Detailed Guide for

Nursing Assistants in California

May also be called: Certified Nurse Assistants; Geriatric Aides; Hospital Attendants; Nurse Aides; Nurse Assistants; and Patient Care Technicians

What Would I Do?

Nursing Assistants carry out the routine work in the general care of patients. They work under the direction of nursing and medical staff. Nursing Assistants' duties depend on training, experience, and type of health care facility. Typically, Assistants answer patients’ call lights, deliver messages, make beds, and help patients eat, dress, and bathe.

In California, a Nursing Assistant can earn the title of Certified Nurse Assistant (CNA) after state certification requirements are completed. A CNA, under the supervision of a licensed nurse, provides basic nursing services to patients in an acute care, long-term or intermediate health care facility.

Tools and Technology
Nursing Assistants use a variety of tools and technology in their work. They may use automated external defibrillators, bedpans, compresses, and electronic medical thermometers. They may also use accounting, query, medical, spreadsheet, and word processing software.

Important Tasks and Related Skills

Each task below is matched to a sample skill required to carry out the task.

TaskSkill Used in this Task
Answer patient call signals, signal lights, bells, or intercom systems to determine patients' needs.Customer and Personal Service
Turn or reposition bedridden patients.Static Strength
Provide physical support to assist patients to perform daily living activities, such as getting out of bed, bathing, dressing, using the toilet, standing, walking, or exercising.Service Orientation
Review patients' dietary restrictions, food allergies, and preferences to ensure patient receives appropriate diet.Written Comprehension
Measure and record food and liquid intake or urinary and fecal output, reporting changes to medical or nursing staff.Problem Sensitivity
Record vital signs, such as temperature, blood pressure, pulse, or respiration rate, as directed by medical or nursing staff.Monitoring
Gather information from caregivers, nurses, or physicians about patient condition, treatment plans, or appropriate activities.Oral Comprehension
Observe or examine patients to detect symptoms that may require medical attention, such as bruises, open wounds, or blood in urine.Near Vision
Document or otherwise report observations of patient behavior, complaints, or physical symptoms to nurses.Social Perceptiveness
Source: U.S. Department of Labor Occupational Information Network (O*NET) at online.onetcenter.org

Working Conditions

Nursing Assistants work in a variety of environments, including acute care, residential care, and skilled nursing facilities, as well as clinics and hospitals. Most facilities are well lit, air-conditioned, and have modern equipment. The work can be emotionally and physically demanding. Nursing Assistants walk or stand most of their work day. They must take precautions to guard against back strain from lifting patients and equipment, exposure to radiation and caustic chemicals, and catching diseases such as tuberculosis and hepatitis. Using proper safety procedures reduces personal risk. Most full-time Assistants work about 40 hours a week, but because patients need care 24 hours a day, some Assistants work evenings, nights, weekends, and holidays. Employers generally provide or pay for uniforms and supplies.

Some of these workers may belong to a union, such as the American Federation of State, County, and Municipal Employees.

Will This Job Fit Me?

This job may appeal to those with social natures who enjoy helping people and providing health care services. Nursing Assistants need to be able to communicate effectively with coworkers and supervisors in order to help meet the needs of their patients.

What Wages and Benefits Can I Expect?

Wages

The median wage in 2017 for Nursing Assistants in California is $31,102 annually, or $14.96 hourly. The median is the point at which half of the workers earn more and half earn less.

Annual Wages for 2017Low
(25th percentile)
Median
(50th percentile)
High
(75th percentile)
California$26,336$31,102$38,827
Source: EDD/LMID Occupational Employment Statistics Survey, 2017 at www.labormarketinfo.edd.ca.gov/data/wages.html Wages do not reflect self-employment.

Hourly Wages for 2017Low
(25th percentile)
Median
(50th percentile)
High
(75th percentile)
California$12.66$14.96$18.66
Source: EDD/LMID Occupational Employment Statistics Survey, 2017 at www.labormarketinfo.edd.ca.gov/data/wages.html. Wages do not reflect self-employment.

