook ever could.

I absolutely love doing home care. However, the company I work with allows me to dump a client if I do not have an enjoyable work experience.

The company I worked with while doing in home care was the same.

Thank you for your response!

Thanks for your question!

How accepting is the CNA profession of transgender people? I just signed up for a CNA class and I'm hoping that I can support myself on the salary.

I never had any experience with transgender in my field that I was aware of. I worked with many gay and lesbian workers and to my knowledge it was a pleasant work experience for them. You do run into older people that will mistake girls for guys if a girl has a more butch appearance and with being from that generation will make comments that aren’t approiate but again that’s part of working with memory care and just that generation in general at times. As far as supporting yourself it’s really hard to on a CNA salary. It depends on your location to job and how much your minimum wage is in your state. CNA’s don’t make a lot of money. My last job I made 10 an hour and that was only because I had made $9.50 at my previous job and had a lot of experience. I had to drive 45 mins to work every day. Had I been living on my own there’s no way I would of been able to support myself with out govt assistance.

Thanks for your answer. Is it hard to find full-time work as a CNA?

Not really. There’s a huge turn over and shortage

Ok thanks. :)

Any time :)

In hospitals, such as ER department, do CNA's receive any type of sensitivity training? Like how to act towards someone who has a phobia of needles, medical gloves, cotton swabs, etc. I have sadly met a lot of CNAs and RNs who are utterly clueless on how to handle phobias and tend to only make things worse. Thanks for the AMA!

I can’t speak for an ER department. I know i’ve never really received any type of training per say on how to handle someone that has a phobia. A lot of it is learn as you go. At my facility there are three “neighborhoods” and we rotate between the three so I work a month with certain residents but then it’s another two before I work with them again so by the time im back with that one person their cares have changed and so have their behaviors. It’s a constant adaptive state. You have to be ready to roll with the punches and learn from your co workers! Maybe someone your working with has dealt with this type of phobia before and know some tricks. It’s difficult because no two people are a like, a common fear i’ve noticed with memory care is bathing. We try a whole slew of different techniques and tactics before we find what works for that one resident.

I'm looking foward to a career similar to yours after graduation, what would you say are some of the tougher things I'm going to have to face?

Depending on which area your working in as a CNA things will differ. I think the one common ground is family. Family can be amazing or they can make your job really tough. You will come across some families that just make your day awesome and are really working with you as a team to give that patient the best care possible but others will do nothing but think your not doing a good enough job. What really breaks my heart is when the families don’t understand, or refuse to, understand the new capacity of the patient. We had one resident who’s son ( that lives out of state) wanted to prove that his dad could still do all the things he used to do and took him out white water rafting. And im not talking baby rapids either. He was ok but in the pictures they took you can tell he was terrified. And if something had gone wrong then he might not of made it back. There will be days when the behaviors of clients and patients will get to you. Also death. When your new losing a patient is tough. We lost 15 in a two month time span. It was tough with so much loss.

Can you please tell me how to change and clean a patient who poop/pee's oneself as quickly as possible? Any tips on keeping a patient with sun downing in bed? I swear they purposefully want to climb over the guard rails and injure themselves lol.

Changing as quickly as possible something all CNA’s and new mothers learn how to do lol. A fantastic trick is if they wear attends you rip the attends off ( on the side that rips not in a mean way lol ) and then while their pants are down you put the attends thru the pants and over the feet on both sides so that you don’t have to take everything off just to change them. I was so grateful when I learned that trick. The keeping them in bed is a bit tricker. Each resident is so different! I recommend a full day of activities so that their more tired and not just sitting around restless all day. I know with some they wake up and are confused as to what time it is so a re direction. Sometimes a snack helps as well, warm up some milk and give a light snack. Peaceful music has helped a few i’ve worked with.

The attends through the pants was a revelation when I learned it.

There needs to be a manual of shortcuts like this lol

I need a video of this, I'm trying to picture of it and I'm having trouble :-/

I’m sure youtube has one. I bet one of your co workers know

What is the biggest problem you've encountered in your profession that you could see fixed by a simple invention?

Hmm that’s a good one. More time. I so often wish I could just pause time and make each moment count with my residents but there are days when im running from one person to the next because it’s just that kind of day.

So i had a friend that yelled at a hospice nurse (he was 16) to "get the fuck out of [his] house. It's not happening this week". How often, if at all, does this happen? I found it quite humerous actually.

It happens quite a bit lol. It depends on the type of care your doing. When I did in home care there was only a few times the clients didn’t want me there but nine times out of ten they had memory issues. My last 24 hour client would send me home after a couple of hours towards the end right before they cancelled our service. It was annoying because I had to drive 45 mins to get there and then drive right back but I still got paid for the whole time so that was nice

First, thanks for the AMA! Second, what is the best way to handle a case of suspected abuse, i.e. what do you do if you are pretty sure your patient/resident has been harmed in some way, particularly in poorly run institutions?

You can report to the local ombudsmen. They should have that person’s information hanging in the facility. If your working there then report to your supervisor or the nurse. If you dont feel comfortable doing that then you can make a call to the ombudsmen. If your also concerned about how the facility is run tell them. I believe you can also be anonymous