Starting your career as a certified nursing assistant (CNA) offers unique rewards and challenges in the healthcare environment. CNAs provide basic care to patients under the supervision of a nurse and accomplish many complex and physical tasks that nurses can’t do on their own. Some of these CNA responsibilities include assisting with personal care tasks like bathing and toileting, helping patients eat and drink, and taking their vital signs when needed.
National Nursing Assistant Week is June 13-19, so now is a great time to celebrate the value of CNAs in healthcare and look at some pros and cons of a nursing assistant’s job. Hopefully, these reasons can provide career advice, if you’re deciding on what you want to do in nursing.
Pros
Enriching Work Experience: Many CNAs have described their work as a tool to help them understand the nursing field in a hands-on environment. Jose Molina, who previously worked as a CNA at Merced Behavioral Health Center in California, describes his experience.
“Working as a Certified Nursing Assistant (CNA) was a life-changing experience for me… I knew I had a purpose in healthcare when patients started treating me like family. In many cases, I was the closest thing to family that a patient had, and the sadness on their face at the end of my shifts was evident. Drawn-out, tear-filled hugs hit the hardest.”
Entry into Healthcare: According to Lynae Sorensen, a nurse practitioner at Restore Care, becoming a nursing assistant is the first step for many in nursing or other medical fields. “It’s beneficial for students interested in pursuing healthcare-related courses as it opens up many opportunities for attachments and internships concerning healthcare environments,” says Sorensen.
Flexibility is key to balancing work and life, and being a CNA can provide a schedule where you can pick what kind of shift you want. Sorensen also mentions that nursing assistants can work in a variety of areas, such as nursing homes, hospitals, and home care, which hire CNAs.
Job Growth: The demand for CNAs is projected to grow at 4% from 2022 to 2032, so there will be no shortage of jobs anytime soon.
Cons
We’ve covered some of the benefits of working as a CNA, but what are some of the job’s drawbacks?
Emotional Toll: “In most cases, CNAs form personal relationships with their patients and families, which are often not easy when dealing with end-of-life care or difficult situations,” says Sorensen. It can be hard dealing with a patient’s pain and even loss of life.
Physical Demands: As part of their duties, CNAs need to lift heavy objects or assist their patients in moving, which can become physically tiring and lead to exhaustion or tension over time. According to Sorensen, this is especially true for those who stand and bend for long periods.
Molina describes his CNA experience as one that came with many challenges. “Long shift hours and unpredictable workflows kept me on my toes at all times. Working entry-level pay to clean human waste is not exactly the most luxurious experience to boast about either,” says Molina. “Make no mistake, this job will test your commitment to nursing from the get-go.”
Low Pay: This career can be a good stepping stone, but the pay can be low compared to other jobs in the medical field. The median annual wage for nursing assistants was $38,200 in May 2023 at $18.33 an hour. However, with more experience and certifications, you can advance to higher pay.
Lack of Advancement: Demand for CNA positions will always be here, but advancing with the proper certifications can be difficult.
Takeaway
Overall, working as a CNA can be challenging; however, it can be worth it to build skills in healthcare and experience meaningful work relationships that will stay with you for your entire career.
With all that CNAs are expected to do, they show dedication to their work, which makes a difference in the lives of the patients they care for.
A Certified Nursing Assistant, or CNA, provides basic care to patients in hospitals, nursing homes, and other medical facilities. There is a demand for CNAs in all 50 states, so the job outlook is good.
Demand for CNAs in All 50 States
The U.S. Bureau of Labor Statistics projects that employment of nursing assistants will grow 11% from 2018 to 2028, faster than the average for all occupations. The median annual salary for CNAs was $28,530 in 2018.
To become a CNA, you must complete an accredited training program and pass a state-approved exam.
CNA Duties and Responsibilities
Job responsibilities of a certified nursing assistant vary depending on the state in which they practice, but general duties commonly performed include:
Helping patients eat, drink and bathe
Changing bed sheets and clothes
Taking patients’ vital signs, such as blood pressure and temperature
Documenting patient medical histories
Assisting with personal care tasks, such as bathing and toileting
Helping patients to ambulate or move around.
