Quick Facts :
Nursing Assistants

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Bureau of Labor Statistics, Nursing Assistants, May 2017

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info-icon $28,540 Annual Wage
info-icon 11% Job Growth

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What Is a Certified Nursing Assistant?

If you are interested in pursuing a career in healthcare, you may want to first work as a CNA before investing one to four years in training to earn the credentials necessary for an LPN certificate or a BSN degree. The certified nurse assistant role is an entry-level position with a high turnover rate; after becoming a CNA, many nursing assistants decide to further their education and gain more experience to advance their careers. The rapid turnover means that healthcare organizations continually need qualified applicants who have completed CNA training and passed the competency exam.

A certified nurse assistant must have a caring, compassionate nature, excellent communication skills, and the stamina required to stand for long periods of time. Additionally, the role requires flexibility; since many of the healthcare agencies that employ CNAs require patient coverage 24 hours a day, seven days a week. As a CNA, many of your workdays will be both stressful and tiring, with demanding patients and myriad tasks. However, most people who choose this career report feeling a sense of personal fulfillment in providing direct, immediate care to needy patients.

Certified Nurse Assistant: Typical Duties & Responsibilities

A CNA’s primary responsibilities are to ensure patient comfort, thereby removing some of the burden off the RNs and LPNs who provide more advanced care. A certified nursing assistant has a variety of tasks, some of which include:

  • Taking vital signs from patients, such as temperature, blood pressure, and oxygen saturation rate.
  • Querying patients about their symptoms and relaying this information to a supervising nurse or physician. As a result, the nurse or doctor has fewer questions and can thus begin treatment more quickly. The CNA documents patients’ previous medical history as it pertains to their current health problems.
  • Recording observations in a patient chart, which becomes part of his or her ongoing medical record.
  • Helping to turn or lift disabled patients or those with temporary mobility issues.
  • Assisting patients with bathing, grooming, and performing other types of personal hygiene.
  • Administering medication to patients, depending on state laws and specific training.
  • Working with billing software to help prepare statements.
  • Monitoring patients’ dietary restrictions.

The CNA often performs highly intimate tasks. Therefore, she or he must be comfortable with close physical contact, nudity, and seeing patients at their most vulnerable. Moreover, the certified nurse assistant must treat every patient with dignity and respect.

Steps to Become a Certified Nursing Assistant (CNA)

1. Complete Education Requirements

Training varies, depending upon the guidelines established by the state in which the CNA resides. A person with no previous training or experience in health care can complete a course to become a certified nurse assistant in as few as four weeks, or, in some states, 16 weeks. Before enrolling in a CNA training program, check with your state’s health agency or the Accreditation Commission for Education in Nursing. Certified nursing assistant training programs are typically available at these facilities and agencies:

  • Community Colleges: Programs at community colleges, which usually run from six to 16 weeks, focus on fundamental nursing skills. Coursework also covers an overview of nursing topics as they relate to a wide spectrum of nursing services. Classes can be completed online, on campus, or in a combination of both online and traditional classes. Class scheduling is often flexible, allowing students to attend classes during the day, evening, or weekend. Students also learn the professional communication skills that enable them to perform effectively as a member of a care team.
  • Hospitals: A certified nurse assistant hospital training program is usually fast-paced and focused on hands-on clinical care. Duration averages four to eight weeks. Compared to other types of training programs, the CNA student in a hospital setting begins working directly with patients fairly quickly. Class sessions are held on the hospital premises, but scheduling is often flexible. Many hospitals, in an effort to find desperately needed staff, provide accelerated real-world training at no charge to program participants.
  • Red Cross: The American Red Cross offers certified nurse assistant classes, but only during regular daytime hours. For more than a century, this well-respected organization has been helping people transition to immediate employment by training candidates to become nursing professionals. The Red Cross curriculum emphasizes communication skills in addition to hands-on patient care, including bathing, dressing, taking vital statistics, and performing personal hygiene tasks. Programs average four to eight weeks in duration.
  • Vocational Schools: Nursing candidates can find CNA programs at vocational schools that combine clinical and classroom training. Some specific class topics include infection control, nursing fundamentals, anatomy and physiology, and nutrition. Courses, which run from four to 12 weeks, can be completed online, in person, or via a combination of the two methods. These programs emphasize practical skills, which makes graduates attractive to employers because the CNA can step right into the role without extensive on-the-job training.

