Career Experience of a Certified Nurse Assistant (CNA)

Photo Courtesy: Germanna CC

Considered working as a Certified Nurse Assistant? This interview will take you through the ups and downs you can expect in the position; what it takes to land the job, what you can expect to earn and more. This is a true career story as told to jobsinhealthcare.com and is one of many interviews with nursing professionals which among others include a nurse aide, a registered nurse, and everything in between.

I ended up working two years in the nursing field after dropping out of my registered nursing program. I worked as a Certified Nurse Assistant. The certification is merely a test and there is also a class if you need preparation. I was really overqualified because of the college education. The test was no problem. I had previously decided that nursing was not for me, but during the recession of the 1980’s, it was good and profitable work. For the first year I worked part time, even though it amounted to 48 hours a week, on weekends while working in not one but two completely different career fields. The second year I was full time, and I stayed all but the 48 hour period I described earlier.

I worked private duty off a hospice recommendation, and later word of mouth spread to a full time client. I was paid directly by two different families to live in with their mothers, and did not have to work through a service. My first job involved working a 48 hour shift with an elderly woman who suffered from Alzheimer’s. The second was with a brilliantly bright and capable 82 year old woman who had fractured her hip. I learned a lot from her.

High Demand

Both male and female nurses are highly in demand for this type of work. Gender is strictly a matter of preference and need. A strong man may be needed to lift a heavy patient. I don’t consider that discrimination, just common sense. An equally strong woman would be just as welcomed. Smaller nurses have to take care of smaller patients, if lifting them is involved.

Education level matters, but not all that much. All education levels are needed, and even if you have no education in the field, many people are willing to pay for a live in “nurse” – even if the nurse is not really a nurse. Families find it very difficult to stay with their elderly loved ones. I have stayed with my own family as well as with strangers, and I can tell you strangers are much easier to deal with when they are sick.

Things You Should Expect

Some people are totally deluded about what nurses do. Even prospective student nurses and recent volunteers are completely unprepared. I remember that even as a candy stripper at age 13, one of my fellow volunteers quit because she saw a man without his underpants. She was horrified but it happens. Don’t think you can work with sick people, either in a hospital or a home situation unless you are prepared to see nudity, clean up feces, deal with exposure to blood, saliva and other bodily fluids and give complete bed baths. Rubber gloves and a good understanding of clean and sterile techniques are a must. It’s a simple concept, but it pays to read up before exposing yourself to patient care.

Job Satisfaction

In the College Nursing program, my job satisfaction on a scale of one to ten was at either a 0 or a 10 depending on the day, but it would have always been expressed as an exclamation point than a number. Working in a hospital is very, very high stress, and there is a lot of pressure to constantly give answer for everything you do. The home nursing environment is much more laid back. I’d say home care is usually about a 5 with moments of 7s throughout. The best thing about home nursing is little or no charting. It is helpful to keep a meds checklist, but there is no constant record of things you barely have time to do, because you have to write every single detail down.

Heart Warming

Being a nurse can be very heart warming when working with patients. The only reason I ever wanted to be a nurse was for the patients, not the charts and the other nurses. I am not fond of hospital administrators, or the fact that hospital nurses are constantly rushed, harassed and tormented by constant second guessing of their every move. I much prefer being employed by a loving family to care for a single patient. Individual patient care is the best. Any patient care is good if you love patients. I adore working with patients of all ages but of course most nursing work is with the elderly. You can learn a lot from your elders.

During the year I lived with Mrs. E.,  she explained to me what it was like being a single mother during the depression. She basically taught me a course on survival to be rivaled by the military. I learned how to split wood, and the right way to peel a potato so as not to be wasteful. She also taught me how to cook when you have virtually nothing; even though her son graciously filled our fridge every week, she still explained what you would do if you did not have this or that. Her hints have helped me throughout my life. She could be a cantankerous old woman till you got to know her, but I can honestly say that I came to love her like my own grandmother during that year. I will never forget her.