CNAs also often provide emotional support to patients and their families, and in some states, CNAs may also administer medication.
They often act as a bridge between the patient and the nurse, relaying information back and forth. Being a CNA can be a demanding job, both physically and emotionally. However, it can also be gratifying to know that you are making a difference in someone’s life.
CNAs typically work shifts that include evenings, nights, weekends, and holidays in various settings, including hospitals, home health agencies, nursing homes, assisted living facilities, and other long-term care facilities. Still, they may also work in clinics, doctor’s offices, and home health agencies.
Skills Needed to Become a Certified Nursing Assistant
Becoming a CNA requires formal training and developing specific core skills. Most states require that candidates complete an accredited nursing assistant program in formal training. These programs typically last several months and cover human anatomy, infection control, and emergency procedures.
In addition to formal training, prospective nursing assistants must pass a CNA skills test. These skills include communicating effectively with patients and coworkers, patience, and physical strength. Furthermore, nursing assistants must be able to think on their feet and make quick decisions in stressful situations. Those with these skills and qualities are well-suited to a career in nursing assistance.
Training and Certification
CNA training and certification are essential for those who want to work in the medical field. The training program covers infection control, patient rights, and emergency procedures. The certification exam tests a candidate’s knowledge of these topics. Those who pass the exam can start working as a CNA.
Working as a CNA is a great way to get your foot in the door of the medical field if you are interested in becoming a CNA, research training programs, and certification requirements in your area.
Career Paths
Most CNAs work in hospitals, but there are many other options available. For example, CNAs can find work in long-term care facilities, such as nursing homes and assisted living communities. Some CNAs also choose to work in home health care, assisting patients who need help with activities of daily living. And there are CNAs who work in hospice care, providing comfort and support to patients during the end-of-life process.
No matter what setting they choose, CNAs play a vital role in providing high-quality patient care. In addition, with the aging population, there is an increasing demand for CNAs, so those interested in a career in nursing have a bright future ahead.
Salary and Outlook
According to the Bureau of Labor Statistics, the median CNA salary was $28,530 in 2019, with the top 10% earning more than $39,390. The job outlook for CNAs is very positive, with an expected growth rate of 7% from 2019 to 2029. This growth is partly due to the aging Baby Boomer population, who will require more care as they age.
In addition, the growing prevalence of chronic conditions such as diabetes and heart disease will continue to drive demand for qualified nursing assistants. As a result, those interested in a healthcare career should consider becoming certified nursing assistants. With a strong job outlook and competitive salaries, it is a great time to enter this growing field.
Patients lean on them every day, and Certified Nursing Assistants (CNAs) contribute so much to the nursing field—yet they rarely seem to receive the credit they truly deserve. Even when writing this story, autocorrect kept changing CNA to CAN [Microsoft Spelling Checker, are you listening? –editor], and this seems an ironic reminder of the way CNAs can be overlooked.
Two years ago, the Evangelical Lutheran Good Samaritan Society started a CNA Training Program. Rochelle Rindels, MSN, RN, QCP, vice president of nursing and clinical services for the Good Samaritan Society, headquartered in Sioux Falls, South Dakota, took time to answer our questions about the program.
What follows is our interview, edited for length and clarity.
When did Good Samaritan start its CNA Training Program? How many students are enrolled currently?
Since its inception in May of 2020, we’ve enrolled more than 600 students into the Good Samaritan Society CNA Training Program with a 91% success rate for students that sit for the certification exam.
Investing in our own team members is extremely important to us. I started as a CNA and progressed through different nursing licenses and degrees and am grateful for the support I received from my employers. We have experts who contributed to the curriculum build for the CNA program, and we recognized the value in training our CNAs in our buildings, familiarizing them with the residents they will care for throughout their employment.
The health care system has experienced a shortage of trained caregivers for critical roles for some time; nurses and nurse aides are among the fastest growing occupations, but supply is not keeping pace.
Building and strengthening the worker pipeline is essential to support current staffing patterns, paramount to any future staffing enhancements and foundational to drive further improvements in delivery of care and services to residents.
