In this career guide, we’ll be discussing the complete path to becoming a Certified Nursing Assistant in the United States. As a certified nursing assistant (CNA), you will be working in a variety of medical facilities, including home health care centers, hospitals, long-term care facilities, and more. You will also be presented with ample opportunities to grow and develop, as well as transition into other roles should you wish to later on in your medical career. With that said, our objective is to make your journey to becoming a certified nursing assistant easier.
By reading over this guide, you are officially taking the FIRST step towards becoming a CNA. To help you, we have provided you below with a step-by-step process that’s easy to follow and understand. Let’s get started!
You can click on any section in the table of contents to jump to that section in this guide.
Table of Contents
What Does A Certified Nursing Assistant Do?
Overview Of The Steps To Become A Certified Nursing Assistant (CHART)
Certified Nursing Assistant Education Requirements And Prerequisites
Understanding The STATE Nurse Aide Examination (Pearson VUE and Prometic)
Renewing Your Certified Nursing Assistant License
Transferring Your Out of State Certified Nursing Assistant License
Certified Nursing Assistant Boards by State
Certified Nursing Assistant Career Paths
Certified Nursing Assistant Salary
Certified Nursing Assistant Industry Statistics
Certified Nursing Assistant Earning Potential by State
Certified Nursing Assistant Highest Paying US Cities
Choosing The BEST Certified Nursing Assistant Program For You
Search Certified Nursing Assistant Jobs In Your Area
If you are wondering what do nursing assistants do, then this section will provide you with an overview of their roles and responsibilities. Firstly, as a certified nursing assistant, you will be working closely with other members of the medical team. You will be DIRECTLY working under the supervision of a licensed practical nurse (or licensed vocational nurse), and registered nurses.
As a certified nursing assistant or CNA, you will be responsible for providing basic care to patients in helping them perform their daily activities. Some of your responsibilities will include:
Listening, measuring and recording vital signs
Assisting patients in using the toilet and getting them dressed
Clean and bathe patients
Help patients eat their food
Serve and administer patients their medication
Turn, reposition, and transfer patients between beds and wheelchairs
Before you can become a Certified Nursing Assistant, you will be required to successfully complete a STATE-approved certified nursing assistant training program. These state-approved training programs have both in-class learning and supervised clinical modules, which are necessary for the applicant to be eligible to sit the STATE nurse aide competency examination.
Each nursing assistant program in your STATE will have their own admission requirements, so ensure these are fulfilled before applying. Here are some requirements that are common amongst the programs:
1) Must meet the minimum age requirement for that program (typically 16 and above)
2) For most programs, applicants must submit proof of completion of 12th-grade education or the equivalent before admission and must hold at least a high school diploma, transcript or GED certificate. *
3) The applicant must verbally demonstrate that he/she has reasonable expectations of how the program would benefit him/her in terms of skill acquisition, academic gains or job marketability
4) Successful completion of the program’s entrance exam (if applicable)
5) Fulfillment of the program’s enrollment prerequisites (valid state ID, Social Security Card**, physical examination by a doctor, proof of a negative TB skin test or chest X-ray, etc.)
To find a list of accredited Certified Nursing Assistant programs, Visit your STATE Board of Nursing website.
The STATE nurse aide examination or NNAAP (National Nurse Aide Assessment) is divided into two (2) sections – a) the written portion, and b) the clinical (practical portion). A majority of STATE’s use third-party providers like Pearson VUE or Prometric to administer the nurse aide examination.
VISIT Pearson VUE or Prometric to find which provider administers the examination for your STATE. NOTE: If your STATE is NOT listed on Pearson VUE or Prometric, please VISIT your STATE Board of Nursing website to find out how you can register for the nurse aide examination.
In the next few sections, we’ll be exploring eligibility, registration, scope, format, scoring, etc
To be ELIGIBLE, an applicant MUST complete a STATE approved Certified Nursing Assistant training program.