Creativity Becomes Relative

I guess it’s important to realize that I was and still am a graphic artist, publisher and writer. I also have an interest in biology and medicine, but at the age of 24, I had major problems with the degree of discipline, supervision and procedural approach I was subjected to as a student nurse. I was accustomed to being creative and there is little room for independent thought or creative solutions in the hospital environment.

I remember the first week of hospital care I had a patient who was paralyzed from a stroke. He could not move despite six months of physical therapy, and eventually the therapist had given up. I went in to do a bed bath and ended up doing two hours of therapy based on things I noticed while bathing him. I noticed that when I asked him to move his arm out he pulled it in tighter to his chest, and I had a brain storm. I told him to pull his arm tight to his chest and it suddenly slung outward. He and I stared at his arm in amazement and the patient smiled.

Suddenly he knew how to use his arm. I took over two hours working with him, and then just as I was finishing up with his bath, he accidentally relived himself all over the clean sheets. There was feces all over him and the bed, and it took another twenty minutes to clean up the mess. When I got finished, and he was all clean again, I felt I deserved a medal. I had rehabilitated my first patient, and done a completely disgusting job without gagging once. I was amazed that it had not bothered me a bit. Instead I got a serious written reprimand for not charting for over two hours. Apparently that was a serious breach of protocol. I was horrified that the chart was so much more important than patient care, and overall well-being, but I don’t regret it, especially when my patient was able to sit up and feed himself and was learning to walk again the following week. One of my fellow students continued my work, and we did in two weeks what physical therapists had failed to do in six months.

This total lack of freedom to do the right thing is not true of home care, which basically is just life with an extra person who is sick. If your family trusts you – and trust is built over time – then you have a free reign to care for the patients as you see fit, as long as you do nothing to harm them. Of course, here I should mention liability. Nurse liability increases somewhat with education level but your liability is similar to that of a doctor’s. You can get sued, so if there is no agency between you and the family, there is a risk.

Recession Proof Profession

I got started in the profession looking for a recession proof profession. I left convinced that anyone who continually worked as hard as I did to become a nurse was recession proof within themselves. Hard work is the key to success anywhere, but in nursing there is also the element of dogged following of procedures and rules, especially in charting. I’m just not that way. I would not change a thing in my life if I could go back. My medical education is invaluable, and my experience as a private duty nurse assistant was priceless, but I’d have no desire to do that again.

One thing I learned the hard way is that stress leads to ulcers, and being a hospital nurse is high stress. While home care has its stresses and responsibilities, it is much more comfortable for me than hospital work. Another thing I learned the hard way is to defend myself verbally. Well, honestly, I still have trouble with that, but it’s absolutely necessary in hospital work. It’s like being on trial constantly. My friends, who are registered nurses, tell me that they are still explaining every action and being constantly called to give answer, often to hospital administrators. Verbal self defense is an art every nurse must practice on a regular basis.

Always Emit a Peaceful Vibe

The most important thing I have learned in working with the elderly is to emit a peaceful vibe. When you are stressed, they are stressed, and so it’s best to be able to flow with your work and seem at peace even when you are stressed to the max on the inside. I learned that when I work with a patient all day, I can reduce their blood pressure with my demeanor. I can create a peaceful setting for their recovery and help them find a lot of comfort even when I am pushed and driven half nuts with procedures.

Life Saving Instincts

I guess the strangest thing that ever happened was years later when I was applying for a job with a mentally and physically handicapped child. It had been over 10 years since my training or any real work in the field and I was rusty, but again economic need led me back to this field. I had come to meet with the child, along with another applicant for a part time care job. We were listening to the interviewer when I noticed something wrong with the child. He was turning blue and his jaw was clenched. I pointed it out to the interviewer. The child fell on the floor in an apparent seizure and turned blue almost immediately. Suddenly my perception of time slowed down to where each second felt like five minutes and I felt a perfect calm. I dropped to the floor and the other applicant followed me. We worked in perfect agreement as if we were somehow driven by the same singular inner instructor. We prepared to do CPR without a word spoken between us. I had role one, and she was taking role two, without saying anything. She and I were both praying as we worked. I felt her prayer more than I heard it.

