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Nursing Assistants

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Nursing assistants are a diverse group of adult workers who come from different cultures and work hard to care for those who cannot care for themselves. Nurses depend on them and their diverse support services and often agree that nursing assistants help promote efficiency and effectiveness. This article will introduce this career and describe people who work as nursing assistants.

The Demographics of Nursing Assistant Careers

Currently there are more than 1.3 million employed nursing assistants, according to Occupational Outlook. During the beginning years of the twenty-first century, job opportunities for nursing assistants are expected to increase more than 35 percent. Future-of-work projections show that there will be 455,000 new jobs for nursing assistants.

Rationale for Career Growth

People are living longer, and, in the near future, an estimated one in four people will be aged eighty-five and over. Aging is a normal life process and longevity is not a disease. However, some aged people will need nursing assistant services because of the effects of chronic illnesses or health conditions that leave them unable to care for themselves. Some health conditions are caused by genetic defects that become evident during mid-life and worsen with age. Parkinson's disease is an example of a genetic defect that attacks and destroys nerve cells throughout the body. It is often diagnosed during mid-life and worsens with age. People with untreated high blood pressure (hypertension) are prone to develop heart disease, stroke, and kidney disease. Hypertension is known as a silent killer because it is symptomless, and people do not realize that they have this health condition.

Future Work Trends

According to United States Labor Department statistics, hospitals employ one-quarter (325,000) of the 1.3 million working nursing assistants and more job opportunities are becoming available. Nursing homes hire approximately one-half (625,000) of this work group to care for frail elderly people (aged eighty-five and over), the fastest growing population in the United States. These hiring trends are expected to continue, and by 2005 there will be a 92 percent increase in job opportunities for nursing assistants in home health agencies. Adult day care centers also are expected to expand their services. Public demand for nursing assistant services has escalated because of two reasons. Shrinking hospital budgets required the hiring of fewer nurses and more nursing assistants, and the largest employed population group (baby boomers) will need more nursing assistants to care for elderly parents at home or at adult day care centers. Some baby boomers will need home care services for infants and children who have health conditions that warrant these services.

New types of mental health centers will become available to care for frail elderly people who have untreatable dementias (memory loss) and depression. Mental health centers also will provide drug treatment programs for younger adults. Nationwide, mental health centers will provide many new job opportunities. Medical offices, schools, and the military will increase job availability for nursing assistants.

Female Nursing Assistants

The majority of nursing assistants are women aged twenty-six to thirty-six; and mid-life women aged thirty-nine to fifty are the second largest group. For many of these women, this is a second or third career. Female nursing assistants are often single heads of households and sole financial supporters of children aged six to eighteen. The majority of these women work for nursing homes. Those who work for community home health agencies tend to be over fifty years old and do not have small children at home. This trend is changing as many grandparents are now taking over parental responsibilities. A significant number of younger women (eighteen to thirty-nine) are now being recruited to enter this career. Among this group are displaced homemakers, many of whom are single mothers. Opportunities for on-the-job training courses and flex-time work schedules offer great career benefits for single mothers of small children.

Male Nursing Assistants

Men represent 35 to 40 percent of 1.3 million employed nursing assistants; the majority of them work for hospitals. The percentage of males in this vocation is increasing nationwide. Mid-life men, many of whom have lost manufacturing jobs due to downsizing, are looking for new career opportunities within the expanding field of health care. Younger men are being recruited to view this career as an opportunity to work in a valued occupation.

Information about female and male nursing assistants comes from a study conducted by the National Councils of State Boards of Nursing, Job Analysis Nurse Aides, and two articles entitled, "A Profile of Pennsylvania Nurse's Aides" and "A National Profile of Homecare, Nursing Home, and Hospital Aides."

High School Students

U.S. Labor Department data indicate that there are opportunities for high school students aged sixteen to eighteen to work as nursing assistants. They should have on-going supervision because their life experience is limited and they need caring workplace mentors. High school students need limited work hours that will not interfere with study time, and they should not be expected to work night shifts. Each state has its own regulations about the employment of high school students.


