A Certified Nursing Assistant (CNA) is a healthcare attendant who gives direct care to patients and is supervised by a Licensed Practical Nurse (LPN) or a Registered Nurse. A nursing assistant or a nursing aide are other names for a CNA. CNAs work as a bridge between the patient and the nurse. They are actively involved in the daily care of the patients in nursing homes, hospitals, hospice facilities, or any other healthcare facility.
Some CNAs use the knowledge gained over time working under other healthcare professionals to advance their careers into becoming Registered Nurses or Licensed Practical Nurses. Other CNAs also use the practice to test waters if nursing is what they want to continue with as a career or if they should take other paths.
It is important not to confuse a CNA with a medical assistant. Both deal with patient assessment and healthcare, but they differ in the levels of education required and some of the responsibilities.
This article will explore the salary expectations for CNA jobs as well as an overview of the CNA career.
Average CNA Salary by State
The average salary per year for a certified nursing assistant in 2019 was $29,660, according to the U.S. Bureau of Labor Statistics (BLS). This, however, varies depending on the area setting. For example, CNAs working in in-home health care services earned median pay of $28,590, which is lower compared to their counterparts in government settings, who earned a median salary of $35,500.
Here is a list of wages for nursing assistants depending on the health care setting they work.
- Government organizations: $33,800
- Hospitals: $30,050
- Nursing care facilities: $27,840
- Home healthcare services: $27,290
- Elderly assisted living facilities and continuing care retirement communities: $27,200.
Average Starting Salary of a CNA in the USA
The base nursing salaries differ across different types of nursing facilities, education level, and experience. For example, many entry-level CNAs are paid on an hourly basis. The BLS reports a $13.73 median wage for a newly employed nursing assistant. However, depending on the setting area or prior experience working in a healthcare facility, a nursing assistant can expect a higher starting pay of up to $19.02 per hour.
How Much Do Senior CNAs Make?
There are two categories of CNAs, both with varying responsibilities and pay levels. A CNA1 is an entry-level position for a nursing assistant. A CNA1 takes 75 hours of clinical lab time and 80 hours of classroom time to complete their training program. In order to take CNA2 training, you need to have already completed CNA1. A CNA2 student spends 28 hours in the clinical lab and 60 hours in the classroom, because the nursing student is already equipped with the base skills acquired in CNA1.
The time required to complete a nursing aide program is about one month.
Since a nursing assistant job is more practical, these programs usually require in-person class attendance. Certification of a CNA may however vary from one state to the other depending on the certification requirements. Here are some of the best schools to take CNA classes.
A CNA1 teaches skills, science courses, and concepts that include anatomy and physiology, diseases and conditions, and work habits. A CNA1 also works in long-term care centers, skilled nursing facilities, assisted living centers, and adult daycare facilities.
CNA2 is a senior nursing assistant who focuses on acute care, intervenes during a crisis, and works in a hospital setting where a CNA1 cannot work.
Due to the demanding nature of responsibilities a CNA2 is entrusted with, their average hourly pay is $15 to $20, compared to $10 to $15 for CNA1. These rates may vary further depending on the location, employer, the position held, and experience.
States With the Highest Paying CNA Jobs
Based on the needs of the employers, nursing assistants work on a variety of schedules that vary considerably. Some CNAs work throughout the week in shifts while others have set schedules and are on an annual salary. Nursing assistants who work on an hourly rate basis have the advantage of earning more on overtime whereas those on salary need to discuss with the hiring committee on any extra remuneration.
Below is a list of the states in the US with the highest average CNA compensation, both on hourly and annual salary.
- Alaska- $18.24, $37,950
- New York- $16.87, $35,080
- Nevada- $16.87, $34,480
- District of Columbia- $16.43, $34,170
- California- $16.13, $33,560
Skills That Can Affect CNA Salaries
The nursing field is diverse with several types of nursing professionals, all with varying responsibilities depending on skills or education level, area of specialization, and experience. There are two major categories of nursing that include bedside caregivers, often referred to as clinical nurses, and administrative nurses, also called non clinical nurses. A CNAs’ job is purely clinical and takes a shorter time, running a few weeks to gain entry into the profession.
However, CNAs seeking to expand their knowledge base in nursing may do so by taking other courses to add to their skills for purposes of either commanding higher salaries or advancing their career in nursing.
