If you’re interested in becoming a CNA, or Certified Nursing Assistant, the first thing you should know is that, for the right person, it can be an incredibly rewarding and dynamic career move. While CNAs are sometimes known by other names, such as Nursing Assistants (NA), Patient Care Assistants (PCA), and State-Tested Nurse Assistants (STNA), the job is the same. As a CNA, you’ll work under the supervision of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN)--sometimes called a Licensed Vocational Nurse (LVN)--helping patients with a variety of healthcare needs. Becoming a CNA is a wonderful vocation, and it can also be a great way to enter the nursing field if you’re looking to someday become an RN or an LPN. In this article, you’ll find information on what to expect as a CNA, how to get started, and what options you’ll have as you develop your career. With the demand for CNAs projected to increase faster than the national average through 2026, your consideration alone means you’re already ahead of the curve!
Part 1: The Basics
Who are CNAs?
While doctors and nurses are people we often associate with healthcare, CNAs are also essential to the industry. You might think of them as the unsung heroes! CNAs attend to the patient’s most primary needs, often being the first to interact with them on a daily basis. Because CNAs work closely with patents and colleagues on the medical team, important qualities for the job include:
- effective communication skills
- physical and emotional stamina
CNAs have a high school diploma or GED and have completed a 6-12 week CNA certification course.
What do they do?
At the heart of what it means to be a CNA is care. CNAs provide patients with assistance in many necessary, day-to-day activities such as eating, walking, dressing, turning over, bathing, and using the restroom. They keep patients’ bodies clean, help make them comfortable, and help them to get around. The best CNAs are those who realize how vital this sort of nurturing can be, and who can relay a patient’s questions and emotional concerns to the rest of the medical team. Because they are the ones with the most one-on-one patient time, CNAs are often the first to notice small but significant changes in patients that may lead to better, more personalized attention.CNAs also have a variety of procedural and administrative duties. Checking vital signs such as heart rate and blood pressure, monitoring and recording food intake, and administering glucose tests are within a CNA’s purview.
How much do they make?
While the median annual wage for nursing assistants was $27,520 in May 2017, or just under $14 per hour, a couple of factors go into determining what you’ll earn as a CNA:
- Location: A CNA’s earnings vary widely from state to state, closely mirroring cost-of-living considerations. States with higher annual earnings include those on the West Coast and the Northeast, with Alaska, New York, Nevada, and California being the highest.
- Availability: CNAs are generally paid an hourly wage, which means that, with demand being as high as it is, your pay will most likely depend on your availability. This type of flexibility means you can work part-time as a CNA while you’re a student or parent OR make it full-time position with opportunities for overtime pay.
- Experience: The longer you work as a CNA, the more opportunity you have for pay increases. Not only are you rewarded for your work experience, but you can also earn more after completing advanced certifications such as Certified Medical Assistant (CMA), which allows you to administer medications.
Overall, employment of CNAs and orderlies is projected to grow 18% from 2016 to 2024, according to the Bureau of Labor Statistics. As baby-boomers age, the need for CNAs will only increase. This is some serious job security.Additionally, experience as a CNA is preferred--and often necessary--for those training to become Registered Nurses. In that regard, working as a CNA can be a stepping stone in what might become a long career in healthcare.
When do they work?
The typical workday for a CNA will vary widely depending on where he or she works. But you can typically count on a shift lasting either eight or twelve hours, and a full-time weekly schedule consisting of 32-40 hours per week. These hours may be scheduled during the morning (AM), the evening (PM), or overnight (NOC).Some CNAs prefer the longer shifts, which means that a typical work week would consist of three 12-hour shifts, leaving more time for more full days off. Others prefer a more standardized daily schedule. It’s useful to determine the best sort of schedule for your lifestyle when considering whether to work at a hospital or a nursing home, for instance. The flexibility in scheduling is one reason why many people enjoy working as a CNA. Often, facilities will discuss the best match for their needs and your availability, so be vocal at the outset about what sorts of shifts you prefer, and consider a range of options, as scheduling tends to vary widely by facility.Because patients need constant care, you can expect to work at least some weekends and holidays (often on a rotating schedule), and there is a need for both daytime and overnight shifts.
