How to Become a Certified Nursing Assistant (CNA)

A CNA, or Certified Nursing Assistant, is a healthcare professional who provides basic care to patients under the supervision of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN). CNAs are sometimes referred to as nurse aides, patient care technicians, or nursing assistants. They assist with daily patient care tasks like dressing, bathing, and checking patient vital signs.

These vital patient care providers are the backbone of the American healthcare system. With a short certification process, becoming a CNA is often the most accessible way for new workers to enter the nursing field. 

This article will explore what certified nursing assistants do, how much they earn, and how to become a CNA. Keep reading to prepare for your nursing assistant career today.

CNAs can help a unit run smoothly, especially for nurses with multiple medically complex patients. Common CNA responsibilities include:

1. Turning or repositioning patients
2. Gathering supplies for the RN or MD
3. Checking and charting vital signs
4. Answering patient calls/bells
5. Bathing, feeding, and dressing patients
6. Measuring and recording patient food/liquid intake
7. Preparing rooms for admissions 
8. Assisting with medical procedures
9. Dressing wounds
10. Assisting patients with elimination

Direct responsibilities will vary based on the location of employment and the nurse's level of need. Different states have individual CNA requirements and duties. You can check your state guidelines for specific details about approved CNA duties and tasks in the state where you plan to practice.

Certified nursing assistants must complete a state-approved training program. CNA programs are generally found at local community colleges, high schools, vocational or technical schools, or local hospitals.

Most programs have similar CNA certification requirements that must be completed prior to application and acceptance. The American Red Cross runs a popular CNA training program throughout the country which runs for 4-8 weeks depending on class size and location. Prerequisites include:

1. Attendance at an orientation information session
2. TABE (reading and math assessment) OR verification of High School diploma or GED
3. Red Cross criminal background check prior to registration
4. Completion of Red Cross physical form and TB test

The most common CNA workplaces include:

• Hospitals (state and local)
• Skilled nursing facilities
• Long-term residential facilities
• Rehabilitation centers
• Adult daycare centers

Certified nursing assistants rarely work in outpatient, office, or clinic settings. These facilities all require nursing assistants to act as a liaison between the nurse and the patient. 

As patient care liaisons, CNAs must enjoy interacting with people and have good bedside manners. But other skills or attributes that can help your nursing assistant career include:

1. Flexibility
2. Advanced communication skills
3. Time management
4. Compassion
5. Reliability
6. Physical Strength
7. Empathy

According to the US Bureau of Labor Statistics (BLS), the median annual nursing assistant salary in 2023 was $38,130 per year or $18.33 per hour. 

However, CNA salary expectations will vary depending on the setting and area. CNAs working in dentistry earn the most, with an average mean salary of $57,450. On the other hand, home healthcare services have the lowest median pay at $35,640. 

Highest Paying States for CNAs

According to the BLS, the following states have the highest pay scale for certified nursing assistants. 

State	Hourly Wage	Annual Salary
District of Columbia	$ 23.01	$ 47,860
Alaska	$ 22.63	$ 47,080
California	$ 22.63	$ 47,070
Oregon	$ 22.58	$ 46,970
Washington	$ 22.32	$ 46,430

Highest Paying Cities for CNAs

Metropolitan areas tend to pay higher for nursing assistants. Some of the highest-paying cities include:

City	Hourly Wage	Annual Salary
San Francisco-Oakland-Hayward, CA	$ 27.18	$ 56,530
San Jose-Sunnyvale-Santa Clara, CA	$ 26.72	$ 55,580
Salem, OR	$ 23.63	$ 49,140
Seattle-Tacoma-Bellevue, WA	$ 23.23	$ 48,320
Salinas, CA	$ 22.96	$ 47,750

Highest Paying Nonmetropolitan Areas for CNAs

Nonmetropolitan areas that pay CNAs the most in the US include:

1. Alaska nonmetropolitan area
2. Eastern Sierra-Mother Lode Region of California nonmetropolitan area
3. North Valley-Northern Mountains Region of California nonmetropolitan area
4. Coast Oregon nonmetropolitan area
5. Hawaii / Kauai nonmetropolitan area

We consulted nursing experts to curate the top 10 CNA programs in the nation. To determine which programs made this list, our nursing panel used Nurse.org's proprietary ranking methodology.

