Certified Nursing Assistant (CNA)

A certified nursing assistant (CNA) provides varying levels of care and support to physically and/or mentally disabled individuals who are unable to care for themselves. CNAs care for patients of all ages in hospitals, inpatient mental health facilities, and clinics. Some certified nurse assistants are employed by a patient’s family and make in-home visits, where they physically care for the patient and provide companionship. Many CNAs are employed at nursing homes and assisted living facilities for the elderly.

These workers fill an important and necessary role in society. Without the help of CNAs, many patients would not receive the physical and mental care they need and deserve. A career as a certified nursing assistant invites both challenges and rewards. As the baby-boomer generation ages, CNAs should be in greater demand; the Bureau of Labor Statistics projects the number of these workers to increase by 11% between 2016 and 2026. The median annual CNA salary is around $29,000, and certified nurse assistants employed by the government earn almost $34,000 a year.

What Does a Certified Nursing Assistant Do?

A certified nursing assistant helps both a patient and their family cope with the daily stressors of living by providing medical attention and care. CNAs help elderly patients transition into roles of dependence and often provide critical support to family members of dying patients. They may be responsible for many duties, including helping patients bathe and dress, dispensing medication, and recording vital signs.

CNAs communicate with nurses and doctors on behalf of the patients in their care; they may also prepare meals for patients, change bed linens, and assist with medical procedures.


Those employed at nursing home facilities typically reposition bedridden patients, feed patients, attend to patients’ hygienic needs, and administer medication. A CNA making house visits may provide companionship for elderly patients. The place of employment influences a CNA’s salary and job responsibilities.

Potential Work Settings

  • Hospital
  • In-home care
  • Nursing home
  • Assisted living community
  • Hospice facility
  • Urgent care clinic
  • Correctional facility
  • Inpatient mental health facility

How Is a CNA Different from a Medical Assistant (MA) or a Licensed Practical Nurse (LPN)?

Unlike a medical assistant or a licensed practical nurse, a CNA specializes in providing direct patient care, often in a long-term care setting. Medical assistants often provide administrative and clinical support within a physician's office or hospital, assisting doctors by taking patient histories and measuring vital signs; some of these workers may specialize as administrative medical assistants or clinical medical assistants.

LPNs support doctors and registered nurses by caring for patients and monitoring treatments. Under the direction of a physician or registered nurse, LPNs may check vital signs, provide basic patient care, and communicate with patients about their treatment. In contrast, CNAs spend most of their time providing basic care for patients, often in a nursing home, hospice setting, or other long-term care environment.

The educational and licensure requirements for CNAs also differ from LPNs or MAs. A licenced practical nurse must complete a state licensing process to practice, which requires an examination. LPNs must hold a diploma or degree with coursework in nursing to earn their license, while CNAs only need to obtain certification to practice. Certified nursing assistant training varies by state; however, CNA students typically complete fewer classroom instruction and clinical hours than aspiring LPNs.

How to Become a Certified Nursing Assistant

Educational Requirements

CNA training involves supervised clinical training and nursing classes. To earn certification, nursing assistants must complete a training program approved by the state, which often sets a minimum number of clinical and classroom hours. Some states also mandate certain coursework, such as HIV/AIDS training. Prospective nursing assistants can enroll in CNA programs through community colleges, hospitals, the American Red Cross, vocational schools, and other educational settings.

Additionally, a growing number of schools are offering CNA certification online. In an online CNA program, students take online classes to build core nursing knowledge while completing clinical requirements at a local site under the supervision of an approved preceptor. Covering anatomy, medical terminology, and physiology, coursework prepares nursing assistants for evidence-based patient care. A clinical component further emphasizes patient care through interactions with patients and their families.

CNA programs typically require 4-12 weeks of study. After completion, graduates can earn certification through their state. Most programs require applicants to hold a high school diploma (or the equivalent). However, students without a high school diploma can often still enroll if they pass reading and math assessments.

