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Job Search and Career Goals of Nursing Assistants

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According to William H. Crown, author of the article "A National Profile of Homecare, Nursing Homes, and Hospital Aides," information about how nursing assistants choose their first jobs is scarce. It is probable that job searches are influenced by supply and demand hiring processes. These processes concern the need of health care employers to hire a certain number of nursing assistants to fill job slots vacated by others. Human resources specialists tend to hire people who have the aptitude to do the job. These hiring decisions are not infallible and can create either positive or negative outcomes. A job fit is vital to career success and requires thorough pre-employment inquires to make valid hiring decisions. Job applicants who are selective about getting and keeping jobs tend to gather enough data to decide whether this career path is suitable for them. Job satisfaction comes when the right people are chosen for the right jobs.

The majority of adults look for jobs that offer them interesting work, steady employment, and on-the-job opportunities to gain professional advancement and personal fulfillment. Employment studies show that adults want to do a good job. They feel self-satisfied when they have opportunities to complete job tasks to the best of their abilities and when they are recognized and rewarded for their efforts. Examples of job recognition happen at problem-solving sessions when nursing assistants are requested to share their ideas and feelings without fear of reprisal. Involvement in group processes develops critical thinking skills and fosters feelings of belonging and job satisfaction.

Nursing assistant careers involve more than having the know-how to assist nurses. Nursing assistants are intelligent people who dedicate their time, talents, and energies to the care of helpless people who need them. Career searches require careful inquires and the desire to make honest appraisals about job placement opportunities.

Career Disillusionment

Career disillusionment often occurs in situations when human resources specialists are pressured by nursing directors (D.N.S.s) to fill nursing assistant job slots as quickly as possible. In these situations, human resources/D.N.S. decisions are rushed and often result in poor candidate selections. Many people want to help others. Some have the personal aptitude and personality to become successful nursing assistants; others do not. Applicants without these attributes should be counseled to study other career choices.

Transitory Workers

Some people accept nursing assistant positions because they are between jobs or can't get a job within their occupation or profession. They often are responsible people who value this work experience, do a good job, and resign with notice when employment opportunities become available within their chosen field. Others accept nursing assistant positions because they need a job for a while and plan to resign as soon as possible. They tend to complete training courses and quit within a short time after being hired. These transitory nursing assistants often cite job dissatisfaction as their primary reason for leaving. In all probability, they should not have accepted these positions because they knew, prior to accepting employment, that they would not enjoy the work.

Case Study

Janet M., aged nineteen, was a job applicant who gained employment as a nursing assistant trainee. She attended training classes and became certified to practice as a C.N.A. After her personal goals were met, Janet quit. She confided to her instructor that she quit because she hated her job but pretended to like it until she could pay off an outstanding loan. She added that C.N. A. certification would look good on future job applications.

In this instance, Janet's behavior was unfair to her employer, her instructor, her peers, and the experienced staff members who were her mentors during the training and precertification periods. She was also unfair to the applicant who might have been selected in her place. Training time and money were spent on a nursing assistant who apparently did not consider that honesty is an important personal value.

Career disillusionment has produced an 85 percent job turnover for nursing assistants. Rapid job turnover is cost prohibitive for health care employers who must constantly hire and train new nursing assistants. To cut costs they lower pay scales and increase job responsibilities, which create feelings of job burnout and dissatisfaction. These universal work standards have discouraged responsible, mature adults from seeking opportunities to become nursing assistants.

Health care administrators, human resources specialists, and D.N.S.s are aware of hiring/retention problems and are actively seeking solutions. Career decisions require time and commitment: time to gather information and commitment to make careful career decisions. An important hiring intervention is to find a career match between person and job. Improved interview techniques and aptitude assessment tools have been developed for this purpose. Positive employee retention interventions include on-the-job advancement opportunities that increase job skills expertise. Opportunities to use different skills and abilities create feelings of job enrichment and add new sources of job satisfaction. Nursing assistants can become multi-skilled workers by participating in work experiences that offer them opportunities for cross-training. Based on the principles of supply and demand, the more skills nursing assistants have, the higher pay scales will become--a bright prospect for those with the aptitude to work in this challenging career.

Career Aptitude

The term career relates to a summary of work experiences that people engage in during their lifetimes. Aptitude refers to personality traits and human potential. Nursing assistants are intelligent people with emotional stamina, strong personal belief systems, and a commitment to the work ethic.

Human Dignity

The United States Constitution guarantees that each citizen is valued and possesses the right to life, liberty, and the pursuit of happiness. Adults with the aptitude to become nursing assistants value each patient as a person and make sure everyone is treated with human dignity in all their caring practices.

