Nursing Assistants

At a Glance

Work in hospitals and nursing homes
Work under supervision of doctors and nurses
Do a variety of tasks from bathing patients to taking blood pressure
Wear uniforms and safety gear, such as latex gloves
May work days, nights, weekends, and holidays
Complete a formal training program
May need to be certified

Career summary

Nursing assistants give personal care to patients in hospitals and nursing homes. They work under the direction of nurses and doctors.

Nursing assistants may also be called nurses' aides, certified nursing assistants or attendants.

Nursing assistants provide basic care to patients in hospitals and residents in nursing homes. They typically:

Clean and bathe patients or residents
Help patients get dressed
Answer call bells
Prepare food trays and help patients eat
Clean rooms and change bedding

At the beginning of their shift nursing assistants check with the supervising nurse for instructions about each patient. They often read chart notes to get updates on patients.

Depending on their training and the state they work in, nursing assistants may give medicines to patients as directed by the supervising nurse or doctor. They also keep records of the amount of food eaten and liquid output.

When patients must stay in bed, nursing assistants help them turn or reposition themselves. They clean bedpans and help patients clean their teeth and wash and brush their hair. They also move patients to examining or operating rooms using wheelchairs or moveable beds.

When family members are visiting, nursing assistants may talk to them while cleaning or working in the room. They may explain some medical instructions to patients and family members.

In nursing homes nursing assistants develop close relationships with the residents. They watch patients for change in mental alertness or emotions. When they see changes, they notify the supervising nurse.

Sometimes nursing assistants set up and monitor equipment. They record vital signs such as blood pressure, temperature, pulse, and respiration. They may collect samples of bodily fluids. They also prepare and stock dressing and treatment trays. Some nursing assistants also do clerical duties, such as filing and making appointments.

At the end of their shift, nursing assistants report patient information to the supervisor or the nursing assistant who is coming on duty.

Related careers

This career is part of the Health Science cluster of careers.

Related careers include:

Military careers

Medical Care Technicians

Job duties

Task list

The following list of tasks is specific to nursing assistants.

Answer call bells and greet patients.
Help patients with walking, bathing, dressing, and eating. Also help them with exercising and using the bathroom.
Prepare food trays and serve meals.
Check temperature, blood pressure, pulse, and respiration of patients.
Turn patients who cannot turn over in bed.
Give medicines as directed by supervising nurse or physician.
Set up and monitor equipment.
Keep records of food intake, liquid output, and vital signs. May collect samples of bodily fluids.
Clean rooms and change beds.
Give lotion and alcohol rubs.
Meet with nursing staff and read chart notes.
Observe and report changes in patients' emotions or alertness.
Speak with family members and other visitors.
Move patients by wheelchair or gurney.
Sterilize equipment and supplies.
Deliver messages, gifts, and flowers.
Stock supplies, such as dressings and treatment trays.

Common work activities

Nursing assistants perform the following tasks. These tasks are common to many careers.

Assist and care for others
Communicate with supervisors, peers, or subordinates
Identify objects, actions, and events
Establish and maintain relationships
Get information needed to do the job
Monitor events, materials, and surroundings
Evaluate information against standards
Perform activities that use the whole body
Inspect equipment, structures, or materials
Make decisions and solve problems
Coordinate the work and activities of others
Explain the meaning of information to others
Handle and move objects
Teach others
Judge the value of objects, services, or people
Organize, plan, and prioritize work
Document and record information
Resolve conflicts and negotiate with others
Develop and build teams
Coach others
Schedule work and activities
Estimate sizes, quantities, time, cost, or materials needed
Process information
Update and use job-related knowledge

Work requirements

Working conditions

In a typical work setting, nursing assistants:

Interpersonal relationships

Have a high level of social interaction with patients, visitors, nurses, and other staff members.
Speak to others in person on a daily basis. They also communicate by telephone, but less frequently.
Are responsible for the health and safety of patients.
Sometimes are placed in conflict situations in which patients and family members may be upset or angry.
Are somewhat responsible for the work done by other assistants.
Nearly always work as part of a team.
Sometimes must handle patients who are physically aggressive or violent.

Physical work conditions

Always wear uniforms.
Always work indoors.
Work very near others. They come in physical contact with patients throughout their shift.
Are often exposed to contaminants.
Often are exposed to diseases or infections from contact with patients.
Sometimes wear safety gear, such as latex gloves, face masks, and back support.