Experience Required

Certified nursing assistant programs require participants to complete clinical hours to strengthen their practical skills. During a CNA program, students build patient care skills, learn how to check vital signs, and practice CPR. Nursing assistant students often complete these hours at a local hospital, nursing home, or extended care facility. Online CNA programs arrange for local supervisors to oversee these required clinical hours. Nursing assistants need to complete 16-100 supervised clinical hours to earn certification, depending on their state. For example, California requires 100 clinical hours.

Nursing Assistant Certification

After completing a CNA program, nursing assistants must earn their state's nursing assistant certification before practicing. Each state sets its own requirements for certification, which may include written exams, oral exams, skills tests, and/or required clinical hours.

Before taking a competency exam, candidates must provide proof of completion of a state-approved CNA program and evidence that they have met the clinical hour requirements. Competency exams test an individual's nursing skills and knowledge. Some states also incorporate a proctored skills test, in which candidates complete basic nursing tasks in front of a proctor.

Because the licensure and certification process varies by state, prospective nursing assistants should carefully research the requirements where they live. For instance, some candidates may need to pass a criminal background check. Additionally, some states require periodic recertification, which may necessitate earning continuing education hours. CNAs can also complete Basic Life Support certification to demonstrate their abilities.

What Does It Take to Become a Certified Nursing Assistant?

Skills

Attention to Detail and Organization

A certified nursing assistant must pay attention to details and stay organized, particularly when administering medication. A CNA keeps track of each patient’s dosage and frequency, as well as any changes in medication. CNAs often provide meals for patients and may be required to document how much a client eats, drinks, and sleeps.

Compassion

Certified nursing assistants care for sick, elderly, and mentally or physically disabled individuals. The emotionally demanding nature of a CNA’s job requires compassion, patience, and empathy. A certified nursing assistant relies on compassion when working with challenging patients and their families in order to understand their worldviews and provide the best service possible.

Mental and Physical Strength

CNAs spends large amounts of time standing. They may also need to move a patient, change bedding, and/or give a patient a bath. Therefore, having physical strength is a must. Mental strength is also important for certified nursing assistants. Patients may be stubborn and disagreeable, especially if they suffer from diseases like dementia, which impact cognition. It is important for a certified nurse assistant to have mental fortitude, especially when working with dying patients.

Effective Communication

A certified nurse assistant must effectively communicate with patients and their families, coworkers, and other medical and support staff. A CNA communicates the needs of patients to family members who provide financial support and to doctors who prescribe medication and determine courses of treatment. Nurse assistants can influence treatment interventions through recommendations and observations.

Ethics

A certified nursing assistant must maintain strong ethics, especially when working with patients who cannot advocate for themselves. CNAs may also come into contact with addictive medications, which makes responsible handling of medication necessary. CNAs must advocate for the ethical treatment of patients and adhere to ethical guidelines designed to protect both CNAs and patients.

Certified Nursing Assistant Salary Information and Job Outlook

How much do certified nursing assistants make?

