How to Become a Certified Nursing Assistant (CNA)

Quick answer: how to become a CNA

Complete a state-approved CNA training program (4-12 weeks), pass your state’s competency exam (written and skills test), and register on your state’s nurse aide registry. Most CNAs start working within 2-3 months of beginning training, making this one of the fastest paths into healthcare.

What does a Certified Nursing assistant do?

Certified Nursing Assistants provide direct, hands-on care to patients in hospitals, nursing homes, and other healthcare settings. They work under the supervision of licensed nurses to help patients with daily activities and monitor their basic health status.

Primary Responsibilities

Daily Patient Care:

• Help patients bathe, dress, and maintain personal hygiene
• Assist with eating and drinking
• Help patients move between beds, wheelchairs, and other locations
• Turn and reposition bedridden patients to prevent bedsores
• Assist with toileting and incontinence care
• Make beds and change linens

Health Monitoring:

• Measure and record vital signs (temperature, pulse, blood pressure, respiration)
• Observe and report changes in patient condition
• Document food and fluid intake and output
• Monitor patient skin for signs of breakdown
• Report patient concerns to nursing staff

Support Activities:

• Answer patient call lights promptly
• Transport patients to tests and procedures
• Set up meal trays and assist with feeding
• Stock supplies in patient rooms
• Collect specimens for laboratory testing
• Provide emotional support and companionship

Work Environment

CNAs work in close physical contact with patients, performing tasks that require lifting, bending, and standing for extended periods. Work settings include:

• Nursing homes and long-term care facilities
• Hospitals (medical, surgical, and psychiatric units)
• Assisted living facilities
• Home health agencies
• Rehabilitation centers
• Hospice care facilities

CNA certification requirements by state

CNA certification is state-regulated, with each state setting its own training and testing requirements. However, all states follow federal minimum standards for CNAs working in Medicare/Medicaid-certified facilities.

Federal minimum requirements

• Training Hours: At least 75 hours (16 hours clinical)
• Competency Evaluation: Written and skills demonstration exam
• Registry Placement: Name placed on state nurse aide registry

State training hour requirements (examples)

State competency exam

All states require passing a competency evaluation consisting of:

Written Examination:

• 60-100 multiple-choice questions
• Topics include safety, infection control, patient rights, communication, basic care skills
• Administered by Pearson VUE, Prometric, or D&SDT depending on state

Skills Demonstration:

• Perform 3-5 randomly selected nursing skills
• Skills may include hand hygiene, vital signs, positioning, and personal care
• Evaluated by state-approved nurse evaluator

Maintaining Certification

• Work at least 8 hours as a CNA every 24 months
• Complete required in-service training (12 hours annually in most states)
• Renew registration per state requirements (typically every 2 years)
• Report address changes to state registry

Step-by-step path to becoming a CNA

Step 1: meet basic requirements

Age: Minimum 16-18 years old (varies by state)

Education: High school diploma or GED (some states allow enrollment without, but require for certification)

Background Check: Criminal background check required; certain convictions may disqualify

Health Requirements:

• Current immunizations (Hepatitis B, TB test, flu vaccine)
• Physical exam demonstrating ability to perform CNA duties
• Drug screening (many programs and employers require)

Step 2: complete a state-approved CNA training program

Training programs are offered by:

• Community colleges
• Vocational/technical schools
• Nursing homes and healthcare facilities
• Red Cross chapters
• High school career programs
• Hospitals

Core Curriculum Topics:

• Body mechanics and patient mobility
• Personal care and hygiene assistance
• Vital signs measurement
• Infection control and standard precautions
• Patient rights and confidentiality
• Communication with patients, families, and staff
• Safety and emergency procedures
• Nutrition and hydration
• Mental health and behavioral management
• End-of-life care

Step 3: complete clinical training

Clinical experience takes place in healthcare facilities under nurse supervision:

• Practice skills learned in classroom
• Work with actual patients under supervision
• Learn facility protocols and documentation
• Develop time management and prioritization skills
• Build confidence in patient care