Lack of Personal Prejudice

Nursing assistants who consider the uniqueness of each person tend to be unbiased in their dealings with others. Unbiased people treat other people with respect regardless of differences in culture, race, religion, age, and sex.

Respect for Personal Confidentiality

Nursing assistants value the need to keep patient care information confidential. They are not gossips and will refuse to listen to others' often misinformed opinions about patients, family members, or work colleagues.


Nursing assistants are empathic in their caring interactions. Empathy is a learned skill that requires an aptitude for compassion. Compassionate nursing assistants identify with patients who are in pain, although they themselves do not experience the pain. The ability to use empathy as a nursing intervention is a universal value recognized by all nursing staffs wherever they care for patients.


Nursing assistants desire to protect and support patients in their quest to get well. They do so through nurturing interventions that include empathy, therapeutic touch (holding a hand), and listening. Nurturing is a necessary intervention in many patient care situations.


Honesty is the intent to follow the truth. Honest nursing assistants value the truth and are willing to admit their mistakes, even when they expect negative outcomes.

Work Ethic

Nursing assistants who value a strong work ethic are honest in their work practices. They arrive to work on time, properly attired and ready for work; they give their work tasks full attention and strive to complete work tasks to the best of their ability.

Mature Behavior

Mature behavior is expected of reasonable adults who are at home, work, church, or at any other social or civic function. Adults may feel angry, but they do not have to choose to act out in angry ways. Mature adults choose to maintain positive attitudes and behaviors. Nursing assistants are expected to conduct themselves as mature adults on and off the job.

Human Personalities

Human personalities are formed from three elements: inherited traits, environmental conditions, and parenting skills. Most experts agree that personality traits and coping skills are formed by the time children are between the ages of five and seven years old.

Work Personalities

Work personalities involve personal traits formed in childhood and aptitudes learned from life experiences, attitudes, and behaviors.

Personality Differences

Personality has an effect on how people approach their work. The following case scenario describes how misunderstandings happen when people with different personalities work together. It is important to understand personality differences between yourself and others.

Case Scenario

Four new C.N.A.s were assigned to work on a skilled nursing unit. Experienced C.N.A.s helped acclimate them to unit operations and advise them about patient care issues. Each of the four new C.N.A.s had problems adjusting, so the assigned mentors asked the head nurse for her assistance. During a meeting, it was noted that personality differences might be involved. Each mentor was asked to identify what the problems were and how they affected staff relations.

Nursing Assistant 1-The Perfectionist: The perfectionist was very organized during the performance of her work tasks. She used her five senses to discover patient problems and reported them with efficiency. However, she criticized others' work habits.

Nursing Assistant 2-The Peacemaker: The peacemaker was a nurturing person who performed her job tasks well but tended to make emotional decisions. She went along with her peers whether or not their actions were correct because she did not want to make scenes. She appeared to be the type of person who wanted peace at any cost.

Nursing Assistant 3-The Thinker: The thinker was very responsible about her work and handled job problems with ease. However, she refused to perform work tasks until her questions were answered to her satisfaction. In addition, the timing of her questions was often inappropriate.

Nursing Assistant 4-The Fortune Teller: The fortune teller loved to learn and trusted her instincts. A future-oriented person, she was unconcerned with the details of the present moment. When questioned about her incorrect temperature reading, she responded that it did not seem important to her that the reading was "off a bit."

At the meeting's close, the head nurse explained how to implement a corrective plan. Each mentor met with her assigned new C.N.A. to discuss performance benefits and problems. Positive behaviors were applauded and negative behaviors were identified. The new C.N.A.s developed corrective plans designed to create unit harmony and team cooperation.

Mentors and new C.N.A.s consulted with the head nurse, as needed, and positive outcomes were eventually produced. Nursing assistant 1 decreased her need for perfectionism, nursing assistant 2 decreased her tendency toward peace at any cost, nursing assistant 3 found the right time and approach for questioning others, and nursing assistant 4 became more accurate in tasks that required exact measurement (vital signs, height, weight, and specimen collection).

Working with People

Working with people in nursing is different from working with people while employed at McDonald's . Food servers at McDonald's work with people who live independent lives. Nursing assistants work with people who live dependent lives, people who are often frightened about their health. Nursing assistants do not wash the counters, clean the stoves, turn off the machines, flip off the light switches, and go home. Nursing is a seven-day, twenty-four-hour job caring for people who may or may not get well.

