How Large Patient Loads Affect CNAs, and Ways to Cope


Article Categories: Caregiver Corner & Tips and Tricks

Certified nursing assistants are known to be bedside warriors, but they are no Wonder Woman or Superman, with extraordinary strength and speed. Neither do they have an extra pair of hands to better multi-task, or a hoverboard to fly across the hallway without having to run. If they had these advantages, then caring for twenty highly dependent patients might seem easy!



In reality, most CNAs take on huge patient loads, resulting in burnout and high turnover. When CNAs leave their jobs, this cycle just continues. Frequently having large patient loads leads to overfatigue, and when CNAs can’t stand it anymore, they quit. Those who stay on the job must absorb their responsibilities while waiting for their colleague's replacement. After some time, others working with large patient loads resign, too. And the story repeats itself.

What is the ideal CNA-patient ratio? Well, there is no definite answer, because it depends on the setting, shift, and individual patient cases. We do know that without proper coping strategies, handling twenty patients each day can get the better of you if you do nothing about it.

So, what happens when the patient load is too large? How does it affect the CNA and their job?

Well, firstly and most importantly, when there are too many duties to carry out in a given day, patient care suffers. For example, CNAs tend to forego handwashing because it is a “waste of time.” Every procedure and conversation is done so quickly that their job becomes centered on finishing tasks, and not helping patients get better or feel more comfortable. Some procedures, such as mouth care, are skipped because they are not on their list of priorities. Errors also happen more frequently.

CNAs feel the burden, too. They become stressed and exhausted. They forego meals and rest periods, and delay going to the restroom in order to complete all needed tasks. They react and communicate negatively with patients and coworkers. Soon the stresses pile up, resulting in burnout.

This burnout is the very thing that we do not want! Exhaustion kills the passion for serving others and prevents a positive outlook at work. Although reality bites, those who cope well are those who will reap the rewards of the job in the end: a stable career, lifelong learning, and a true connection with people.

Here are effective ways to cope:

1. Develop a system for doing things and stay organized.

The idea is to continue looking for ways that work best for you, and soon enough most everyday tasks will be done automatically. For starters, figure out how to lessen the number of your trips to the station, the supplies room, and the bedside, how to multi-task, and the best methods for you to remember instructions.

2. Know your patients and anticipate their needs.

If you cannot keep complete mental note of their needs, write them down. Cluster activities as you see each patient. Doing so saves a lot of time and energy.

3. Invite your colleagues to work as a team.

A lot can be said about the power of teamwork. Great achievements are often the result of teamwork. The saying, “Alone we can do so little; together we can do so much,” can be especially true in healthcare. Some tasks and responsibilities can be rearranged to make life easier for everyone. Let one person take charge of restocking supplies, while another cleans and replaces equipment. Bank on everyone's strengths so that they can perform their duties effectively.

4. It is ok to involve the patient’s family in their care.

If your patients have loved ones staying with them, motivate them to help, emphasizing the bonding moments that become possible when they help with care. What can they do? Start with small tasks such as hair grooming, mouth care, and positioning.

5. Practice proper body mechanics at all times.

Your spirit may be strong, but your body won’t be forever. Don't let a recurring back pain from all that lifting and twisting get the best of you and your career. You know better!

6. Speak with the supervisor.

Yes, you may, and you can! Sometimes, all that is needed is accurate feedback. Tell them how the huge patient load is affecting your health and the way you care for patients, and then work with them to find a solution.

You chose this career because of your love of caring for others. Don’t forget to care for yourself so you can be the best CNA possible.

Try reviewing the course material on body mechanics class from our course library.

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