Our nurses considered several crucial factors in selecting these programs, including:

• Reputation
• Tuition
• Program length
• Acceptance rate, when available

3 Registered Nurses with years of experience and multiple degrees comprise our selection panel:

• Tracy Everhart, MSN, RN, CNS
• Tyler Faust, MSN, RN
• Kathleen Gaines, MSN, BSN, RN, BA, CBC

Because individual nursing pathways take various forms, our panel ranked the top CNA programs in no particular order. 

Online CNA Programs

While most of the top CNA programs offer in-person classes, some vocational schools and community colleges offer online CNA programs. Many programs operate clinics at local hospitals.

There are pros and cons to online programs. While individuals may be able to obtain their CNA certification quicker, there is concern that graduates from these programs are not gaining the same core knowledge and skills as their in-classroom counterparts.

Becoming a certified nursing assistant will not immediately prepare you for other nursing occupations.

However, the base of knowledge and experience earned as a CNA can help you gain entry into LPN or RN programs. However, earning these nursing certifications will require completing separate continuing education programs.

Remember that your CNA experience and education won't likely translate to shortened LPN or RN training. But it could translate to less stress and confusion as you navigate nursing school courses. It can also help your career outlook because you'll already have a professional network when you graduate.

Certified nursing assistants are in high demand, and the need is projected to continue through the next decade. The BLS predicts CNA career growth of 4% between 2022 and 2032. 

This number will only increase as the baby boomer generation ages, and there is an increased demand for additional long-term nursing care facilities. Nursing assistants will be needed to care for this population which is more likely to suffer from dementia and other neurologic changes.

If you're interested in becoming a CNA, you might also want to check out these other healthcare careers you can start working in quickly!

CNA vs Medical Assistant

While certified nursing assistants and medical assistants (MAs) have some similarities, they are not the same job. Both careers assist doctors, nurses, and other healthcare providers with treatments, procedures, and tests. However, MAs primarily conduct patient assessments and evaluations as they assist doctors with patient care and treatment.

On the other hand, certified nursing assistants focus on direct patient care and have specific job-related duties that are dictated by their state of employment.

>> Related: Medical Assistant vs CNA: What's the Difference?

CNA vs LPN

To become an LPN, you must pass a state-mandated exam and obtain a nursing license. On the other hand, CNAs only need to obtain a certification to practice.

Though both career paths don't require a college degree to practice, LPNs have higher education requirements than CNAs. For example, LPNs gain a deeper knowledge about healthcare and the human body during their year-long training programs. Such additional knowledge allows them to perform more complex procedures that CNAs cannot, like inserting a peripheral intravenous catheter.

CNA vs STNA

State-tested nursing assistants, or STNAs, essentially have the same role as CNAs. The only difference is their state of practice. While most states use the CNA title, Ohio uses STNA. You can learn more about the differences in these careers in our STNA vs CNA guide.

Professional nursing organizations such as the Nursing Association of Health Care Assistants are great resources for information about becoming a CNA. Being a member of an organization provides you with several professional development opportunities, including:

• Discussions on growing healthcare trends impacting CNAs
• Healthcare conventions for nursing assistants
• Access to education hours
• Job boards and opportunities
• Contact information for local chapters

These associations are more than just a great resource for new CNAs. They also provide vital information for those who are already established in their career. By joining these professional organizations, you can make vital connections with industry experts and managers, leading to future career growth opportunities.

• What Does CNA Mean?

  • CNA stands for Certified Nursing Assistant. 

• What Does a Nursing Assistant Do?

  •  A CNA assists with nursing duties in patient care–this can include everything from help with grooming, bathing, feeding, and activities of daily life. 

• How Much Do CNAs Make an Hour?

  • A CNA's median hourly income is $18.33, according to the BLS.

• How Long is CNA Training?

  • You can become a CNA in as little as 4-12 weeks. 

• What State Pays CNAs the Most?

  • The District of Columbia, Alaska, California, Oregon, and Washington are the five highest-paying states for CNAs.

• What is the Difference Between a CNA and an LPN?

  • A CNA is a nursing assistant, while an LPN is a Licensed Practical Nurse. An LPN has more responsibilities and earns more than a CNA.

• How Much Does it Cost to Become a CNA?

  • You can complete nursing assistant training for under $1000. 

• How Can I get my CNA Faster?

  • Most CNA programs can be completed in a matter of weeks. 

• What Type of CNA Earns the Most?

  • CNAs who work at dentist offices earn the highest salaries.

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