Step 4: pass the state competency exam

Exam Preparation:

1. Review all course materials and skills checkoffs
2. Use state-specific practice tests
3. Practice skills with timing (most allow 10-15 minutes per skill)
4. Study common skills tested: hand hygiene, vital signs, positioning, perineal care

Exam Day:

1. Arrive early with required ID
2. Complete written portion first
3. Perform skills demonstration
4. Receive pass/fail notification (same day or within 10 days)

If You Don’t Pass:

• Most states allow 3 attempts within 2 years of program completion
• Can retake only the portion failed (written or skills)
• May need to repeat training after 3 failed attempts

Step 5: register with state nurse aide registry

After passing:

• State adds your name to the nurse aide registry
• You receive certification number
• Employers verify your status before hiring
• Maintain active status through work requirements

Training programs and education options

Program types comparison

Free and low-cost training options

Employer-Sponsored Training: Many nursing homes and healthcare facilities offer free CNA training in exchange for a work commitment (typically 6-12 months). Benefits include:

• No tuition cost
• Paid or stipend during training
• Guaranteed employment upon completion
• Uniform and supplies provided

Workforce Development Programs: State workforce agencies may cover training costs for qualifying individuals:

• WIOA (Workforce Innovation and Opportunity Act) funding
• SNAP Employment and Training
• Vocational rehabilitation programs
• Dislocated worker programs

What to look for in a program

State Approval: Must be approved by your state’s nursing board or health department

Pass Rates: Ask about first-time exam pass rates (aim for 80%+)

Clinical Sites: Quality clinical sites with adequate patient exposure

Schedule Options: Day, evening, and weekend classes available

Job Placement: Employment assistance and employer connections

Cost breakdown: CNA training

Tuition and Fees

Additional Expenses

Financial aid options

• Employer Sponsorship: Free training with work commitment
• Workforce Development: WIOA and state-funded training
• Payment Plans: Many schools offer installment options
• Scholarships: Healthcare association scholarships
• Pell Grants: For longer certificate programs at Title IV schools
• State Grants: Many states offer healthcare training grants

CNA Salary and Job Outlook

National salary data

Salary by Experience Level

Salary by Work Setting

Job Outlook

• Current Employment: 1,526,500 nursing assistants nationwide
• Projected Growth (2022-2032): 4% (about as fast as average)
• Annual Job Openings: 220,200 positions
• Growth Factors: Aging population, chronic disease prevalence, preference for aging in place

Salary by State

Career advancement opportunities

Specialization Options

Advanced CNA Roles:

• Certified Medication Aide (CMA): Administer medications under nurse supervision
• Geriatric Aide: Specialized elder care
• Restorative Aide: Focus on rehabilitation and mobility
• Hospice Aide: End-of-life care specialization
• Pediatric Aide: Care for children in hospitals or home settings

Specialized Settings:

• Operating room aide
• Emergency department aide
• Dialysis technician (with additional training)
• Home health aide

Nursing career pathway

Many CNAs use their experience as a stepping stone to nursing careers:

Bridge Programs

CNA to LPN Bridge:

• Accelerated LPN programs for experienced CNAs
• May reduce training time by 1-3 months
• Clinical experience counts toward program requirements

CNA to RN Bridge:

• Some ADN programs give credit for CNA experience
• LPN-to-RN programs offer accelerated path
• Employer tuition assistance often available

Other healthcare transitions

• Patient Care Technician: Additional skills training, hospital focus
• Medical Assistant: Training in clinical and administrative duties
• Phlebotomist: Specialized blood draw certification
• Physical Therapy Aide: Work with rehabilitation patients
• Health Unit Coordinator: Administrative role on nursing units

Pros and challenges of this career

Frequently asked questions

How long does it take to become a CNA?

Most CNA programs take 4-12 weeks to complete, though some accelerated programs finish in as few as 2-3 weeks. After completing training, you’ll need to pass your state competency exam. From enrollment to certification, expect 6-16 weeks total.