The required nursing skills may be divided into two categories- hard skills, and soft skills. A CNA job is less technical, and CNAs may need soft skills to professionally execute their duties and stand a chance of commanding higher salaries.
Soft skills play an important role across all nursing careers, and clinical caregivers who handle patients directly need to cultivate them to greater lengths. Empathy and patience towards patients and their families are top soft skills required for direct caregivers such as CNAs.
1. Critical Thinking
Healthcare involves solving different daily puzzles. While a nursing aide doesn’t offer any diagnosis for illnesses, they are expected to respond appropriately to situations that might involve emergencies. Although some of the decisions might be obvious based on the existing healthcare standards, a CNA will always encounter new challenges that require an instant and different approach.
2. Strong Written and Communication Skills
A nursing aide acts as a link between the patient and the nurse. Strong communication skills, both written and spoken are non-negotiable when interviewing for a CNA post at any level. A nursing aide will from time to time be required to transmit information, instruct and educate patients, and brief nurses and doctors on the patients’ status. Since many patients have little knowledge of medical terms, a CNA is expected to relay information to them in less technical terms.
Proper communication also incorporates good listening skills. A CNA should be an attentive listener to enable them to collect accurate information from the patient or their families to be passed to the doctors for an informed diagnosis.
3. Kindness and Empathy
A nursing assistant will encounter different personalities in the course of their career. Some are so arrogant, abusive, and ungrateful. The ability to remain calm and considerate in the face of all these is a critical skill for a nursing aide.
4. Physical Endurance
A nursing assistant job can be physically demanding and requires one to be in good bodily shape. From washing patients and repositioning them to moving heavy equipment, these activities require physical endurance to perform lest a nursing aide develops health problems in the course of their duties.
5. Observation Skills
Correcting a subtle sign like a strange odor in a care room can be enough diagnosis to a condition that might not require the intervention of a nurse. While it is true that a CNA is not necessarily responsible for a patient’s diagnosis, some of these signs might occur in the absence of nurses and doctors. It is critical that a CNA takes note and treats them as important signs.
Other skills required for a CNA also include:
- Time management
- Customer service
Factors That Determine How Much a CNA Earns
Skills such as communication, critical thinking, and observation can be learned or cultivated over time to maximize a CNA’s earning potential. However, there are other factors beyond skills learned that will determine how much a CNA earns.
Below are some of the factors that will determine the certified nursing assistant salary.
1. Job Experience
Entry-level CNAs are usually paid hourly with a starting pay as low as $10. However, CNAs with prior experience working in a medical field can ask for a higher pay of up to $20 average hourly wage. Additionally, a CNA2 is more skilled and works mostly in hospitals hence, they command higher pay than their CNA1 counterparts who only work in nursing homes.
2. Geographical Location
A CNA’s salary is greatly determined by the state or city of employment. According to a survey by the Bureau of Labor Statistics, New York, Nevada, Alaska, Massachusetts, and Connecticut were among the top-paying states in 2013. Metro cities reportedly pay well compared to rural areas in the country.
The term employer here means the healthcare facility you choose to work for. As we saw earlier, working in nursing homes such as elderly assisted living facilities is less rewarding compared to working in a government organization. Also, hospitals pay higher wages considering the variety of work and responsibilities a CNA is entrusted with.
4. Power of Negotiation
Industry standards define how much you will be paid as a CNA. However, that does not bar you from negotiating for pay that matches your experience and the value you are willing to bring to the organization. The best way to do this would be by taking online or part-time classes, graduating as either a certified nurse or a licensed practical nurse, and then asking for a salary raise.
In addition to the above-discussed factors that determine your earnings as a CNA, here are more ways on how to become a CNA that will help you command higher pay in the industry.
Benefits a Skilled CNA Can Expect
Outstanding skills in any profession will always guarantee both long and short-term rewards. The diversity of the nursing industry can offer immeasurable benefits for those looking to create a lasting career out of it. A Certified Nursing Assistant with skills as we have discussed in this article can expect benefits such as:
- Opportunity to advance into becoming a registered nurse
- Flexible working hours
- Job stability, notwithstanding the location due to the high demand for nursing assistants
- Opportunity to specialize
- High-pay prospects
- Continued learning as a result of working daily with professional nurses and doctors
- Opportunity to travel
CNA Careers and Salary Outlook
Scientists continue to encounter new diseases and viruses. COVID-19 shook the entire globe and paralyzed economies, and there is no reason to think it will be the last pandemic virus. Between novel viruses and an aging population, a career in any nursing profession is expected to experience steady growth in the coming years.