Work performance

Must be exact in their work. Errors could seriously endanger patients' health.
Often make decisions that affect patients and other assistants. They make some decisions without talking to a supervisor, but usually consult someone first.
Set some of their daily tasks and goals without talking to a supervisor first.
Abide by daily and weekly deadlines.
Sometimes must repeat the same activities.

Hours/travel

May work days, nights, weekends, and holidays.
May work full time or part time. Most work full time.
Generally work a set schedule.

Physical demands

Nursing assistants frequently:

Walk or run for long periods of time.
Stand for long periods of time.
Bend or twist their body.
Repeat the same movements.
Use their hands to handle, control, or feel objects, tools, or controls.

It is important for nursing assistants to be able to:

See details of objects that are less than a few feet away.
Understand the speech of another person.
Speak clearly so listeners can understand.
Use muscles to lift, push, pull, or carry heavy objects.
Use stomach and lower back muscles to support the body for long periods without getting tired.
Bend, stretch, twist, or reach out.
Hold the arm and hand in one position or hold the hand steady while moving the arm.

It is not as important, but still necessary, for nursing assistants to be able to:

Use fingers to grasp, move, or assemble very small objects.
Be physically active for long periods without getting tired or out of breath.
See details of objects that are more than a few feet away.
Use one or two hands to grasp, move, or assemble objects.
Move two or more limbs together (for example, two arms, two legs, or one leg and one arm) while remaining in place.
See differences between colors, shades, and brightness.
Coordinate movement of several parts of the body, such as arms and legs, while the body is moving.
Hear sounds and recognize the difference between them.
Move arms and legs quickly.
Use muscles for extended periods without getting tired.
Focus on one source of sound and ignore others.
Keep or regain the body's balance or stay upright when in an unstable position.
Determine the distance between objects.
Make quick, precise adjustments to machine controls.
Choose quickly and correctly among various movements when responding to different signals.
React quickly using hands, fingers, or feet.
Use muscles to jump, sprint, or throw objects.

Skills and abilities

Nursing assistants need to:

Communicate

Understand spoken information.
Listen to others and ask questions.
Speak clearly so listeners can understand.
Understand written information.
Read and understand work-related materials.

Reason and problem solve

Notice when something is wrong or is likely to go wrong.
Combine several pieces of information and draw conclusions.
Analyze ideas and use logic to determine their strengths and weaknesses.
Use reasoning to discover answers to problems.
Develop rules that group items in various ways.
Follow guidelines to arrange objects or actions in a certain order.

Manage oneself, people, time, and things

Check how well one is learning or doing something.

Work with people

Look for ways to help people.
Be aware of others' reactions and understand the possible causes.
Change behavior in relation to others' actions.

Education and training

Educational programs

The programs of study listed below will help you prepare for the occupation or career cluster you are exploring.

Programs of study directly related to this occupation

Other programs of study to consider

Training

To work as a nursing assistant, you typically need to:

have a high school diploma or equivalent; and
complete a training program.

Education after high school

Nursing assistants must complete a formal training program. You can get training at high schools, professional-technical schools, and two-year colleges. In these programs you learn anatomy and physiology, infection control, and nutrition. You also learn how to help patients bathe, eat, and groom. These programs take two to five weeks to complete.

On-the-job training

Some employers provide classroom training for nursing assistants. Others rely on experienced nurses to give on-the-job training. This type of training may last from several days up to a few months. As a nursing assistant, you may also attend workshops, lectures, and in-service trainings.

Military training

Some branches of the military train people to be medical care technicians. Training lasts seven to 52 weeks, depending on your specialty. Additional training occurs on the job.

Helpful high school courses

You should take a general high school curriculum that meets the state's graduation requirements. You will be required to take both math and science classes to graduate.

Helpful electives to take in high school that prepare you for this career include:

Health Education
Introduction to Health Care
Medical Office
Nursing

The courses listed above are meant to help you create your high school plan. If you have not already done so, talk to a school counselor or parent about the courses you are considering taking.

You should also check with a teacher or counselor to see if work-based learning opportunities are available in your school and community. These might include field trips, job shadowing, internships, and actual work experience. The goal of these activities is to help you connect your school experiences with real-life work.

Join some groups, try some hobbies, or volunteer with an organization that interests you. By participating in activities you can have fun, make new friends, and learn about yourself. Maybe one of them will help direct you to a future career. Here are examples of activities and groups that may be available in your high school or community.

Things to know

Most employers require a high school diploma, equivalent, or experience. Many employers have training programs. Some states require a license. Employers prefer to train people who are healthy, patient, and tactful. They want people who like to help people and who can be depended on. They look for teamwork skills, such as working well with others, communicating carefully, and being willing to do routine tasks over and over. Because evening and weekend shifts are common, high school and college students can find part-time work in this occupation while they are attending school.