We do not want to lose the heroes who answered the call to serve and continue to step up to care for our nation’s seniors in a time of crisis. We need to retain these caregivers, so they are not facing job loss, and residents in nursing homes are not facing the loss of caregivers who know them and love them.
We have proactive strategies in place to ensure we have the positions we need to continue to provide care as close to home by investing in growing our own frontline nurses, one being our CNA Program.
How does the program work? Do students attend in-person, online, or a combination of both? Do they attend full or part-time? How long does it last?
Our CNA program is a hybrid program. The curriculum consists of online coursework and in-person skills lab and clinicals, which allows the student to apply skills and knowledge in a care setting. Full-time and part-time options are available for employees to complete the 80-hour program.
Students receive training in our locations while they are working for us and earning a paycheck. They are trained in person by preceptors and nursing team members who are also their coworkers. The students also get to know the residents who they will continue serving after they graduate and pass certification.
What does a CNA do in health care, and why is it important for aspiring nurses to train as one?
A CNA is more than the title alludes to–nurse assistant. CNAs are absolutely the eyes and ears of our nurses and assist in completing nursing interventions. They are intimately involved with residents’ day-to-day care and needs, and they build lasting relationships with residents and their families. They complete daily activities of living with residents, perform dressing, bathing, and meal assistance. CNAs assist with restorative interventions to help residents maintain function and document important needs and data points related to the resident’s overall condition. They are a valued and essential part of the care team.
Why is this program important? What does it offer that makes it different from others?
The nurses who work for the Good Samaritan Society tell us they find their jobs incredibly rewarding. It’s hard work, but they believe they are called to do their roles. They build special relationships and friendships with their coworkers, and their residents become family. It’s the experiences like celebrating birthdays and anniversaries as well as the wisdom they gain from their residents that makes being a nurse such a rewarding career.
If someone wanted to get into the program, what would they need to do? What steps would you tell them to take?
Applying to the program is easy! Anyone interested can apply to a nurse aid position and upon hire will automatically be enrolled in the CNA training program. We offer the internal program in six of our states, including South Dakota, North Dakota, Iowa, Minnesota, Florida, and Tennessee. We are currently in the application process in five more states.
Is there anything I haven’t asked you about that is important for our readers to know?
I personally grew up with the Good Samaritan Society. My mother spent nearly 40 years as a nurse at Good Samaritan Society–Luther Manor in Sioux Falls, South Dakota. I remember performing ballet recitals and Christmas programs for the residents and staff. My mother and I have just one of many Good Samaritan Society stories of family working together. It’s that sense of calling and the family-like connection to residents that makes our culture so unique.
We’ve supported our people with investments to maintain the stability of our workforce and new programs to support employee well-being. These investments have paid off–our turnover rate is below the industry average and we were a Forbes top midsize employer in 2021.
In 2021 alone, we invested $15 million in direct care wages, and we recently announced a $5 million investment in starting wages.
We’re focused on how we can create positions that allow for more work-life balance for our people who are carrying out our mission every day. As a large organization, we have opportunities to solve for some of these things. But at the end of the day, we still need meaningful policies and long-term solutions to support and address our workforce needs now and in the future.
The California Nurses Association (CNA) today welcomed Gov. Gavin Newsom’s signature Friday enacting landmark legislation to require implicit bias education and training for nursing students and new graduates in California, an important step in addressing persistent racial disparities, particularly in health care.
CNA-sponsored AB 1407, by Assemblymember Autumn Burke, will require nursing schools and programs to include implicit bias education as part of their curriculum, and hospitals to implement an evidence-based program on implicit bias as part of new graduate training. Additionally, verification of implicit bias training will become part of the licensure requirement for all new California RNs.
California is now believed to be the first state in the nation to require implicit bias training as a graduation requirement for nursing students. Michigan has similarly mandated implicit bias training for all health care workers seeking licensure effective next June.
“Awareness and then education are critical first steps toward eliminating implicit bias,” said CNA Director of Government Relations Stephanie Roberson. “AB 1407 is a preemptive approach, starting with educating our future nursing workforce prior to entry into practice. There is no better way to start.”