Where do they work?
Nursing assistants are employed in a variety of settings, the most common of which are hospitals, assisted living facilities, home health agencies, and nursing homes. Each facility will require different things from their CNAs. Here are some general ideas about what it is like to work for each:
At a hospital, you’ll typically be assigned to multiple patients per shift. You’ll be responsible for monitoring and recording vitals, helping patients with day-to-day grooming, mobility, and hygiene needs.
Assisted Living Facilities
In this environment, your patients will be elderly and have varying levels of need. Responsibilities may be similar to those required in a hospital, but your patients are more long-term, so you will have the opportunity to build relationships with patients that don’t always happen in short-term care.
Home Health Agencies
If you decide to work for a home health agency, you’ll likely be assigned to one primary patient. Along with duties already mentioned, you may be responsible for meal prep, laundry, distributing medication, and perhaps some socialization. This type of job requires a lot of time spent with one patient, and you will have the opportunity to get to know your patient well.
Patients in nursing homes often need high levels of care and are often at the end stages of life. They’ll need help with many daily activities, and you’ll monitor their health and levels.
Part 2: Getting Started
You’ll need a high school diploma (or the equivalent), and to have completed a CNA training program that is approved by your state. CNA training programs can be found at nearby community colleges and trade schools, and also through the American Red Cross. The typical cost of a complete CNA training course is around $1200.Training will include some classroom time and a clinical lab setting, although each state is different in what it requires, so take some time to research your state. After you successfully complete the training program (which usually take between 4-12 weeks), you’ll be eligible to take the certification examination. You must meet a minimum requirement of CNA training hours required in your state. The number of hours varies from 75-180. Included in this number are clinical hours, which, again, varies widely. You can expect as little as 16 clinical hours to as much as 100, depending on your state. In order to begin your training program, you may be asked to bring some or all of the following:
- Valid state driver’s license or ID card (this will be checked for proof of age, which in most states is 18.)
- High school diploma (or GED equivalent)
- Physical exam
- Immunization records
- TB results
- Fingerprint background check
- CPR and First Aid certification
For your certification exam, you’ll be asked to complete a written portion of the test and a clinical skills portion. There are many skills covered on the exam, including client rights, data and vitals collection, responsibilities of a CNA, anatomy and physiology (including body mechanics and range of motion), ethics and legal issues, medical terminology, nutrition, and general knowledge of the aging process and daily living activities.Each state’s written test varies in terms of test length and time. There are accommodations available, too, to help if you have any learning, motor, or attention difficulties. Taking a few practice exams may be helpful.The clinical portion of the exam averages about 30 minutes. Although it is difficult to predict exactly what skills will be tested on this portion, note that you will automatically fail the exam if you fail to properly wash your hands for the full 20 seconds. This portion of the exam will be proctored by a licensed nurse and will be in the style of a mock exam, using either another clinical student or a mannequin. Here are more in-depth tips that can walk you through how to master the clinical exam.
When the time comes to begin applying for positions, be confident! Remember: CNAs are in high demand! Finding your first job may seem daunting, but here are a couple of easy ways to begin the search:
- Work your network: Talk to friends and co-workers who have jobs in facilities you’re most interested in. Often, word-of-mouth is the best (and fastest!) tool for finding an opening.
- Talk to a career counselor: Check to see if the school where you completed your training has a career counselor. This person can get you in touch with facilities that have good relationships with your program and who regularly hire graduates.
- Comb through online job boards: Many healthcare facilities use online job boards such as Indeed, Monster, and SimplyHired to post listings.
- Give them a call: A quick phone call to the hospital, extended care community, or nursing home near you is often the personal touch you need to get your foot in the door. Places like these are consistently looking for responsible people to hire, so they’ll likely welcome the inquiry.
- Work with an agency: Nurse staffing agencies (such as Clipboard) can be a great way to plug into relationships at multiple local healthcare facilities and navigate various requirements. If you already have a license, feel free to register as a CNA with us.
