Nurse Assistant Career

Nurse assistants (also called nurse aides, orderlies, or hospi­tal attendants) work under the supervision of nurses and handle much of the personal care needs of the patients. This allows the nursing staff to perform their primary duties more effectively and efficiently. Nurse assistants help move patients, assist in patients’ exercise and nutri­tion needs, and oversee patients’ personal hygiene. Nurse assistants may also be required to take patients to other areas of the hospital for treatment, therapy, or diagnostic testing. They are required to keep charts of their work with their patients for review by other medical personnel and to comply with required reporting. There are about 1.5 million nurse assistants in the United States, and about 40 percent of them are employed in nursing homes.

Nurse Assistant Career History

From earliest times, healthy people have been called upon to care for the sick and injured. Methods for dealing with illness exist in all soci­eties and are a necessity for any type of community life. The social and economic development of societies throughout history has been closely tied to the fundamental need to tend to the needs of the unwell.

To care for the sick in their midst, early Greek, Indian, Chi­nese, Aztec, and other civilizations established special caregiving places resembling today’s hospices and hospitals. The spread of Chris­tianity gave new impetus to efforts for caring for the sick. Monaster­ies had infirmaries for their own sick members, and they welcomed pilgrims and travelers who were ill to use their facilities. Military and chivalric groups also tended to the sick with hospital and charity work. Two hospitals were founded in the 11th century in Jerusalem by the Knights Hospitallers of St. John, who cared for both the mentally ill and the physically ill.

Nurse Assistant CareerAs the practice of medicine has become more complex, the need for nurses—and consequently nursing aides— grew. In the 19th century a nurse named Florence Night­ingale led a movement for reform in nursing. In 1873 the first school of nursing in the U.S. was established in New York City at Bellevue Hospital.

The increased burden on trained nurses has made nursing aides irreplaceable. Aides provide basic care for those who are incapacitated or who need the same ser­vices regularly, which frees nurses and doctors to minis­ter to their patients’ diseases.

Nurse Assistant Job Description

Nurse assistants generally help nurses care for patients in hospital or nursing home settings. Their duties include tending to the daily care of the patients, including bathing them, helping them with their meals, and checking their body temperature and blood pressure. In addition, they often help persons who need assistance with their personal hygiene needs and answer their call lights when they need immediate assistance.

The work can be strenuous, requiring the lifting and moving of patients. Nurse assistants must work with partners or in groups when performing the more strenu­ous tasks to ensure their safety as well as the patient’s. Some requirements of the job can be as routine as chang­ing sheets and helping a patient or resident with phone calls, while other requirements can be as difficult and unattractive as assisting a resident with elimination and cleaning up a resident or patient who has vomited.

Nurse assistants may be called upon to perform the more menial and unappealing tasks of health and per­sonal care, but they also have the opportunity to develop meaningful relationships with patients. In a nursing home, nursing assistants work closely with residents, often gaining their trust and friendship.

Nurse Assistant Career Requirements

High School

Although a high school diploma is not always required to work as a nurse assistant, there are a number of high school classes that can help you do this work. Communi­cation skills are valuable for a nurse assistant to have, so take English classes. Science courses, such as biology and anatomy, and family and consumer science, health, and nutrition classes are also helpful. Some high schools offer courses directly related to nurse assistant training. These classes may include body mechanics, infection control, and resident/patient rights.

Postsecondary Training

Nurse assistants are not required to have a college degree, but they may have to complete a short training course at a community college or vocational school. These training courses, usually taught by a registered nurse, teach basic nursing skills and prepare students for the state certification exam. Nurse assistants typically begin the training courses after getting their first job as an assistant, and the course work is often incorporated into their on-the-job training.

Many people work as nurse assistants as they pursue other medical professions such as a premedical or nurs­ing program.

Certification or Licensing

Some states require nurse assistants to be certified no matter where they work. The Omnibus Budget Recon­ciliation Act of 1987 requires nurse assistants working in nursing homes to undergo special training. Nursing homes can hire inexperienced workers as nurse assis­tants, but they must have at least 75 hours of training and pass a competency evaluation program within four months of being hired. Those who fulfill these require­ments are then certified.

Other Requirements

You must care about the patients in your care, and you must show a genuine understanding and compassion for the ill, the disabled, and the elderly. Because of the rigor­ous physical demands placed on you, you should be in good health and have good work habits. Along with good physical health, you should have good mental health and a cheerful disposition. The job can be emotionally demanding, requiring patience and stability. You should be able to work as a part of a team and also be able to take orders and follow through on your responsibilities.

Exploring Nurse Assistant Career

Because a high school diploma is frequently not required of nursing aides, many high school students are hired by nursing homes and hospitals for part-time work. Job opportunities may also exist in a hospital or nursing home kitchen, introducing you to diet and nutrition. These jobs will give you an opportunity to become famil­iar with the hospital and nursing home environments. Also, volunteer work can familiarize you with the work nurses and nurse assistants perform, as well as introduce you to basic medical terminology.


Approximately 42 percent of the 1.5 million nurse assis­tants in the United States are employed in nursing homes, and another 27 percent worked in hospitals. Others are employed in halfway houses, retirement centers, homes for persons with disabilities, and private homes.

Starting Out

Because of the high demand for nurse assistants, you can apply directly to the health facilities in your area, contact your local employment office, or check your local newspaper’s help wanted ads.


For the most part, there is not much opportunity for advancement with this job. To advance in a health care facility requires additional training. After becoming familiar with the medical and nursing home environ­ments and gaining some knowledge of medical terminol­ogy, some nurse assistants enroll in nursing programs or pursue other medically related careers.

Many facilities are recognizing the need to retain good health care workers and are putting some training and advancement programs in place for their employees.


Salaries for most health care professionals vary by region, population, and size and kind of institution. The pay for nurse assistants in a hospital is usually more than in a nursing home.

According to the U.S. Department of Labor, nurse assistants earned median hourly wages of $10.20 in 2004. For full-time work at 40 hours per week, this hourly wage translates into a yearly income of approximately $21,220. The lowest paid 10 percent earned less than $7.40 per hour (approximately $15,400 per year), and the high­est paid 10 percent earned more than $14.19 per hour (approximately $29,520 annually).

Benefits are usually based on the hours worked, length of employment, and the policies of the facility. Some offer paid vacation and holidays, medical or hospital insurance, and retirement plans. Some also provide free meals to their workers.

Work Environment

The work environment in a health care or long-term care facility can be hectic at times and very stressful. Some patients may be uncooperative and may actually be com­bative. Often there are numerous demands that must be met at the same time. Nurse assistants are required to be on their feet most of the time, and they often have to help lift or move patients. Most facilities are clean and well lighted, but nurse assistants do have the possibility of exposure to contagious diseases, although using proper safety procedures minimizes their risk.

Nurse assistants generally work a 40-hour workweek, with some overtime. The hours and weekly schedule may be irregular, depending on the needs of the institution. Nurse assistants are needed around the clock, so work schedules may include night shift or swing-shift work.

Nurse Assistant Career Outlook

There will continue to be many job opportunities for nurse assistants; the U.S. Department of Labor predicts that this occupation will grow faster than the average through 2014. Because of the physical and emotional demands of the job, and because of the lack of advance­ment opportunities, there is a high employee turnover rate. Additional opportunities may be available as differ­ent types of care facilities are developed and as facilities try to curb operating costs.

In addition, more nurse assistants will be required as government and private agencies develop more programs to assist people with disabilities, dependent people, and the increasing aging population.

For More Information:

National Network of Career Nursing Assistants