Workplace Wednesday

So, you want to work in a hospital?

Not everyone has the skill set necessary to thrive in the complex, chaotic and diverse hospital environment…it takes a unique combination of flexibility and desire to work closely with a team to thrive in a hospital setting.

Overview

As a hospital CNA, you will be caring for the sickest people in the community, and that often means a lot of additional equipment is needed – but that doesn’t scare you! You are willing to learn new skills as they are needed and aren’t afraid to try new things!

Hospital CNAs work very closely with a large healthcare team including nurses, doctors, phlebotomists, physical therapy, respiratory therapy, radiology techs, food service, administrative personnel and volunteers. Since you play well with others, and have no problem developing workplace connections, this is your playground! These are all potential career pathways that you might consider, so make friends and ask why they chose that career and what it takes to get there! Put those socialization skills to work!

“We spend our whole lives worrying about the future, planning for the future, trying to predict the future, as if figuring it out will cushion the blow. But the future is always changing. The future is the home of our deepest fears and wildest hopes. But one thing is certain when it finally reveals itself. The future is never the way we imagined it."

Meredith Grey (Grey's Anatomy, Season 5, Episode 23)

Working in a hospital brings very specific challenges, and great rewards. Read below for some specifics!

1. Pace

Healthcare in a hospital is fast-paced. There are a million different things going on, all at the same time. You have to be easily adaptable to work in this setting, and not mind a constantly changing workflow. With tests, admissions, discharges, doctor’s rounds, visiting hours, surgeries, transfers and sudden condition changes interrupting your day, it helps to be able to go with the flow and keep a cool head.

You tend to thrive in a clinical environment, and it shows in everything you do. From getting another set of vitals to helping a patient to the bathroom, you know it’s all about the patient. But you also find joy in helping visitors find their way around and lending a helping hand to a coworker. In this setting, everyone can count on you!

2. Type of Patient

Hospital patients are the sickest kind of patient. But there is a wide variety in the type of help that each one will need. From babies to the elderly, they all seek help at the local hospital. You have to be very versatile and be able to adapt to the needs of each different age group, and individual level of ability. You know that, when it comes to people, one size really does NOT fit all. Luckily, you are able to change your approach as needed.

3. Number of Patients

Because there is a lot to juggle in a hospital, CNA’s here usually have a moderate patient assignment.

The number of patients you have will depend on what shift you are working. It is also affected by what department you are in. But ultimately, it comes down to the amount of help your patients need. Day shift is where all the action happens, so each patient requires more care. This means each CNA can only care for a few patients. But on the night shift, when most patients are sleeping, less care is required. This means night shift CNAs can care for more patients, so there are fewer CNAs on this shift). But staffing can also vary widely from one department to another. For example, a day shift CNA working on a telemetry floor where most patients are able to care for themselves might be able to handle 12 patients easily but one floor down, a day shift CNA working in a step-down unit with patients recovering from a stroke could only safely care for 5 patients. And a CNA helping out in the ICU may only have 3 patients to assist because each one is much sicker.

Overall, though, hospital CNAs generally have fewer patients to work with than a CNA in a nursing home. This is because hospital patients generally require a lot more care and attention. You need a high level of energy and drive to keep up this demanding pace for twelve hours, and the patience to change and adapt when something comes along to derail your rhythm.

4. Oversight and Supervision

Hospital CNAs like being part of a healthcare team. They work very closely with nurses and usually develop a close-knit team over time. A hospital CNA is secure in their skill level and doesn’t mind having someone (the nurse, family members or new CNAs) watch them perform skills. They are comfortable with supervision and their role.

Hospital CNAs may also float to other departments when there is a shortage of CNAs available to work, so they must be willing to work with a new team occasionally and provide a different level of care than they are used to.

5. Length of Patient Interaction

Hospital care is usually short, often no longer than a few days, but can be as short as a few hours. The Hospital CNA is generally friendly and comfortable talking with strangers, but keeps conversations short and does not get to know the patients very well.

6. Schedules and Shifts

Hospitals usually run on 12 hour shifts, which means you only have to work 3 or 4 days a week. This leaves more days open in your personal schedule, and who doesn’t like that? But those long hours away from home can be a problem for parents of young children, so it is not a good fit for everyone!

With only two shifts to choose from (day shift or night shift), there isn’t much flexibility in this schedule. Nights, weekends and holidays may be required (but usually on a rotating basis).

Schedules will vary depending on facility and department. Some will offer a set schedule that rarely varies, working the same days every week. Some will require more flexibility as the days you are scheduled will be different every week.

Hospitals often have a “Pool” system as well, where employees are only scheduled to work on an “as needed” basis. This is often called a “PRN” position. When this CNA is hired, they are not assigned to a particular floor or unit, they agree to work wherever they are needed, whenever they are needed. Generally, these positions are scheduled (not on-call) at least a week in advance and provide an excellent opportunity to try out different areas of a hospital to see which one fits you.

7. Pay and Benefits

Hospitals do not offer the highest pay for CNAs, but they aren’t the lowest paying, either. It’s all about supply and demand!

Most new CNAs want to work in a hospital. They may have watched a medical drama and think, “I want to work with Dr. McDreamy, too!” Or, maybe they have a family member or friend that works at a hospital. But the end result is the same…more people want to work at hospitals than nursing homes. So, the hospitals are in demand and have a never ending supply of applications. As such, they don’t have to pay as well to get you in the door! But they also may offer additional benefits to offset the moderate pay like medical insurance, paid time off, tuition reimbursement, continuing education, staff training for new skills, etc.

Shift differentials (more money per hour for nights, weekends and holidays) is common in this setting, so it pays to consider non-traditional shifts. Some facilities may offer hiring bonuses and bonuses for picking up extra shifts too!

PRN workers often do not qualify for these benefits, but get a higher rate of base pay instead. This can be helpful if you need a higher pay rate to take care of your monthly obligations and don’t need insurance.

8. Learning New Skills

Hospital CNAs have to be versatile and willing to learn new skills. Every department will require a different skill set, depending on the needs of the patients they serve. This means that CNAs in the hospital may have to learn how to interpret basic EKG rhythms, or draw blood, or use a bladder scanner, or remove IVs. Training is usually provided by the employer, which makes you much more valuable as an employee!

9. Opportunity for Advancement

Hospitals generally offer some of the best options for those that want to advance your career. Tuition reimbursement is common (which means they will pay for your schooling!) and scholarship opportunities may be available (often run by the volunteers). Many hospitals promote from within, if you have the right credentials. I once knew a surgical tech who took advantage of all the opportunities available for education and training in the hospital and eventually worked her way up to CEO!

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Patricia Laramee, RN March 31, 2023