Benefits

Nursing Assistants in hospitals often receive at least one week of vacation after one year of service. Holidays and sick leave, hospital and medical benefits, extra pay for late-shift work, and pension plans are available to many hospital employees and to some nursing care facility employees. In some cases, dental and long-term disability insurance is offered.

What is the Job Outlook?

The elderly population, a group with much greater than average health care needs, will grow faster than the total population, increasing the demand for health services, especially for home health care, nursing, and personal care. This ensures continued demand for Nursing Assistants to work in the growing number of nursing homes and long-term care facilities. Further increasing the demand for Nursing Assistants is the managed health care practice of moving patients from acute care hospitals to skilled nursing facilities as quickly as possible.

In addition, the high turnover rate means that many job openings will likely occur in the foreseeable future. Many Assistants leave the occupation to attend training programs for other health care occupations. Others decide they do not enjoy the work. Therefore, persons who are interested in, and suited for, this work should have excellent job opportunities.

Projections of Employment

In California, the number of Nursing Assistants is expected to grow faster than average growth rate for all occupations. Jobs for Nursing Assistants are expected to increase by 19.3 percent, or 19,200 jobs between 2014 and 2024.

Estimated Employment and Projected Growth
Nursing Assistants
Geographic Area
(Estimated Year-Projected Year)
Estimated
Employment
Projected
Employment
Numeric
Change
Percent
Change
Additional Openings
Due to Net
Replacements
California
(2014-2024)
99,700118,90019,20019.322,500
Source: EDD/LMID Projections of Employment by Occupation at www.labormarketinfo.edd.ca.gov/data/employment-projections.html

Annual Job Openings

In California, an average of 1,910 new job openings per year is expected for Nursing Assistants, plus an additional 2,250 job openings due to net replacement needs, resulting in a total of 4,170 job openings.

Estimated Average Annual Job Openings
Nursing Assistants
Geographic Area
(Estimated Year-
Projected Year)
Jobs From GrowthJobs Due to
Net Replacements
Total Annual
Job Openings
California
(2014-2024)
1,9102,2504,170
Source: EDD/LMID Projections of Employment by Occupation at www.labormarketinfo.edd.ca.gov/data/employment-projections.html

How Do I Qualify?

Education, Training, and Other Requirements

The minimum education that employers typically prefer is a high school diploma or general education diploma (GED). In order to work in California, Nursing Assistants need to be certified, earning the title of Certified Nurse Assistant or Aide (CNA). The CNA programs, adult education, community colleges, and private training facilities may offer training. Facility-based CNA training programs do not charge tuition if the individual is employed by the facility. The armed forces provide training in related fields and those trained can challenge the test.

Nursing homes and convalescent centers are willing to train mature applicants on the job. Formal training usually lasts one to nine weeks under supervision of a general duty nurse or licensed vocational nurse. Nursing Assistants may work in a skilled nursing facility for four months from the time they enroll in training before passing the state exam. Those who cannot pass the CNA exam within that time are unable to work in the field until they pass the exam.

Acute care hospitals require high school graduation and six months to one year of experience.

Equivalency applicants are individuals who have had Certified Nursing Aide training, such as nursing services personnel from the U.S. Armed Services.

Early Career Planning

High school preparation courses in biology, chemistry, mathematics, and health science can be helpful for job preparation. Strength training may also be helpful, as Nursing Assistants may have to lift or carry patients. Volunteer work in a hospital or long-term care facility can be valuable exposure to the work setting. Regional Occupational Programs (ROPs) providing training for Nursing Assistants may be available in the local area. To find an ROP program near you, go to the California Association of Regional Occupational Centers and Programs Web site at www.carocp.org/carocps.html.