One report by the World Health Organization shows US$7.8 trillion global healthcare expenditure in 2017, which was up from US$7.6 in 2016.
Career Outlook for a CNA
There has been a high demand for certified nursing assistants and the growth is projected to stretch further through 2028 across the US. The aging baby boomer generation requires more nursing care facilities (elderly assisted living facilities), and more nursing assistants to staff them.
There is a projected 9% growth of employment for nursing assistants between 2018 and 2028 as estimated by the US Bureau of Labor Statistics.
Jobs You Can Get With CNA Certification
The long array of medical careers for people in the nursing industry provides an opportunity to hop from one career to the other based on their requirements.
Before we get to alternative jobs you can get with a CNA Certification, let’s first go through the list of topics covered in a CNA Certification classroom:
- Cardiopulmonary resuscitation (CPR)
- Hydration and nutrition
- Personal care
- Patients’ rights
- Basic first aid
- Infection control
- Samples and specimen collection
- Data gathering and medical records keeping
Duties of a CNA
After successful completion of a CNA training program. A CNA will be able to carry out responsibilities such as:
- Taking patients’ vital signs and measurements
- Monitoring patient’s wounds to prevent further infections
- Repositioning and moving patients as directed by senior nurses
- Relaying patient information to doctors and nurse and vice-versa
- Assisting patients with their daily functions such as dressing, eating, and using the restrooms
- Recording patient symptoms after keen inquiry and listening
- Bathing patients
Alternative Jobs for Certified Nursing Assistants
Those who have either completed a nurse aide training program or worked as a nurse assistant can easily transition into medical careers such as:
1. Medical Assistant
A medical assistant has job roles closely related to those of a certified nurse assistant. Just like CNAs, they provide support to healthcare professionals and physicians in a nursing care facility. Some of the areas they work in include hospitals, doctor’s offices, outpatient care centers, assisted living facilities, diagnostic laboratories, and clinics.
2. Patient Care Technician
Just like a certified nurse aide, a patient care technician assists in patient examination and treatment, collects samples, records information on patient’s charts, measures patient’s vital signs, and prepares patient’s treatment rooms.
A patient care technician earns slightly higher than a certified nursing assistant.
3. Medical Records Clerk
A certified nursing assistant can easily transition into a medical records clerk given the proximity in their responsibilities. Both careers are involved in the handling of patient information. A high school diploma is required for the entry-level in both. Other responsibilities carried out by a medical records clerk include:
- Gathering patient’s personal information
- Distributing medical charts to the relevant hospital departments
- Issuance of medical files to agencies and persons as per the law and regulation requirements
- Filling patients’ medical information
- Helping in clerical duties like answering phone calls, patient admission processing and discharge, and responding to all incoming emails.
4. Respiratory Therapist
A nursing assistant can easily transition into a respiratory therapist with close to no additional training. Some of the responsibilities of a respiratory therapist that can be carried out by a CNA include:
- Examining and interviewing patients with cardiopulmonary and breathing disorders (Cardiopulmonary resuscitation)
- Performing humidity–aerosol therapy
- Carrying out pulmonary drainage procedures
Some responsibilities by a respiratory therapist such as developing patient treatment plans and performing diagnostics tests like lung capacity measurement may, however, require a little more orientation for a CNA to perform.
5. Emergency Medical Technician
Also referred to as ER Technicians, these professionals have responsibilities that can comfortably be undertaken by a nursing assistant without any additional training. Some of the duties carried out by ER Technicians that a CNA can perform include:
- Phlebotomy procedures
- Caring for patient wounds
- Collecting and delivering lab samples
- Preparing patients for medical procedures
- Visitor coordination and patient transportation
Other jobs that CNAs can do include:
- Unit secretary
- Mental health technician
- Direct support professional
- Administrative assistant
- Home health aide
- Care associate
It is important to note that, based on the experience gained working alongside nurses and professional doctors, a certified nursing assistant can easily transition into a registered nurse, a practical nurse practitioner, or a licensed practical nurse after the acquisition of the right training.