Basic definitions about working with people include two behaviors: the need to like yourself and the need to like others. According to Richard N. Bolles, author of What Color Is Your Parachute?, adults who have people skills are of normal intelligence, communicate and work well with others, and maintain a sense of humor in times of stress. Nursing assistant job tasks involve serving, treating, persuading, and diverting patients in efforts to support the healing process.

Calm Demeanor

It is difficult to remain calm when the workplace tends to be hectic and stressful. Coping with nursing's stressful work environments is a skill that can be mastered by the majority of nursing assistants who have the desire to learn. Coping skills include the use of relaxation techniques to foster abilities to focus on work tasks with a calm sense of purpose. Excitability tends to create unsafe working conditions, because this state of mind interferes with the ability to concentrate. Inattention causes people to make mistakes.


Nursing assistants tend to be people who like to interact with others through communication skills like speaking, listening, reading, and writing. They observe body language and report suspected patient problems to nurses in charge. Communication skills can be learned and adapted for the performance of nursing assistant work tasks.

Verbal Skills

Nursing assistants persuade patients to cooperate with treatment modalities, encourage personal independence, and discuss patient care issues at forums such as shift-to-shift reports and patient care meetings.

Attentive Listening

Listening attentively honors speakers and gives them a chance to share personal views and feelings. The healing process is enhanced when patients are encouraged to share their feelings of pain, fear, and anxiety.

Nonverbal Skills

Observation techniques are a vital part of patient care procedures and practices. Nursing assistants provide personal care services for patients during treatment. Nursing assistants have ample opportunities to observe and report patient responses that enable nurses to identify existing problems. Approaching patients in a calm, good-natured way puts patients at ease and encourages them to express their feelings and concerns. Attention to what patients say and how they behave are important observational skills. Some patients deny having pain, but they behave as if they do have pain. When patient verbal expressions and body language differ, nursing assistants should report these findings to their nurses in charge.

Reading and Writing

Reading and writing are important communication skills that support good patient care outcomes. Nursing assistants must be able to read and write in English with clarity and brevity. Knowledge of a second language, especially Spanish, is beneficial for nursing assistants and the patients in their care.


Motivating others requires the potential to divert negative attitudes and behaviors that impede the healing process. Some motivational techniques include listening skills, an empathic attitude, and a good sense of humor. Humor is a therapeutic tool used by people who have the ability to laugh at themselves by telling funny but inoffensive jokes or stories about comical incidents that happen during the course of a day. Human beings have a natural sense of humor that can be activated when they be-gin to look on the bright side of life.

The Use of Creativity

Creativity is the ability to use one's imagination. Nursing assistants develop and use their imaginations to create therapeutic environments for their patients. Most human beings have creative traits that may lie dormant in the recesses of their minds. Examples of using creativity as a therapeutic tool include a pleasing hair style, a varied and beautiful flower arrangement, or an appetizing meal tray.

Case Study

Mrs. G., a ninety-one-year-old resident, behaved in manipulative ways at bedtime. She demanded extra time and attention regarding the placement of her bed pillows. No matter how often Gina Mays, C.N. A., fluffed her pillows and changed their position, Mrs. G. was dissatisfied, and when Gina left her to care for others, Mrs. G. rang her call bell for further assistance. When Gina responded, Mrs. G. said, "I need attention because I have more problems than the others." Finally, Gina tried a creative approach to the problem. She encouraged Mrs. G. to show her how to fluff and position her pillows, and Gina pretended to position them as she was taught. The patient responded, "Darling, this is just right."

The use of creativity to deal with Mrs. G.'s pillow placement problems produced positive results. Mrs. G. was satisfied, and Gina was able to complete her work tasks without further interruption.

Nursing Information

Nursing is an occupation with a vast body of knowledge. Data collection requires the aptitude to be observant, report findings, question uncertainties, and explain ideas. The ability to discuss issues in objective ways is a learned skill that involves the ability to speak and listen with clarity. Nursing department informational systems, such as shift reports, provide opportunities to share information.

Computer Skills

The use of computers to gather and store information is an important communication tool in nursing. Nurses and nursing assistants are expected to be computer literate in some work environments. Computer literacy is needed to input, store, and access patient care information. In the future, computer literacy skills will probably be included in nursing assistant training curriculums.

Work Environments

Nursing's work environments are filled with people, technological machines, environmental noise and odors, and patient care supplies needed to complete patient care tasks.

Machine Noise

Machines can create high noise levels. They are attention-getting devices that are designed to beep, buzz, sigh, or make whirring noises. Some machines produce fire alarm sounds when they malfunction. Environmental noises also include ringing telephones and computers that beep and/or send and receive voice messages.