How much does CNA training cost?

CNA training typically costs $500-$2,500 at community colleges and vocational schools. However, many nursing homes offer free training in exchange for a work commitment, making this a no-cost option for many aspiring CNAs.

Is CNA a good career choice?

CNA work offers quick entry into healthcare, job stability, and a foundation for advancing to nursing or other healthcare careers. However, it involves physically demanding work and lower pay than other healthcare roles. It’s ideal for those who want hands-on patient care and are considering a nursing career.

What is the hardest part of being a CNA?

Many CNAs cite the physical demands (constant lifting and standing), emotional challenges (patient suffering and death), and high patient loads as the most difficult aspects. Time pressure to complete all tasks while providing quality care can also be stressful.

Can I work as a CNA while in nursing school?

Yes, and many nursing students do. CNA experience provides valuable patient care skills that enhance nursing education. Some hospitals offer tuition assistance for CNAs pursuing nursing degrees, and the flexible scheduling works well with class schedules.

How do I transfer my CNA certification to another state?

Most states allow reciprocity for CNAs in good standing. You’ll need to apply to the new state’s nurse aide registry, provide verification from your current state, complete additional training hours if the new state requires more than your original state, and may need to pass that state’s competency exam.

What’s the difference between a CNA and a patient care technician?

CNAs focus on basic nursing care under RN/LPN supervision. Patient Care Technicians (PCTs) typically have additional training in skills like phlebotomy, EKG, and catheter care. PCTs usually work in hospitals and earn slightly higher wages than CNAs in nursing homes.

Do CNAs give shots or draw blood?

Generally, no. CNAs are not licensed to administer injections or draw blood. Some states allow Certified Medication Aides (an advanced CNA credential) to give certain medications. Phlebotomy requires separate certification.

How much do CNAs make per hour?

Based on national averages, CNAs earn approximately $14-$17 per hour at the median level. Entry-level positions start around $10-$14 per hour, while experienced CNAs in high-paying settings can earn $20-$26 per hour.

What shifts do CNAs work?

CNA positions are available around the clock. Common shifts include 7am-3pm (day), 3pm-11pm (evening), and 11pm-7am (night). Many facilities also offer 12-hour shifts. Weekend and holiday work is typically required, though schedules vary by employer.

Can I become a CNA with a criminal record?

It depends on the type and severity of the offense and your state’s regulations. Most states conduct background checks and may deny certification for felonies, drug offenses, or crimes involving abuse, theft, or fraud. Some offenses may disqualify you permanently while others may allow certification after a waiting period.

What’s the job outlook for CNAs?

With 220,200 annual job openings - the highest of any healthcare occupation - CNAs face excellent job prospects. The aging population ensures continued demand for nursing assistants in long-term care, hospitals, and home health settings.

How to get started today

Ready to begin your CNA career? Follow these steps:

1. Check State Requirements: Verify your state’s training hour requirements and approved programs
2. Research Programs: Use the search tool below to find state-approved CNA programs near you
3. Consider Free Options: Ask local nursing homes about employer-sponsored training
4. Gather Documents: Prepare for background check, immunization records, and physical exam
5. Complete FAFSA: If pursuing programs eligible for financial aid

Additional Resources

State nurse aide registries

Contact your state’s nurse aide registry for:

• Approved training program lists
• Competency exam scheduling
• Certification verification
• Reciprocity applications

Professional Organizations

• National Network of Career Nursing Assistants (NNCNA): Advocacy and recognition for CNAs
• American Health Care Association: Resources for long-term care professionals

Exam preparation resources

• Pearson VUE: Practice tests and exam scheduling for many states
• Prometric: Testing services for select states
• D&SDT (Headmaster): State exam provider for various states

Career Development

• State Boards of Nursing: LPN and RN program information
• Bureau of Labor Statistics: Current salary and employment data
• Local Workforce Development Boards: Training funding opportunities