Part 3: Growth and Development
Resources for CNAs
As part of a vibrant and active medical community, CNAs are invited and encouraged to seek out the many resources available to them. Here are some examples:
The website for this government agency offers an engaging way to stay up-to-date on public health promotion, disease prevention, and emergency preparedness. You’ll find seasonal and region-specific updates and news, indexed information on common diseases and illnesses, and information on wellness and lifestyle.
This online community of CNAs is a nonprofit organization that began in Ohio in 1977. After over 40 years, the community has grown nationwide, with a mission to promote “recognition, education, research, advocacy and peer support development for nursing assistants in nursing homes and other long term care settings.”
A website run by and for nurses with a contemporary slant, the contributors at Nurse.org are especially diverse and engage in current trends and developments in healthcare. They include CNAs in their audience, “publishing thought-provoking content and launching culture-changing initiatives.”
Of particular importance to CNAs is the practice of self care. While this term is gaining popularity for all types of people, it really is crucial for caregivers such as educators, parents, and nurses. Think of the ubiquitous instruction you hear when you fly: “Put on your own oxygen mask before helping those around you.” You cannot offer to others what you don’t have. Don’t underestimate the effects of maintaining a nutritious diet, quality sleep habits, and a regular way to relax. If you begin to experience bouts of irritability, anxiousness, exhaustion, sadness, or apathy, talk to a friend, colleague, or family member. It’s not unusual for caregivers to experience “compassion fatigue,” a type of chronic stress that researchers are recently finding is common in the nursing community.
There are several career paths you can take after working as a CNA.
Patient Care Tech (PCT)
PCTs have most of the same caregiving responsibilities as CNAs with additional tasks in medicine, such as EKG readings and drawing blood. In addition to having a high school diploma or GED and CNA certification, PCTs must also have certifications in CPR, phlebotomy, electrocardiography, and first aid. In some settings, you can be hired as a CNA and train on the job to earn the certifications required to be a PCT. With additional certifications and responsibilities comes slightly higher pay: PCTs earned an average of $32,480, or $15.61/hour, in 2017.
Certified Medical Assistant (CMT)
If you are interested in a change of setting and responsibilities as a CNA, but don’t have the Bachelor’s degree required for RNs, you may want to consider the 1-year certification degree or 2-year associate’s degree for a CMT. While CNAs work under the supervision of a nurse and are responsible for the patient’s daily care, CMTs work under a physician or advanced practitioner and are involved in medical assessments, physical exams, and may administer medication. CMTs also perform clerical duties and often work in out-patient clinics and urgent care. On average, in 2017 CMTs earned $33,580 or $16.15/hour.
Licensed Practical Nurse (LPN)
Like CNAs, LPNs also work under the supervision of an RA, providing daily care for patients. In addition to the personal care that CNAs give, LNAs are also responsible for medical attention and care, such as administering medication, collecting data and recording vital signs. LPN programs generally consist of a 2-year associate’s degree and fieldwork in a supervised clinical setting. A CNA will see a jump in salary after becoming an LPN: the 2017 average was $45,030, or $21.65/hour.
Occupational Therapy Assistant (OTA)
OTAs perform many of the same daily, personal care duties as a CNA with an additional focus on helping the patients develop, recover, or improve those skills to be able to perform them independently. Because of the emphasis on progression, work as an OTA can be very rewarding. OTA programs generally consist of a 2-year associate’s degree from an accredited program as well as at least 16 weeks of fieldwork. In 2017, OCTs averaged $56,690 annually, or $27.25/hour.
Registered Nurse (RN)
While plenty of CNAs find the work to be fulfilling as a career in itself, many begin as CNAs on their way to becoming an RN. Registered nurses make up the majority of healthcare workers as a nexus between patients, assistants, physicians, and families. RNs earn a 4-year bachelor’s of science in nursing (BSN) with options to pursue an area of specialization, such as critical care, oncology, geriatrics, or pediatrics. The 2017 average salary for RNs was $70,000 or $33.65/hour.Excited? Register as a CNA with Clipboard to instantly connect with local opportunities!