Environmental noises can be handled through selective listening skills, that is, the learned ability to differentiate between sounds. Normal environmental noise can be tuned out; abnormal sounds must be recognized and dealt with immediately.

Human Calls for Assistance

Patients get staff attention by clicking call bells that flash on and off. Some patients call out by yelling "Nurse, nurse." These kinds of signals can be annoying when staff members are working hard to complete routine tasks. Annoying or not, each patient is entitled to receive attention when it is humanly possible to do so.


Unpleasant odors that flow into nursing's work environments are caused by poor personal hygiene, human excreta, and illnesses that cause the body systems to break down. Sometimes offensive odors are present in rooms where there are dying patients. Empathic nursing assistants learn how to concentrate on patients' needs and ignore the odors until they can be eliminated. Most odors are attended to and eliminated as soon as possible.

Hectic Work Days

Work tasks and routines tend to run on schedule on days when nursing's work environments are free of interruptions. These days are rare, and work tasks must be altered to meet the needs of immediate situations. Examples of altered work tasks include situations in which physicians must see their patients at 8:30 A.M. instead of 10:30 A.M., or when uninformed housekeepers start wet-mopping patient unit floors at the same time nursing staffs are rushing to perform delayed morning care tasks. These situations require the aptitude to deal with other team members with patience and to remain mentally focused and in control. Chaotic days require a personal intent to do one's best and not take oneself or the work situation too seriously.

Unrealistic Expectations

High demands and unrealistic expectations are sometimes placed on nursing assistants by patients, work colleagues, and supervisors as they strive to perform their work tasks. When these problems arise, they must seek assistance to work out positive solutions for negative work situations that create personal stress. Problem solving can take time and patience. Those with the ability to be persistent and determined to find solutions create therapeutic environments for patients and themselves and experience feelings of accomplishment and job satisfaction. Nursing's workplaces are challenging but personally rewarding environments.

Caring for others become positive life experiences for those with the right aptitude and attitude.

Lifestyle Preferences

Individual lifestyle preferences should be addressed when conducting a career search. Budget needs, commuting distance, family responsibilities, time orientation, and opportunities for leisure are important personal concerns that require preemployment scrutiny.

Family Budgets

The match between family finances and employer benefits is an important issue. Does the salary meet family budget needs? Family budgeting requires portioning out weekly/biweekly or monthly incomes to meet family expenses for housing, food, clothing, gas and electric, travel, leisure, and other issues that may pertain to a particular family. Does the job include needed job benefits? Job benefits add between 25 and 35 percent to annual salary rates.

Commuting Distance

Will the salary compensate for commuting time and distance to and from work? Is there available public transportation near home? Is the job located in a rural area where there is no public transportation? If this is the case, are there car-pooling opportunities at work, or would it be necessary to purchase a car? Car purchases/leasing options can produce financial difficulties if salaries do not compensate for the necessity to own or lease a car.

Family Responsibilities

Fifty-one percent of women of childbearing age are currently in the workforce. The needs of working mothers are a major consideration for families and employers alike because child care issues can directly impact on employee production. It is difficult for a mother to leave a child at home and come to work. She must ensure that her child will receive adequate care and supervision while she is away. Working mothers and single fathers need opportunities to find good day care services and flex-time opportunities that meet their family's needs before taking a job.

In households where breadwinners are middle-aged adults, there is probably a need to look for career opportunities that offer access to geriatric day care centers. In addition, many mid-life adult workers have the responsibility of finding care for small children and/or teens.

Time Orientation

People have different time orientations or biorhythms that are a part of their genetic inheritance and cause them to feel more/less energetic at different times during each twenty-four-hour day. Some people are more alert in the morning and would be more energetic working the day shift. Others cannot get the day started until three o'clock and would feel more energetic working evening shifts. The rest feel alert at night and would be more energetic working night shifts.

Time orientation also relates to how people react to the passing of time. Adult workers who live in the past do not want change and fight the implementation of new ideas. Those who live for today might not view being on time for work important and often have a difficult time understanding why their employers are annoyed with their tardiness. Those who are future oriented tend to be impatient and hard to please. Before accepting a job, it is important to look at individual biorhythms and reactions to the passing of time and the ability to adjust them to an employer's needs.


Leisure time activities are important for good mental health, and nursing assistant careers provide ample time to enjoy these pursuits. Problems arise when some nursing assistants are unable to leave their work problems at their workplaces. Nursing assistants who cannot take a day off without worrying whether their peers will care for their patients and they would create emotional tension for themselves and negative interactions with their peers. Time off from work to enjoy other life pursuits is necessary for good job performance and the ability to work well with others.
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