2. Pass the Certification Exam

All 50 states, the District of Columbia, and the United States territories require that candidates complete a certification exam before becoming a certified nurse assistant. In some states, those who have completed a training program may work up to four months before taking the exam. Most CNA training programs offer practice exams to help prepare students, so they’ll know what to expect when they take the actual test. Narrowing the training focus on the topics included on the exam gives students an opportunity to clarify problem areas with their instructors before the examination.

Shortly before the end of the program, students should schedule their exam while the training they have received is still fresh and accessible. Instructors may assist students in finding a local exam center and making an appointment to take the test for CNA certification.

What You Need to Know About the Exam

The certified nurse assistant exam is divided into two parts: a clinical test and a computerized or written exam. Students may be asked to bring a volunteer with them on exam day to role-play the part of a patient while the candidate demonstrates his or her skills to the test proctor. Demonstrated mastery is required in these abilities:

  • Follow procedures for infection control
  • Adhere to patient privacy laws
  • Bathe a patient
  • Transfer a patient from a bed to a wheelchair
  • Take patient vital signs such as temperature and blood pressure

The computerized or written portion of the CNA certification exam consists of multiple-choice questions that evaluate the student’s knowledge of the duties required of the job. Students should expect to answer 50 to 70 questions that demonstrate their knowledge in these topics:

  • Role of the certified nurse assistant
  • Patient observation skills
  • Methods of reporting, using common abbreviations
  • Managing patient behavior
  • Safety measures
  • How to handle emergencies
  • Personal care skills
  • Bloodborne pathogens and infection control
  • Caring for patients of all ages
  • Common patient emotional and physical problems
  • Care of the terminally ill
  • End-of-life issues
  • Legal and ethical concerns in nursing

Students learn whether they passed or failed an exam the same day they take it. Those who pass are eligible to immediately begin work as a certified nurse assistant. Should you fail, check your state guidelines for the amount of time you must wait before you can take it again. Each state maintains a registry of those who have passed the certification exam.

Some states have additional requirements that the CNA must meet before certification, such as enrolling in continuing education and passing a criminal background check. It’s up to the student to check with his or her state board of nursing to learn about additional requirements and adhere to them. In some states, the CNA may take additional coursework and pass an exam to become a certified medication assistant (CMA). Unlike CNAs, this medical professional can dispense medication to patients along with their other duties.

Certified Nursing Assistant Salary & Job Outlook

In May of 2015, the Bureau of Labor Statistics (BLS) reported the median annual salary for a CNA as $25,710 for full-time workers, which equals an hourly wage of $12.36 per hour. Certified nurse assistants at the lowest 10th percentile of earnings reported a yearly salary of $19,390, while those at the highest 90th percentile earned $36,890 annually.

CNAs employed by local, state, and federal governments earned the highest salary, followed by hospitals, nursing care facilities, assisted living facilities, and home health care agencies. In 2015, 41 percent of certified nurse assistants worked in nursing homes and other long-term care facilities.

In 2015, approximately 1.5 million people held a position as a certified nurse assistant. The BLS anticipates that 267,800 new CNA jobs will be filled between 2018 and 2024, which equals a growth rate of 17 percent per year, much higher than the projected growth in other occupations. Because it’s an entry-level position, the need for CNAs is ongoing. Those who have taken the training course and passed the certification exam will have many opportunities to work in the healthcare setting of their choice.

Increasing Demand for CNAs

The increasing complexity of the health care needs of an aging population is the primary reason behind the projected demand for certified nurse assistants. Not only is 13 percent of the population currently at retirement age or older, but people live longer lives than even a generation ago. Elderly residents of nursing homes require trained nurse assistants to assist them with daily living tasks such as dressing, bathing, and grooming. People with diabetes, heart disease, and other chronic health conditions need health professionals to help them manage their illness at home.

Since many nursing homes depend on funding from the federal government, cuts in social programs such as Medicare and Medicaid affect the number of residents who live in these facilities, requiring fewer CNAs.

A gradual shift is taking place in health care and assisted living, resulting in a greater need for CNAs in home-based settings. This change is based on two factors: a lack of funding and many geriatric patients’ preference to remain in their homes rather than enter a facility. Many of these patients also receive outpatient services at physical rehabilitation and memory care centers. All these factors combine to drive the need for both entry-level and experienced certified nurse assistants.