If you live in a STATE that requires the Nurse Aide Examination to be administered through Pearson VUE, complete the appropriate application form for your STATE. When completing the application, you will require your personal information and a signature from the approved nurse aide program, where you completed your training. The following STATES use Pearson VUE to administer the NNAAP (National Nurse Aide Assessment) –
Alabama, Alaska, California, Colorado, District of Columbia, Georgia, Maryland, Minnesota, New Hampshire, North Carolina, Pennsylvania, Rhode Island, South Carolina, Texas, Virginia, Washington
If you live in a STATE that requires the Nurse Aide Examination to be administered through Prometric, complete the appropriate application form for your STATE. When completing the application, you will require your personal information and a signature from the approved nurse aide program, where you completed your training. The following STATES use Prometric to administer the National Nurse Aide Assessment –
New York, Idaho, Oklahoma, Louisiana, Delaware, Hawaii, Connecticut, Wyoming, New Mexico, Michigan, Florida, Arkansas
Pearson VUE Examination Structure:
Part 1 – Written – Seventy (70) multiple-choice questions.
This written section will also be split into two sections. The time you will have to complete this section is two (2) hours.
In part one (1), there will be sixty (60) multiple-choice questions that will be read out loud in an oral format. Each question will be read two (2) times. You will select and mark down the correct answer on the answer sheet.
In part two (2), there will be a total of ten (10) multiple-choice questions. The purpose of these types of questions is to test your ability to speak a minimum amount of English and determine how familiar you are with the words used as a nursing aide working in long-term care facilities. For example, each word will be read three (3) times, at which point you will match the word you hear on the tape to the written word in the test booklet.
Part 2 – Clinical – Skills Evaluation
To summarize this section of the examination, the skills evaluation will test your ability to perform nurse aide skills in a work environment. The work environment will be set up to resemble an actual caregiving situation. For example, during your skills testing evaluation, you will have all the equipment necessary to perform the assigned skills. Furthermore, this section of the examination will be administered by a Nurse Aide Evaluator.
Pearson VUE Scoring And Results:
Pearson VUE will provide score results in a PASS or FAIL format.
Your results will be made available online within a few hours after a testing event is completed for the day. To access your score report, please click here for printable instructions.
Prometric Examination Structure:
Part 1 – Written – Seventy (60) multiple-choice questions.
There will be a total of sixty (60) multiple-choice questions that evaluate your nursing assistant knowledge and skills. You will have 90 minutes to take the test.
You do have the option to take the written test in an oral format. With an oral format, you will hear each question read to you. You will answer each question on the computer afterward. If you would like to take the oral test, you should select this option on the application form. This request cannot be made on the day of testing.
Part 2 – Clinical – Skills Evaluation
This portion of the exam is timed and will be assigned by a computer. The average time ranges from 31 minutes to 40 minutes based on the skills you are asked to perform. The clinical skills testing exam consists of five (5) questions, out of which three (3) will be assigned to you by the computer. You will be scored for the other two (2) additional skills while performing the three assigned skills – Handwashing and Indirect Care.
You will be marked by a qualified Nurse Aide Evaluator (NAE)
The amount of time allocated to you to complete this portion of the exam will depend on the number and type of skills assigned to you to complete. For example, some number and type of skills are more challenging to complete, so require more time while other less complicated skills requiring less time.
NOTE: When assigned the skills to perform, you will be told how much time you have to complete the exam.
For you to successfully PASS the clinical skills testing portion, you MUST demonstrate competency of all five skills and perform them correctly.
Prometric Scoring And Results:
Prometric will provide score results in a PASS or FAIL format.
Once you have completed the examination, you will receive a printed SCORE REPORT immediately. As mentioned, the score report will be in a PASS or FAIL format. If you have passed the examination, it means you have answered the overall number of questions correctly. Please keep in mind each section on the examination has its own scoring weight. With that said, you can PASS the exam even though you may have FAILED specific content areas.
Prometric will send information on the candidate’s successful completion of the Nurse Aide Competency Examination to the state’s Nurse Aide Registry within two business days of the candidate passing the exam.
