A big dilemma we run into as CNAs is the fact that we can be responsible for a hall full of residents/patients who all think that they should come first. It can get stressful, especially when you add other CNAs asking for help, your charge nurse asking you to do things, and even family members following you around asking for things. The key is to prioritize, which is something I still don't think I've mastered but that I work on during each and every shift. 

Prioritizing in the nursing home can seem like a no-brainer, but you'd be surprised how many CNAs buckle under pressure. A good system I try to follow is this: If a resident is in some kind of crisis, obviously they come before anything. If a resident is in a situation that could quickly lead to a crisis, drop what you're doing and prevent the potential crisis. Then the order of importance goes to: nudity, incontinence, bathing, going to bed, then miscellaneous things like snacks, drinks, changing tv channels, etc (unless specified by the charge nurse in the case of snacks and drinks).

Prioritizing is important for the residents, to make sure more urgent needs are met first, obviously, but it's also important for you so that you have a plan of action and don't feel overwhelmed. However, sometimes even a well thought out plan can be turned upside-down due to the fact that your residents are people and we can't predict when someone will vomit, have diarrhea, aspirate, go into cardiac arrest, fall in the floor, or even pass away. You can't beat yourself up when your plan gets derailed due to a sudden occurrence. Our goal is to find the balance between structure and flexibility where we can let one resident wait for their snack until an incontinent resident has been changed, but can quickly wrap up giving a shower when another resident falls or aspirates. It's a constant effort to manage all of the things you have to do and prioritize, especially on a busy shift, but sometimes just thinking about the steps to your plan can have a calming effect, making you feel in control. 

There are always going to be residents who think they should come first, but in time you'll get used to the idea that they can wait, just like anyone else can, until others' more urgent needs have been taken care of. 

Keep up the hard work! 

Clarissa