Many employers require graduation from a formal training program, which includes theory and practical care.

Tips

Volunteer work, job shadowing, and summer jobs in hospitals and skilled nursing facilities provide a helpful background. Contact local health care facilities to see if they offer educational programs. Attend career days at local schools to make contacts with health care facility representatives.

Costs to workers

Costs for comfortable shoes and uniforms vary depending on one's personal preferences. Some institutions permit workers to wear lab coats over their street clothes.

Licensing/certification

Nursing assistants must be registered or certified through the State Department of Health. Registered nursing assistants can work in facilities such as hospitals and retirement homes, but not nursing homes. Registration requires submitting an application, paying a fee and completing seven hours of HIV/AIDS education.

Nursing assistants who work at nursing homes are required by state and federal law to be certified. They may begin employment as registered nursing assistants, but within four months of being hired, they must obtain certification.

Certification requirements include:

completion of an 85-hour training program (which includes seven hours of HIV/AIDS education) approved by the State Nursing Care Quality Assurance Commission; and
passing an examination.

Certified nursing assistants, who have at least 1,000 hours work experience in a nursing home, can also get additional training and licensing for endorsement as a medication assistant. This endorsement allows workers in a nursing home to give medications and specific treatments to residents under the direct supervision of a registered nurse. Workers must also pass a medication assistant exam.

For more information, contact:

Washington State Department of Health
Health Systems Quality Assurance
Customer Service Center (external link)
PO Box 47877
Olympia, WA 98504
360.236.4700

#2/5/20

Job listings

Listed below are links to job categories from the National Labor Exchange that relate to this career. Once you get a list of jobs, you can view information about individual jobs and find out how to apply. If your job search finds too many openings, or if you wish to search for jobs outside of Washington, you will need to refine your search.

Nursing Aides, Orderlies, and Attendants

To get a listing of current jobs from the WorkSource system, go to the WorkSource website (external link) .

Wages

The minimum wage for Washington State as of January 1, 2020 is $13.50 per hour. Some areas of the state may have a higher minimum wage.

Nursing assistants (SOC 31-1014)

Location	Pay Period
Location	Pay Period	10%	25%	Median	75%	90%
Washington	Hourly	$12.31	$13.31	$15.01	$17.38	$19.22
	Monthly	$2,133	$2,307	$2,601	$3,012	$3,331
	Yearly	$25,600	$27,690	$31,220	$36,160	$39,980
Bellingham	Hourly	$12.63	$13.59	$15.20	$17.72	$19.71
	Monthly	$2,189	$2,355	$2,634	$3,071	$3,416
	Yearly	$26,279	$28,275	$31,621	$36,860	$41,002
Bremerton-Silverdale	Hourly	$12.22	$12.83	$14.13	$15.56	$17.82
	Monthly	$2,118	$2,223	$2,449	$2,697	$3,088
	Yearly	$25,420	$26,678	$29,383	$32,366	$37,084
Clarkston-Lewiston	Hourly	$11.48	$12.73	$14.27	$15.71	$18.11
	Monthly	$1,989	$2,206	$2,473	$2,723	$3,138
	Yearly	$23,868	$26,479	$29,688	$32,671	$37,665
Kennewick-Richland	Hourly	$12.24	$12.76	$14.14	$15.52	$18.07
	Monthly	$2,121	$2,211	$2,450	$2,690	$3,132
	Yearly	$25,452	$26,542	$29,414	$32,278	$37,599
Longview	Hourly	$12.25	$12.89	$14.89	$17.57	$20.64
	Monthly	$2,123	$2,234	$2,580	$3,045	$3,577
	Yearly	$25,491	$26,814	$30,978	$36,535	$42,932
Mount Vernon-Anacortes	Hourly	$12.89	$14.82	$16.70	$18.53	$19.67
	Monthly	$2,234	$2,568	$2,894	$3,211	$3,409
	Yearly	$26,812	$30,833	$34,731	$38,535	$40,910
Olympia-Tumwater	Hourly	$12.56	$13.22	$14.48	$15.84	$18.56
	Monthly	$2,177	$2,291	$2,509	$2,745	$3,216
	Yearly	$26,127	$27,507	$30,115	$32,954	$38,597
Seattle-Tacoma-Bellevue	Hourly	$13.14	$14.33	$16.12	$18.46	$20.20
	Monthly	$2,277	$2,483	$2,794	$3,199	$3,501
	Yearly	$27,327	$29,790	$33,541	$38,407	$42,008
Spokane-Spokane Valley	Hourly	$12.32	$13.07	$14.85	$17.29	$19.60
	Monthly	$2,135	$2,265	$2,574	$2,996	$3,397
	Yearly	$25,642	$27,186	$30,900	$35,950	$40,772
Vancouver	Hourly	$12.36	$13.85	$16.25	$19.50	$22.97
	Monthly	$2,142	$2,400	$2,816	$3,379	$3,981
	Yearly	$25,720	$28,815	$33,792	$40,548	$47,793
Walla Walla	Hourly	$12.27	$12.74	$13.96	$15.44	$17.93
	Monthly	$2,126	$2,208	$2,419	$2,676	$3,107
	Yearly	$25,517	$26,495	$29,056	$32,123	$37,289
Wenatchee	Hourly	$12.26	$12.99	$14.55	$16.38	$18.95
	Monthly	$2,125	$2,251	$2,522	$2,839	$3,284
	Yearly	$25,495	$27,030	$30,261	$34,079	$39,419
Yakima	Hourly	$12.83	$13.62	$14.90	$16.98	$19.82
	Monthly	$2,223	$2,360	$2,582	$2,943	$3,435
	Yearly	$26,691	$28,331	$31,001	$35,310	$41,210
United States	Hourly	$10.24	$11.70	$13.72	$16.15	$19.02
	Monthly	$1,775	$2,028	$2,378	$2,799	$3,296
	Yearly	$21,290	$24,340	$28,540	$33,580	$39,560

