What does a CNA do?
A certified nursing assistant gives hands-on daily care to patients and residents. CNAs work under the direction of nurses, usually RNs or LPNs. They spend more time with patients than almost anyone else on the care team, so they are often the first to notice when something is wrong.
Much of the job is helping people with basic needs. CNAs help patients bathe, dress, eat, use the bathroom and move safely between bed, chair and wheelchair. They turn patients who cannot move on their own to prevent bedsores. They also take vital signs, record how much patients eat and drink, and report changes to the nurse.
CNAs also give emotional support. Many residents in nursing homes see their CNAs every day, and a kind, patient aide makes a big difference in their lives.
Tools of the job include blood pressure cuffs, thermometers, mechanical lifts, gait belts, wheelchairs and electronic charting systems.
CNAs work in:
- Nursing homes and long-term care facilities
- Hospitals
- Assisted living communities
- Home health agencies
- Rehabilitation centers
A typical day
- Get a report from the nurse on each resident or patient
- Help patients wake up, wash, dress and eat breakfast
- Take vital signs and record intake and output
- Help patients walk, transfer and change positions
- Chart your care and report any changes to the nurse
CNA pay and job outlook
According to the U.S. Bureau of Labor Statistics, nursing assistants earn a median of $42,260 a year, or $20.32 an hour. Hospitals often pay more than nursing homes, and pay varies widely by state.
The BLS counts about 1,505,900 nursing assistant jobs, making it one of the largest healthcare jobs in the country. Employment is projected to grow 3% from 2025 to 2035. Even so, there are about 196,200 openings a year, mostly because many CNAs move on to nursing school or other careers.
Pros
- Training is short and affordable, and sometimes free.
- Jobs are available almost everywhere.
- You get real patient care experience before nursing school.
- Flexible shifts, including nights, weekends and part time, are common.
Cons
- Pay is lower than many skilled trades and healthcare roles.
- The work is physically hard, with lots of lifting and standing.
- Staffing shortages can mean heavy patient loads.
- Caring for very sick or dying patients can be emotionally tough.
Training options: school vs. employer-paid training
CNA program. Community colleges, trade schools, adult education centers and some high schools offer state-approved CNA programs. Many take a few weeks to a few months and typically cost a few hundred dollars to about $2,000, depending on the school. Programs combine classroom learning, lab practice and supervised clinical hours in a nursing home or hospital.
Facility-sponsored training. Many nursing homes and some hospitals train new aides at little or no cost. In return, they may ask you to work for them for a set time. Federal rules also require nursing facilities to pay back training and testing costs in some cases for aides they hire within a year. Ask about this before you pay for a class.
Make sure any program you choose is approved by your state. Training that is not state-approved will not qualify you for the exam.
Certification and licensing by state
Every state runs its own nurse aide training and testing program under federal rules. The federal minimum is 75 hours of training with at least 16 hours of supervised practical training. Many states require more, often somewhere between about 100 and 180 hours.
The state competency exam usually has two parts: a written or oral knowledge test and a hands-on skills test. Some states use a national exam given by a testing company, while others have their own. After you pass, you are listed on the state nurse aide registry.
To stay active, you generally must work as a nursing assistant for pay at least once in every 24-month period. If you do not, you may need to retrain or retest. Some states also require continuing education.
If you move, you will usually apply to the new state’s registry. Many states accept aides in good standing from other states, though some require extra steps.
Specializations and where they lead
- Hospital CNA or patient care technician. Hospital roles may add skills like EKGs or blood draws, depending on the employer and state.
- Medication aide. In states that allow it, CNAs with experience can take extra training to give certain medications.
- Home health aide. Care for clients in their own homes, often with more independence and one-on-one time.
- Restorative aide. Helps residents keep or regain strength and mobility through exercise and daily routines.
- LPN or RN. Many CNAs go on to nursing school. Your CNA experience can make you a stronger nursing student, and some programs require it.
How to choose a CNA program
The right program gets you through the state exam and ready for real patient care. Ask these questions:
- Is the program approved by my state? Only state-approved programs qualify you for the competency exam.
- How many classroom, lab and clinical hours are included? Make sure the program meets or exceeds your state’s minimum.
- What is the exam pass rate? Ask how many students pass both the written and skills tests on the first try.
- What does tuition include? Ask about books, scrubs, background checks, TB tests and exam fees.
- When are classes held? Many programs offer evening or weekend schedules for working students.
- Are there employer-sponsored or free options nearby? Ask local nursing homes before you pay.
- What job placement help do you offer? Ask which facilities hire graduates.