National statistics about the elderly show that the majority of retirees are healthy, energetic, and actively engaged in life pursuits. Many retirees want to work to supplement pensions and social security funds. Nursing assisting offers part-time, per-diem, and flex-time opportunities for retired workers. Employers, such as McDonalds and Wal-Mart, recruit retirees because they are capable workers who interact well with others and are rarely absent from work. In addition, employers do not have to provide employee benefits.

Nursing assistant careers offer possibilities to engage in challenging work, experience professional growth, and take advantage of attractive career ladders. These are important considerations for both men and women who are seeking a new career path.

Professionals and Paraprofessionals

Registered nurses (R.N.s) are known as licensed professional nurses, practical nurses are known as licensed practical nurses (L.P.N.s), and certified nursing assistants (C.N.A.s) are known as paraprofessionals. These occupational groups work together within the occupation of nursing.

Registered Nurses

R.N.s are professional nurses who study nursing's vast body of knowledge, techniques, and skills through formal education programs at accredited educational institutions (colleges or nursing schools). After completing a required course of study (courses last from two to five years), nurse graduates participate in two-day testing programs that demonstrate their mastery of nursing knowledge and skills. Successful candidates are licensed to practice as professional registered nurses.

Licensed Practical Nurses

L.P.N.s study nursing's vast knowledge, techniques, and skills through formal education programs at vocational/technical schools for a year before they qualify to participate in a day-long written licensing examination. Successful candidates are licensed to practice as licensed practical nurses. The L.P.N. course of study requires less time and content than the R.N. course of study.

Nursing Assistants

Nursing assistants are known as paraprofessionals who study a small portion of nursing's vast body of knowledge and techniques at training centers (high schools, vocational adult education courses) or at health care institutions (hospitals, nursing homes, or home health agencies). Nursing assistant graduates are tested for mastery of knowledge and skills, within their scope of practice, and are then certified to practice as certified nursing assistants. The nursing assistant certification process is not equal to the licensing of R.N.s and L.P.N.s.

Scope of Practice

R.N.s' scope of practice relates to The Nurse Practice Act, which concerns mastery and application of nurse functions when caring for patients. For example, registered professional nurses are expected to know how to start an intravenous infusion (IV). However, they are not expected to know how to perform an IV cut down, because that surgical procedure is within the physician's scope of practice. R.N.s are supervised by physicians or dentists.

L.P.N.s' scope of practice relates to The Practical Nurse Act, which concerns mastery and application of nurse functions when caring for patients. L.P.N.s can start IVs in some states. They are not permitted to start blood transfusions or perform other functions delegated to the R.N. scope of practice. They are supervised by physicians, dentists, and R.N.s.

Nursing assistants' scope of practice relates to federal guidelines (OBRA), which concern mastery and application of nurse assistant functions when caring for elderly patients. Measurement of vital signs (temperature, pulse, respiration, and blood pressure) is legal certified nursing assistant (C.N.A.) job functions because they are within the nursing assistant scope of practice. Setting up fluid delivery systems (IVs) are not legal job functions for certified nursing assistants because these functions are not within their scope of practice.

Activity: Finding Nursing Assistant Career Opportunities

How many jobs for nursing assistants are available in your community? Where are they? To find the answers to these questions you need to do some newspaper and telephone research. First, do newspaper research. Look at the employment pages in your local newspaper. Find the nursing section. Count jobs available for nursing assistants. When you know how many jobs are available, take your pencil and write down where the majority of jobs are located. Are they in nursing homes, hospitals, home health agencies, or adult day care centers? Are there other types of health care employers (medical offices, schools, Veteran's Administration hospitals) looking for nursing assistants in your community?

Next, open your local telephone book to the sections titled "Health, Hospitals, and Nursing." Count how many health-care businesses are listed in your community. List how many health care businesses are possible sources for employment as a nursing assistant. How many jobs are available in your community and where are they located? Look over your list to learn where the jobs are.
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