Certification

To become a CNA, applicants must be at least 16 years of age and meet the prescreening requirements. Applicants must successfully complete either an Aide and Technician Certification Section (ATCS)-approved training program or one of the Department of Education’s ROP or adult education programs for Nursing Assistants, be eligible through an equivalent training program, or be eligible through reciprocity from another state. In an ATCS-approved training program, applicants must submit fingerprints upon enrollment and complete a minimum of 50 hours of classroom training as well as 100 hours of supervised clinical training in a nursing facility. They must also successfully complete a competency evaluation conducted by an ATCS-approved testing vendor.

As part of the certification process, applicants must have a physical examination and provide a report prepared by a physician, physician's assistant, or nurse practitioner stating that the applicant has no health condition that would create a hazard to self, fellow employees, residents, or visitors. For more information, go to the U.S. Department of Labor's Career InfoNet Web site at www.acinet.org and scroll down to "Career Tools." Click on "Certification Finder" at www.acinet.org/certifications_new/default.aspx and follow the instructions to locate certification programs.

Where Can I Find Training?

There are two ways to search for training information at www.labormarketinfo.edd.ca.gov/resources/training-and-apprenticeships.html

Contact the schools you are interested in to learn about the classes available, tuition and fees, and any prerequisite course work.

Where Would I Work?

Most Nursing Assistants work in nursing care facilities and general medical and surgical hospitals. A small number work in community care facilities for the elderly and employment services as well as residential care facilities for those with intellectual disabilities and mental health issues. The largest industries employing Nursing Assistants are as follows:

Industry TitlePercent of Total Employment for Occupation in California
Nursing Care Facilities 50.2%
General Medical and Surgical Hospitals 23.1%
Community Care Facility for the Elderly 8.0%
Employment Services 4.3%
Residential Mental Health Facilities 2.6%
Source: EDD/LMID Staffing Patterns at www.labormarketinfo.edd.ca.gov/iomatrix/staffing-patterns1.asp

Finding a Job

Direct contact with employers is a good way to find a job in this field. Program placement offices in training locations may also assist in locating a position. Some applicants find jobs through newspaper or online classified advertisements. Online job opening systems include JobCentral at www.jobcentral.com and CalJOBSSM at www.caljobs.ca.gov.

To find your nearest One-Stop Career Center, go to Service Locator. View the helpful job search tips for more resources. (requires Adobe Reader).

Yellow Page Headings

You can focus your local job search by checking employers listed online or in your local telephone directory. Below are some suggested headings where you might find employers of Nursing Assistants.

Find Possible Employers

To locate a list of employers in your area, use "Find Employers" on the LaborMarketInfo Web site at http://www.labormarketinfo.edd.ca.gov/aspdotnet/databrowsing/empMain.aspx?menuChoice=emp

Where Could This Job Lead?

Nursing Assistant is the entry-level position in the nursing field and sets the foundation, skills, and knowledge that could lead to other health care occupations. With additional education and training, a Nursing Assistant can work in a specialty area such as pediatrics, geriatrics, surgery, obstetrics, orthopedics, or psychiatry. A typical nursing career path would be Nursing Assistant to CNA to licensed vocational nurse to registered nurse.

Many employers encourage advancement by giving training within the facility and offering flexible work schedules to make formal classroom study easier.

Related Occupations

Below is a list of occupations related to Nursing Assistants.

Other Sources

These links are provided for your convenience and do not constitute an endorsement by EDD.

For the Career Professional

The following codes are provided to assist counselors, job placement workers, or other career professionals.

SystemCode
SOC - Standard Occupational Classification at www.bls.gov/soc/31-1014
O*NET - Occupational Information Network at online.onetcenter.org/
   Nursing Assistants31-1014.00
   Interest Codes (RIASEC) at online.onetcenter.org/find/descriptor/browse/Interests/#curSCR

The California Occupational Guides are a product of:
The California Employment Development Department
Labor Market Information Division
www.labormarketinfo.edd.ca.gov

Printed on Monday, December 11, 2017