$20,500+ $24,650+ $28,790+ $32,940+
Certified Nursing Assistant (CNA): Average Salary by State This map presents average annual salary for the occupation Certified Nursing Assistant (CNA) in each state in the U.S. Average Annual Salary in HI: $33,440 HI Average Annual Salary in AK: $37,950 AK Average Annual Salary in FL: $25,930 FL Average Annual Salary in NH: $31,000 NH Average Annual Salary in MI: $29,200 MI Average Annual Salary in VT: $29,720 VT Average Annual Salary in ME: $27,250 ME Average Annual Salary in RI: $30,540 RI Average Annual Salary in NY: $35,080 NY Average Annual Salary in PA: $30,010 PA Average Annual Salary in NJ: $29,400 NJ Average Annual Salary in DE: $29,740 DE Average Annual Salary in MD: $30,470 MD Average Annual Salary in VA: $27,920 VA Average Annual Salary in WV: $25,990 WV Average Annual Salary in OH: $26,740 OH Average Annual Salary in IN: $26,070 IN Average Annual Salary in IL: $27,770 IL Average Annual Salary in CT: $32,970 CT Average Annual Salary in WI: $28,830 WI Average Annual Salary in NC: $24,680 NC Average Annual Salary in MA: $32,340 MA Average Annual Salary in TN: $25,090 TN Average Annual Salary in AR: $23,970 AR Average Annual Salary in MO: $25,360 MO Average Annual Salary in GA: $24,840 GA Average Annual Salary in SC: $24,810 SC Average Annual Salary in KY: $25,920 KY Average Annual Salary in AL: $23,050 AL Average Annual Salary in LA: $21,880 LA Average Annual Salary in MS: $22,790 MS Average Annual Salary in IA: $28,300 IA Average Annual Salary in MN: $32,560 MN Average Annual Salary in OK: $24,770 OK Average Annual Salary in TX: $26,390 TX Average Annual Salary in NM: $27,050 NM Average Annual Salary in KS: $25,290 KS Average Annual Salary in NE: $27,650 NE Average Annual Salary in SD: $25,970 SD Average Annual Salary in ND: $32,880 ND Average Annual Salary in WY: $29,970 WY Average Annual Salary in MT: $27,070 MT Average Annual Salary in CO: $32,040 CO Average Annual Salary in ID: $26,450 ID Average Annual Salary in UT: $26,150 UT Average Annual Salary in AZ: $30,470 AZ Average Annual Salary in NV: $34,480 NV Average Annual Salary in OR: $32,190 OR Average Annual Salary in WA: $30,410 WA Average Annual Salary in CA: $33,560 CA

  • Median Hourly Wage: $13.72
  • Mean Salary: $28,540

Source: Data taken from Payscale and The Bureau of Labor Statistics . Accessed: May 2019.

Employment of Nurse Assistants

Industries With the Highest Levels of Employment for Nurse Assistants

Industry Employment Percent of Industry Employment Annual Mean Wage
Nursing Care Facilities (Skilled Nursing Facilities) 594,460 36.66 $27,470
General Medical and Surgical Hospitals 365,360 6.64 $30,640
Continuing Care Retirement Communities and Assisted Living Facilities for the Elderly 164,580 18.03 $26,700
Home Health Care Services 78,940 5.65 $27,210
Employment Services 39,300 1.09 $28,870
Source: BLS, 2019

Industries With the Highest Concentration of Employment for Nurse Assistants

Industry Employment Percent of Industry Employment Annual Mean Wage
Nursing Care Facilities (Skilled Nursing Facilities) 594,460 36.66 $27,470
Continuing Care Retirement Communities and Assisted Living Facilities for the Elderly 164,580 18.03 $26,700
Specialty (Except Psychiatric and Substance Abuse) Hospitals 26,530 10.21 $31,120
General Medical and Surgical Hospitals 365,360 6.64 $30,640
Home Health Care Services 78,940 5.65 $27,210
Source: BLS, 2017

Meet a Certified Nursing Assistant

Additional Resources

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Online Certified Nursing Assistant Programs

Some certified nursing assistant programs are offered online, although they require some face-to-face training. The American Red Cross specifically addresses the importance of experiential learning for those interested in becoming certified nurse assistants. Therefore, no fully online certified nursing assistant programs at nonprofit universities are currently available.

Fully online CNA classes available through for-profit universities only prepare individuals seeking certification for the theoretical portion of the certification exam; this is insufficient to become a CNA.

Once learners have completed enough coursework and clinical hours, they are tested on their theoretical knowledge and practical experience. Certified nursing exams can be taken at regional testing centers. Exam preparation courses and training material are available online and are often included in CNA program coursework. Dozens of free continuing education classes are also available online for CNAs. In some instances, these courses can count toward initial certification. Individuals interested in pursuing CNA classes online can register here to find courses that meet their needs.

If you are an accredited, nonprofit institution that offers an online certified nursing assistant program that is not listed below, please contact us with details about your program, a link to your program page, and proof of accreditation.

Certified Nursing Assistant Programs

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