Wages vary by employer and by the assistant's level of experience and responsibility.

Depending on the employer, assistants who work full time may receive health insurance, paid leave, and a retirement plan. However, many jobs are part time and not all employers offer benefits.

Employment and outlook

Washington outlook

The table below provides information about the number of workers in this career in various regions. It also provides information about the expected growth rate and future job openings.

Nursing assistants (SOC 31-1014)

		This occupation	All occupations
Location	Current employment	Growth over 10 years		Annual openings
Washington	34,250	13.9%	16.1%	5,023
Adams, Chelan, Douglas, Grant, and Okanogan Counties	1,440	21.5%	13.4%	241
Asotin, Columbia, Ferry, Garfield, Lincoln, Pend Oreille, Stevens, Walla Walla, and Whitman Counties	1,476	19.2%	8.6%	236
Benton and Franklin Counties	1,223	18.9%	15.0%	195
Clallam, Jefferson, and Kitsap Counties	1,891	7.5%	11.9%	244
Clark, Cowlitz, and Wahkiakum Counties	2,391	15.6%	15.2%	360
Grays Harbor, Lewis, Mason, Pacific, and Thurston Counties	1,937	12.8%	14.1%	279
Island, San Juan, Skagit, and Whatcom Counties	1,553	7.9%	14.6%	202
King County	11,575	14.3%	19.6%	1,709
Kittitas, Klickitat, Skamania, and Yakima Counties	1,410	11.5%	13.8%	196
Pierce County	4,590	17.0%	15.2%	711
Snohomish County	2,422	12.8%	12.4%	347
Spokane County	2,401	10.0%	13.9%	326
United States	1,513,200	8.9%	5.2%	190,700

National employment

Major employers:

Nursing and personal care facilities
Hospitals
Residential care homes

National outlook

Demand is very strong for this occupation. Growth is mainly due to the increase in the aging population. Conditions such as dementia lead to a strong need for nursing assistants. The strongest demand for nursing assistants will be at residential care homes.

Job prospects are best for people who have completed state-approved training programs. Job openings also occur as people leave the occupation. This is a physically-demanding job and some people leave to find better paying jobs.

Other resources

American Health Care Association
1201 L Street NW
Washington, DC 20005
202.842.4444

Explore Health Careers: Nurses Aide/Nursing Assistant

National Association for Home Care & Hospice
228 Seventh Street SE
Washington, DC 20003
202.547.7424

National Network of Career Nursing Assistants

National Student Nurses' Association
45 Main Street, Suite 606
Brooklyn, NY 11201
718.210.0705

Washington State Nurses Association
575 Andover Park West
Suite 101
Tukwila, WA 98188
206.575.7979
800.231.8482

References

Career cluster

Health Science

Career path

Social

O*Net occupation

Nursing Assistants (31-1014.00)

O*Net job zone

Job Zone 2 - Some preparation needed. Some previous work-related skill, knowledge, or experience may be helpful in these occupations, but usually is not needed.