A certified nursing assistant (CNA) must renew their license every two (2) years. However, the requirements for each STATE differ. For example, as per the requirements of the STATE of California –
“a CNA MUST complete forty-eight (48) hours of In-Service Training/Continuing Education Units (CEUs) within your two (2) year certification period. A minimum of twelve (12) of the forty-eight (48) hours shall be completed in each year of the two (2) year certification period. A maximum of twenty-four (24) of the forty-eight (48) hours may be obtained only through a CDPH-approved online computer training program. You may submit the application by mail or by faxing it to our department.”
Whereas, in the STATE of Connecticut –
“you must have worked for pay as a CNA for at least eight hours during the last 24 months. Renewal periods are for two years from the last day you worked as a CNA.” – portal.ct.gov
With that said,
Make sure you VISIT your STATE Board of Nursing website to check the renewal requirements of your STATE.
You MAY BE eligible to transfer your out-of-state certified nursing assistant license through Reciprocity. Each STATE will have different requirements when accepting out-of-state CNA licenses. Therefore, we recommend that you visit your STATE Board of Nursing website to find out more about the “Reciprocity” option.
Some common STATE requirements which are needed are as follows:
1) A complete “reciprocity” STATE application
2) Legible Copy of Social Security Card
3) Legible Copy of Government Issued Photo ID
4) Copy of current State Certification Card or Web Portal Printout
5) Candidates not on a Certified Nurse Aide Registry- Must submit a copy of the Certified Nurse Aide Training Program Completion Certificate
6) Proof of Employment (review Section B)
7) Obtain your LIVE SCAN fingerprints in STATE you are requesting a license
With that said,
Make sure you VISIT your STATE Board of Nursing website to check the reciprocity requirements of your STATE.
Alaska | Alabama | Arizona | Arkansas | California | Colorado | Connecticut | District of Columbia | Delaware | Florida | Georgia | Hawaii | Iowa | Idaho | Illinois | Indiana | Kansas | Kentucky | Louisiana | Maine | Maryland | Massachusetts | Michigan | Minnesota | Mississippi | Missouri | Montana | Nebraska | Nevada | New Hampshire | New Jersey | New Mexico | New York | North Carolina | North Dakota | Ohio | Oklahoma | Oregon | Pennsylvania | Rhode Island | South Carolina | South Dakota | Tennessee | Texas | Utah | Vermont | Virginia | Washington | West Virginia | Wisconsin | Wyoming |
As a certified nursing assistant, you will have the opportunity to work in different medical facilities. Furthermore, you’ll have the chance to pursue higher education too.
Let’s explore these two options:
As a certified nursing assistant, you will have the opportunity to gain experience in many areas. For example, Nursing Care Facilities (Skilled Nursing Facilities, General Medical and Surgical Hospitals, Continuing Care Retirement Communities, and Assisted Living Facilities for the Elderly, Home Health Care Services, Individual and Family Services.
You can view additional STATISTICS HERE.
As a certified nursing assistant, you will be working long hours gaining valuable experience in many areas of medicine. As you gain more experience, you can explore ways to advance your educational qualifications. For example, certified nursing assistants can transition into becoming a Registered Nurse, a Licensed Practical Nurse, or even work towards getting your BSN (Bachelors of Science in Nursing). With that said, let’s explore each one a bit more detail:
Registered Nurse (RN): The experience you gain as a certified nursing assistant will help you as a Registered Nurse. There are many CNA-to-RN bridge programs available in the United States. The length to complete these programs varies between twelve (12) to twenty-four (24) months. After successful completion, you will need to PASS the National Council of State Boards of Nursing (NCLEX). With that said, registered nurses work long hours, and their work is very demanding. However, as you gain experience, you will enjoy improvements in salary and benefits.
Licensed Practical Nurse (LPN): transitioning from a certified nursing assistant (CNA) to a Licensed Practical Nurse (LPN) can mean a jump in salary by $22,000 per year. You’ll also enjoy more excellent benefits depending on your place of employment. As a certified nursing assistant, you can explore the option of transitioning into a Licensed Practical Nurse if you feel the time is right. There are several CNA-to-LPN bridge programs available across the United States.
