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Starting Out: A Nursing Assistant and Nurse Aide Overview

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Certified Nurse Aides, Certified Nursing Assistants, State Registered Nurse Aides: They go by different titles in different states, but they share a critical role. Nurse aides provide direct patient care in nursing homes and in other settings such as hospital long-term care wards or community rehabilitation. Duties can include taking vital signs, assisting residents to move about the facility, helping them manage their meal trays and use bathroom facilities, turning bedridden patients, offering emotional support.

Nursing assistants have a huge impact on a vulnerable population. All states regulate nurse aides who work in nursing homes. This is mandated at the national level. All states maintain a registry. They also set standards for training and competency evaluation. Some set the training requirement at the federal minimum of 75 hours. Some set it at the 120 hour minimum recommended by the Institute of Medicine. Some set it even higher.

Nursing aides typically take a test that requires them to carry out duties such as taking blood pressure, putting on compression stockings, or giving a partial bed bath.

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Job Outlook for Nursing Assistants and Nurse Aides

The Bureau of Labor Statistics predicts the nurse aide occupation to grow by 21% during the years 2012 to 2022 (http://www.bls.gov/ooh/Healthcare/Nursing-assistants.htm). One reason: The American population is getting older.

Some metropolitan areas have greater need for nurse aides. The following are among the metropolitan areas with the highest concentration of nurse aide jobs:

  • Punta Gorda, Florida
  • Bismarck, North Dakota
  • Battle Creek, Michigan
  • Bay City, Michigan
  • Hot Springs, Arkansas
  • Danville, Virginia
  • The Steubenville-Weirton metropolitan area spanning Ohio and West Virginia
  • The Lewiston metropolitan area spanning Idaho and Washington

On a local level, nursing homes can experience shortages for various reasons, including the presence of a large medical center that draws experienced workers.

Wages are highest in Alaska, Nevada, New York, and Connecticut (http://www.bls.gov/oes/current/oes311014.htm).

Rewards and Challenges

The greatest rewards are generally the emotional ones. The U.S. Department of Health and Human Services, reporting on a large-scale survey of nursing assistants, notes that only a small segment make nurse aide their lifelong profession; just over 35% of respondents had been in the field 11 years or longer (http://aspe.hhs.gov/). At the same time, nursing assistants expressed a lot of pleasure in their jobs. When asked about their reasons for staying in their current job, the vast majority of survey participants reported that the prime reason was that they had a chance to help others or that the work felt good. There was just one age group where a majority cited good pay among the reasons for staying; it was the youngest workers: those under age 25.

Dr. Jules Rosen, who is part of an ongoing study of the direct care workforce, notes that CNAs satisfaction by forging personal relationships with residents and going above and beyond their duties, for example, finding resources to make residents' lives more comfortable or sharing their prayers (http://www.mcknights.com/guest-columns/getting-to-the-bottom-of-cna-turnover/article/121691).

New Directions for Nursing Assistants and Nurse Aides

The nurse aide profession isn’t for everyone, but it is for both genders. Health organizations know that it’s imperative to put effort into recruiting and retaining – and that means increasing the number of male nurse aides beyond the current 10%. The National Network of Career Nursing Assistants notes another reason to create a culture where men feel comfortable: Their presence creates a more normal living environment for residents (http://cna-network.org/task-force-for-male-nursing-assistants/).

Other areas of focus include implementing preceptorships and developing a nurse aide career ladder. Some organizations have called for a career ladder with career nurse aides moving on to specialized roles like restorative nursing assistant. Some nurse aides already have training in this field. There are other opportunities to advance; these can vary by state. Some states require an additional certification to work as a medication aide. Some allow nursing assistants the option of self-employment.

Exceptional long-term care workers sometimes receive scholarships to continue their education as nurses.

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