The child’s jaws were clamped shut and artificial respiration was likely to prove impossible, but I tilted his head into position anyway while she sought a pulse in his wrist. She said “no pulse” and my hand went to his neck. He was dead. There was no pulse in his neck or heartbeat in his chest. I put my hand over his heart firmly seeking the spot for CPR and suddenly I felt something powerful come out of my hand, and I felt something from her hand on her side too. There was a sort of arc of electricity there, from both of us at once….. Suddenly I felt a pulse and she felt one on his wrist as well. This was real healing but not medicine at all. We looked at each other knowingly and still silent. The mother called the ambulance but when they arrived the child was fine. It was especially strange because we’d normally have talked but instead we just did what we knew was right instinctively, and it was perfect.

A Rewarding Profession

The medical profession can be very rewarding, despite the fact that early rising is a must and that really did not agree with my health. In training, I was getting up at the time I normally would go to bed – at four AM! That part can be a nightmare. I’d arrive early in hopes of getting a head start on a grueling day. Still it was the patients who made it all worth while. I felt good about everything I ever did with the patients. I just hated the regimentation and lack of time to spend with the patients. In home healthcare, you simply do not have someone watching over your shoulder all the time and that feels good.

In the end, the constant accusation, even when you’ve done an exemplary job, made me quit my training, mostly because I saw that this attitude didn’t change even with registered nurses. They were constantly accused, questioned and verbally abused by hospital administration as well as physicians. I’d say that this happened even when they did their jobs, but it seemed to me that this happened especially when they were trying to do their jobs with the patients. Some nurses seemed to opt for spending hours on the chart, claiming to do work they had not touched. I saw that in some cases, it didn’t matter to the hospital if you did the work at all as long as the chart reflected that you had. This part I found alarming. I think this, more than anything else, led to my quitting.

A Position of Responsibility

Being a nurse is an all consuming responsibility. It involves early mornings and exhaustion by afternoon. Home care is just a 24 hour a day responsibility. Some nurses work with agencies and they work a shift, but still the feeling was there. Even when you aren’t on duty, you feel responsible. I also remember vividly that we were told that we had an obligation on the scene of an accident or emergency to volunteer our services. If I’m on the road driving anywhere and I see an accident, I must stop and assist, doing whatever is necessary, with or without proper equipment or gloves. This is dangerous, so I recommend keeping gloves in the car.

Being trained as a nurse changes you for life. It’s never the same again. I view nudity to this day as common place and not at all strange. I hardly notice nakedness in movies while my friends are asking, “Can they show that in an R movie?” I ask, “Show what?” On a brighter note, I hold together really well in an emergency and have my training to fall back on in most situations. It is nice to know what to do when something goes wrong.

Getting a Job in Medical Field is Quick

I’ve always been able to get a job in the medical field more quickly than fields where I have much more experience. Even without a degree, I pull higher pay than most of my peers who have more certifications. My reputation is above reproach and my knowledge and skills are apparent even to people who don’t know me.

Pay varies but unless the job involves government aid or some sort of institution, I could generally name my price. I gave up a good job offer in my career field once, simply because someone was willing to pay me a lot more. That job paid $300 a week, back in the 80’s, plus room and board five days a week. It wasn’t easy on my social life but I saved almost every dime I made because I was always at work and living for free. Right now though, they could not pay me enough to return to nursing. Its way too demanding and not what I want to do right now. I’ve considered it but frankly, unless I was literally starving would I want to do that again.

Do Not Sell Yourself Short

Honestly, my greatest regret is not becoming a doctor instead. I’d give anything now to have taken those extra years of education. It’s what I wanted from the beginning but I couldn’t really afford it at the time. I think nurse practitioner or physician’s assistant might also have been more satisfying.

I tell my friends to go for their doctorate and be an MD or PhD. Do not sell yourself short! If you are going for it, go all the way so that you use your brain and not just follow directions. If I could I’d get my own PhD and be a doctor. Inversely, if I had to make a living immediately in the field, anyone can be a nurse assistant. It takes heart and it’s demanding but anyone with the motivation can find a decent job in that field.

Patricia C has a degree in International Relations and enjoys learning from other cultures and traveling.