“Long-term racial disparities in health care access and treatment continue to be a deplorable stain on our nation,” said CNA President Cathy Kennedy, RN. “Biases, whether intentional or unconscious, directly contribute to those disparities, especially in a context in which we continue to see corporate health care disparities for which health care services are provided, and what services are prioritized.”
Racial gaps in health care have been increasingly documented from maternal and infant mortality to diagnostic procedures to prescription of medication to interactions with medical professionals and institutions generally. A report from the Urban Institute this July, for example, found that Black patients are significantly more likely to suffer dangerous bleeding, infections, and other surgery-related problems than white patients who received care in the same hospital.
“Health care facilities and educators must demonstrate their commitment to ending racial health disparities and working toward health equity by aggressively pursuing strategies that eliminate implicit bias within the health care system. This bill is a part of the solution,” said Roberson.
Hospitals, health care facilities, and health care educators offer very little, if anything, to bring awareness to or address this phenomenon and problem. Even structural characteristics such as an institution’s physical space project how welcoming an institution might be to patients of color. Too often, facilities fail to look at the communities they serve, those communities’ needs, and the resources facilities need to tap to fill those needs.
“The legacy of structural racism in medical care has been deadly, and has contributed to distrust of medical services among medically underserved communities and patients. It is essential that we guarantee that our future health care workforce is fully aware of the debilitating consequences of implicit bias to bring this scourge to an end and ensure equal, high quality medical care for everyone,” Kennedy added.
In health care, as in a number of professions, if it’s not your job focus, you may not know what other people do in theirs. For example, if you’re not a Certified Nursing Assistant (CNA), you may not be aware of what is in their scope of practice.
Kim Warren, RN, BSN, nursing assistant program director at Dawn Career Institute, a private, post-secondary school preparing students to pursue a new career in the health care and wellness fields, took some time to answer questions about what tasks a CNA is responsible for, what kind of training they need, and what someone considering this type of position needs to do.
An edited version of our interview follows.
For those who don’t know, what is a CNA and what kind of tasks does he/she perform?
A CNA assists nurses in the care of patients of all ages. Care includes bathing, dressing, grooming, feeding, and personal care.
What kind of training does a CNA need? From what kind of school? Do students usually attend part-time or full-time? Do they go through clinicals like other health care professionals do?
To become a CNA, a candidate must take a state required training and competency evaluation program and pass a certification exam. These programs are offered in every state in a career training school, some high schools, and some community colleges. Programs are usually 6 to 8 weeks in length, which includes classroom and clinical, depending on individual state requirements. Students usually attend full-time.
What changes, if any, have occurred lately with regard to being a CNA?
Over the last year, some post-secondary schools have required that students who are pursuing a nursing degree take a CNA course before entering the clinical portion of the nursing program. I think this is a good idea because it gives the student more clinical, hands-on experience and also allows them to get this experience early on in their education path.
What kind of career paths can CNAs have? Where can they work?
Many CNAs go on to become RNs and work in a variety of health care settings. Some choose to work as a CNA, and they find jobs in hospitals, nursing homes, hospice facilities, and home health care settings.
What are the biggest challenges?
There is often a lot expected of a CNA! The positive side is that there are always CNA jobs available and the flexibility to work in multiple places is convenient.
What are the greatest rewards?
A CNA position is very rewarding in many ways. You have daily one-on-one contact with patients and clients of all ages and ethnic backgrounds. A CNA spends more time with the patient than any other health care professional and therefore is able to meet their changing needs.
What would you say to someone considering this type of nursing work?
I would recommend CNA to anyone looking to pursue a career in nursing, as it really provides insight into the health care profession and also allows students to gain experience that they don’t get until later in nursing school. For those who may be unsure if the medical field is the right fit for them, a CNA program provides the opportunity to get this experience early in order to make an informed decision. I believe that CNAs are valuable and such an important part of the nursing team. I have worked with many CNAs throughout my career, and I have the utmost respect for them. I truly believe that I would not be the nurse I am today without the great team of CNAs that I have worked with.
For those who don’t know, what is a CNA and what kind of tasks does he/she perform?