CNA to BSN: Advancing your education can lead to job opportunities in demanding nursing specialties. The experience you gain as a certified nursing assistant can open the path to getting your Bachelor of Science in Nursing (BSN). When obtaining your BSN, this will enable you to branch into nursing specialties, such as becoming a Clinical Nurse Leader, Clinical Nurse Specialist, and others that can be viewed here – 61 Types of Nursing Specialties – Requirements, Demand, and Salary. This investment in your further education will also lead to a higher pay bracket, greater benefits, and more fulfilling/challenging job roles.
The average annual certified nursing assistant salary is $32,410, with the average hourly pay being $14.35.
Figures are reflective as of May 2020 (Indeed.com)
Figures are reflective as of May 2019 (bls.gov)
Figures are reflective as of May 2019 (bls.gov)
Figures are reflective as of May 2019 (bls.gov)
Figures are reflective as of May 2019 (bls.gov)
1) Is your CNA program available BOTH online and offline? Does it offer flexible studying?
The option you choose will be totally dependent upon your lifestyle, flexibility, and preference. Naturally, for those individuals who have to balance full-time jobs and a wide range of responsibilities, it may be a more convenient choice to opt for an online CNA program. Whereas, for those who have a bit more time and who prefer a more face to face interactive style of learning, then a ‘classroom’ experience may be a more favorable learning choice. With that said, there are many schools and facilities to choose from for both online and offline courses. Either way, whatever mode of learning you choose, you should ensure that the CNA program is a reputable one so that you get all the studying benefits and experience.
2) How long does it take to complete the certified nursing assistant (CNA) program?
The quicker you complete your CNA program, the quicker you can apply for jobs and start your career. With that said, there are many accelerated programs available that can be completed within a few weeks or so. Such programs that have shorter durations may be quite compact, fast, with an intense style of learning. This style, however, can be overwhelming for some individuals. Hence, in cases where time is not of a critical essence, then perhaps a longer CNA program with more in-depth learning, maybe the right pace for you.
3) Is your program your applying to accredited by your STATE Board of Nursing?
Accreditation is absolutely imperative when choosing a CNA program. Without the appropriate accreditation, you will not be eligible to sit for the licensing exam. Hence, before applying for your CNA program, be sure to check that it has been accredited by your STATE.
4) Are there any applicable student reviews/ratings about the CNA program?
Reputation and student ratings of the program is also another essential factor to consider. Naturally, as a potential student, you want to have the best access to knowledge, tuition, resources, and overall want the best learning experience possible to be able to complete the course successfully. Therefore, it’s essential to research what other fellow students have said about the course and their own learning experience. For example, you can find out their views on the quality of tuition, the ability to convert the course into future employability, the duration of the course, and so on. These areas of interest should help you make a more informed decision when choosing an appropriate CNA program.
5) What affiliations/associations does the CNA program have?
Ideally, you want to be associated with a CNA program that has a broad reach and affiliations with hospitals and other medical facilities. Through a wider pool of such affiliations, your CNA program can perhaps help you in securing a job directly. This subsequently reduces the stress and time for having to look for jobs later and independently.
6) Will the CNA program offer opportunities to transition into other progressive roles or further education?
It is essential to be associated with CNA programs which will enable you to progress into other areas of opportunity for the future. Even if your priority is to remain a CNA throughout your career, having the option to transition into other roles should not be dismissed completely. This is because, in the latter part of your career, you may want to excel further. Hence, you should consider applying to those programs that offer CNA to RN bridge programs, and so on, to help you progress with your future nursing career.
National Council of State Boards of Nursing
CNA Practice Test – Basic Restorative Services – Part 1
61 Types of Nursing Specialties – Requirements, Demand, and Salary
Pearson VUE Nurse Aide Examination
Prometric Nurse Aide Examination