C.N.A. questions?

I'm new in my field and i have two days of training left, however, the person training me isn't very helpful and expects me to know what im doing after one time of watching.Some of my things i'm having problems with are as follows:


1) How do i dress a resident in bed(i got to dress them but not get them out of bed yet)?


2) Whats the best way to place the incontinence pads under resident? I know u got to roll it partially before tucking under the person but am i supposed to shove the new one under while i take the old one out?


3)How do i place a bed pan under someone who can't raise their butt? I can't quite this one down pat..i know u turn them on their side but i cant seem to get it under them really good.


4) What's the easiest way to transfer a patient from bed to wheelchair?





Your answers will be appreciated. If u know of a good website that will diagram these procedures let me know. If u have any other helpful hints that would be great also.

C.N.A. questions?
While I am not a CNA, I do work as a nurse in the health-care field, so I think I can help answer your questions.





Dressing a resident can be a challenge. It all depends on their ADLs and how much they can cooperate, vs how bed-bound they are. Honestly, I find it best to always include the resident in any kind of personal grooming skill. I have seen so many CNAs treat residents as nothing more than overgrown children or just blobs. Try not to do that. Even in residents that seem unresponsive, always try and 'include' them in some manner, you may be surprised that one day you will get them to help you.





So, when you have to dress a resident in bed, you want to make sure you draw the privacy curtain and raise the bed to working height (make sure the rails are up). As a CNA, you must maintain proper body mechanics to prevent injuring yuorself. So what you can do, is either 'walk' the outfit over their body, like you are dressing an over-sized doll, if they cant be of any assistance. Or even if they dont seem responsive, gently ask them to place their arms in the sleeves, etc. Certain positions work the best, usually either a side-lying (Sims) or a supine position.





2) Now about the incontinence pads, also known as Chux.....there is a proper technique. Remember, you want to maintain medical asepsis as much as you can. So what you do is, you have the patient roll to their side and grab onto the rail. You then see the old Chux pad, you want to take that pad and roll it in toward them, so you will only be able to 'roll' half of the old Chux at a time.....but when you roll that one half, you now have an exposed sheet, correct? So you take the new chux pad, and you then tuck it under neath the rolled up old one......dont 'shove', it should 'tuck" under. Then have them roll on to their other side, and you will be able to remove the old Chux and straighten out the new one.





3) Bed pans are a pain in the butt, no pun intended. Again, this is an area that requires one of two things...either it requires a compliant resident (one who will move to the Sims position so you can slide the bedpan in) or it requires another CNA to help move the resident to the Sims and hold in place while you put in the bed pan.





So, even if you have a stubborn client.....you can get them to try and get into a Sims position, holding both hands onto 1 rail....and thats the opportunity to slide the bed pain under them...that way they just gently 'roll' back onto the pan without having to lift themselves.





Please please please, never ever ever think that you cant ask for assistance. I always tell my CNAs that they MUST rely on each other, because its just not worth hurting your back.





4) Now your last question is a sticky one....because it all depends on many factors. One it depends on how much the patient weighs and how tall they are......Then it depends on their compliance....are they easily irritable, etc? If they dont like following orders, then they will literally fight against everything you do, when it comes time to transferring them from bed to chair. It also depends on their risk for fall....so you will want to check their medical record for the Braden risk for falls sheet.....as well as, their own individual health and the effect of their disease processes have on their mobility and sight, as well as proprioception.





Heres the deal -%26gt; Never ever ever ever ever lift a patient by yourself. Not even one that looks "light".....anything can happen, and then you have an injured back, and now you are out of a job.





Every place should have lifting devices....such as a Hoyer Lift, or a gait-belt, or walkers, etc.





Now, to transfer a patient from wheelchair to bed.....yuo will need to assess the situation to see if you will need another persons help....again, never feel like you would make a "bad" CNA or "incompetent" CNA by getting help in transferring a resident.





The first thing you will want to do, though, is make sure the wheelchair is locked into place (they have 2 brakes). You will then, grab their walker so they have something to hold onto as they get out of bed.....you will need to assist them to standing position....and you need to maintain proper body mechanics while doing this.





I know that sounds vague. But the best thing you can do, is go to a search engine and type things like "Patient Hygiene Practices" or "Using Assistive Safety Devices" or "Ambulating patients" or "Proper body mechanics for transferring patients".....And then I recommend you go to amazon.com and look for a good CNA textbook....Delmar makes a wonderful series of texts for CNAs, LVS, RNs, that way you have a solid book that allows you to look through it as well.





Lastly, tell your manager that you feel like you need to be trained by someone else, as you dont feel you have enough "grip" of accomplishing the tasks in a safe manner.





Good luck!
Reply:i took and passed a n.a. class so i might be able to help you on some of these.





1) pick an outfit from their closet and ask for their approval. if they can put their own shirt on, let them and work on the pants. if the patient had a stroke, put clothing on affected side first then work their other arm. same goes with pants.





2) when re/placing a pad put the guard rails up on the opposite side youre working on. ask the resident to gently roll over and grab the rail. try the best you can to remove the old pad. repeat with new pad.





3) i forget the bedpan





4) bring the chair close to the bed, locking the wheels with the brakes and foot rests down. assist the resident with standing and gently tell them to pivot their bodies so that they may be next to the chair. gently ease them in the chair. once its done raise the rests if they want them up.





i took the nurses aide class in march 06 and passed april 06. it was a month-long course. i never took the state test because of murphys law attacking my car. everytime i was ready and had the money, something would happen to the car, forcing me to delay the test.





i hope i was of some help to you. good luck.