Demand Level For CNA Jobs
Nursing facilities are feeling the pinch of caring for the rising number of patients that require the services of certified nursing assistants. The demand for nursing assistants is expected to grow by 9% by 2028 according to the BLS. This high demand is fueled by high workforce non-participation and record-low unemployment rates.
However, away from the workforce trends, healthcare generally faces the challenge of a growing number of the older population. About 10,000 people turn 65 daily whereas 60% of Americans suffer from at least one chronic ailment. The chronic conditions are even higher in those aged 65 and over.
Prevalence in chronic health conditions and higher aging populations means high demand for CNAs. There is a competition between hospitals, in-home care agencies, and other elderly assisted living facilities to acquire enough CNAs. The struggle by rural nursing facilities is even higher compared to the cities.
To curb this alarming shortage, many organizations are going back to older ways of recruitment. These are the three major ways nursing facilities and hospitals are using to address this menace.
- Hiring certified nursing assistants and offering them further training
- Hiring training professionals into their facilities
- Up-skilling entry-level employees.
Which CNA Jobs Pay the Most?
As we saw at the onset of this article, CNAs have the opportunity to work in different healthcare facilities depending on their preferences and levels of experience. These include nursing homes, hospitals, and other home healthcare settings. The duties in each of these settings vary, which explains the differences in average salary. Generally, CNAs working in hospital settings have the highest average pay at $14.73 per hour.
How Quickly Can You Start Earning as a CNA?
A certified nursing assistant job is among the most sought-after careers today. A list of 15 in-demand careers by Career Guide ranked home health aides on top followed by the nursing assistant positions. These statistics are a clear indication of just how quickly a certified nursing assistant is likely to start earning right after completing their CNA program.
Additionally, the training for a nursing assistant takes a very short time. This is usually between one to four weeks. However, the training period may vary by state. The prospects of being absorbed into a nursing facility are almost immediately after certification. They may start from a skilled nursing facility that doesn’t require much experience. It may take some time to gather the required experience to work in a hospital setting that has a little more responsibilities.
Here are some well-paying nursing degrees that CNAs might also consider.
Types of CNA Jobs
Generally, CNA jobs vary by healthcare setting. The setting a certified nurse chooses to work in determines several things including pay rates as we’ve previously seen. The following are the four major types of places you can find a job after submitting your CNA resume:
1. Skilled Nursing Facilities CNA Jobs
Most entry-level CNAs start their careers here due to the increased activities. It is a perfect platform for a newly employed nursing assistant to jumpstart a career in nursing. However, others may find satisfaction here and decide to stay for their entire career. One best thing about working in a skilled nursing facility is job security. A CNA employee can easily develop skills and gain more experience here before considering moving to other demanding settings like hospitals or any other government organization that may require prior working experience.
2. Home Health Aide Agency CNA Jobs
This is one of the most popular starting points for CNAs. The job openings here are less demanding and CNAs will always attend to one patient at a time. You are likely not going to experience burnout compared to CNAs working in hospital settings. However, the starting pay might be very low, and it might also take longer before having a patient assigned to you. Although stress levels are low here, you might have to deal with the trauma of a patient dying while under your care since you’ll have cultivated a close personal relationship with the patient.
3. Assisted Living Facilities CNA Jobs
CNAs working in an assisted living facility have less demanding responsibilities compared to other settings, like hospitals. Most of the patients in assisted living facilities are still very independent, although a little weak due to their advanced age.
There are always vacancies for this post, and it can be rewarding for those who find pleasure in assisting the elderly. Although the job may not be well-paying, it can serve as a stepping stone to advance in your nursing career. Stress levels are also very low compared to other settings. The longer you stay and develop skills, you may decide to negotiate higher pay.
CNA Jobs With the Highest Starting Salary
Local hospital jobs offer the best pay for CNAs hence the fierce competition among nursing assistants to land these jobs. CNAs seeking opportunities in hospitals can always check on their websites for advertisements on vacant positions.
However, within the hospital, different specialties also command different pay rates. The highest-paid CNAs work in the Intensive Care Unit (ICU), Telemetry, Emergency Rooms, Operating Rooms, surgery, and medicine. In Seattle, CNAs working in ICUs can earn up to $37,000 annually.
One of the best ways to find employment in a hospital as a CNA is to offer to work as a volunteer. When a job opportunity comes up, you’ll have an upper hand for consideration. Hospitals also offer the best extra benefits, and you can expect an annual pay rise.