Nursing Assistants are RNs Eyes and Ears

April 30th, 2012

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By , BSN, RN

On more than one occasion I have recommended to students heading into the nursing profession that they get a job as a nursing assistant. We, at RNCentral.com have even tweeted about it.

Training as a nursing assistant is a great way to find out if you really want to work in a hospital. It will use some skills you are currently learning if you are already in nursing school. For many people what may be most important is—it is income. In these days of rising higher education costs, the possibility of rising student loan rates, and a generally poor economy being a nursing assistant is a great opportunity.

To understand the role of the nursing assistant you have to understand the “Team Nursing” model. In the early 1950s, Eleanor Lambertson and her colleagues proposed team nursing to overcome the fragmentation of care resulting from the task-oriented functional approach and to meet increasing demands for professional nurses created by advances in the technological aspects of healthcare.

This style of care delivery is characterized by a nursing team made up of registered nurses (RNs), licensed practical nurses (LPNs), and often nurse’s aides. With the advent of managed care, team nursing has experienced a resurgence. In this revisited form, licensed nursing personnel (RNs and LPNs) are frequently paired with unlicensed assistive personnel (UAP). The licensed nurse is the responsible authority for client care but delegates appropriate tasks to the UAP (read: nurses aides, medical assistants, orderlies).

Fans of the team nursing model believe the approach increases the efficiency of the licensed nurse.

By Any Name

As a UAP, this particular job is known by many names: Certified Nursing Assistant (CNA), Home Health Aide (HHA), Home Care Aide, Caregiver, Personal Care Aide, Personal Care Attendant (PCA), Personal Care Assistant (PCA), and most simply, Nurses Aide. The Bureau of Labor Statistics (BLS) has an online database called O-Net Online which includes information about every job you can think of, including nursing assistant.

The job of the nursing assistant is essentially a liaison between the nurse and the patient. That role can cover a lot of ground depending on where you are employed. In a hospital setting, a CNA may assist patients with the normal Activities of Daily Living (ADLs) such as bathing or showering, getting dressed, brushing their teeth and even helping to feed them. As a nursing assistant you are qualified to take vital signs, gather other patient data and make sure all the information is charted. A CNA is the nurses eyes and ears for changes in the patient’s status.

In a nursing home or extended care setting the nursing assistant have daily contact with patients and often build extended relationships with them. There is more total care from daily hygiene and dressing or sometimes acting as a sitter when patients need to be monitored overnight. CNAs in most areas make beds, help assist with or give baths, change sheets with a patient still in the bed—many skills we learn in nursing school but rarely put to use once we become RNs.

There are many jobs for nursing assistants outside formal facilities like hospitals and nursing homes. Home health is a major business and with an aging population more people can stay in their own homes longer if they have the right help.

A CNA working in home health may have the same tasks as above, assisting with ADLs. According to O-Net Online other duties can include:

  • Perform housekeeping duties, such as cooking, cleaning, washing clothes or dishes, or running errands.
  • Care for individuals or families during periods of incapacitation, family disruption, or convalescence, providing companionship, personal care, or help in adjusting to new lifestyles.
  • Plan, shop for, or prepare nutritious meals or assist families in planning, shopping for, or preparing nutritious meals.
  • Transport clients to locations outside the home, such as to physicians' offices or on outings, using a motor vehicle.
  • Instruct or advise clients on issues such as household cleanliness, utilities, hygiene, nutrition, or infant care.
  • Participate in case reviews, consulting with the team caring for the client, to evaluate the client's needs and plan for continuing services.
  • Training family members to provide bedside care.

As you can see there are many facets and opportunities involved in working as a nursing assistant. It can be a great summer job, it can be a part-time job during school, and it can be a great way to learn if you want to stay in the hands-on side of healthcare.

Becoming a CNA

Most employers require a high school diploma or the equivalent. Nursing assistant training is offered in a variety of settings including: high schools, vocational schools, community colleges, geriatric facilities, and even sometimes by employers. Many schools offer training within medical facilities as part of their course programs as well. These courses usually last six to eight weeks.

CNA training programs can cost several thousand dollars, but it is possible to get financial aid to help shoulder this burden. The federal government, the military, and even hospitals themselves offer financial assistance.

After completing training, you’ll need to take a competency exam that tests both your book knowledge and practical skills that were taught during training. Practice tests and study guides are freely available online. All CNAs must take an examination before they become qualified nursing assistants.

Job prospects for nursing assistants looks very good for the near future. There is an expected 21%-35% growth in the job market over the next decade. This exceptional growth is attributed to the rapidly growing older population that will demand more emphasis on rehabilitation and long term care. As a result, a major employer in this sector will be nursing homes and long term care facilities for people with chronic illnesses and disabling conditions. Replacing current employees will be the major source of openings for nursing assistants.


CNAs typically earn an hourly wage rather than an annual salary, so your pay will fluctuate depending on whether you take a few hours here and there, steadily work full time, or constantly pull 60 hour weeks. According to The BLS, the median annual wage for CNAs was $24,010 in May 2010.

Whether you are just starting to consider a career in nursing or are already in pursuit of your nursing degree, working as a nursing assistant can be of great benefit, both financially and in experience. It shows future employers your commitment to the field and it will cement many of the skills you will need once you become an RN. For more information on nursing assistants you can check out RNCentral.com and also the website of the National Association of Health Care Assistants.

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