Nursing assistants and orderlies help provide basic care for patients in hospitals and residents of long-term care facilities, such as nursing homes.
Nursing assistants, sometimes called nursing aides, provide basic care and help with activities of daily living. They typically do the following:
- Clean and bathe patients or residents
- Help patients use the toilet and dress
- Turn, reposition, and transfer patients between beds and wheelchairs
- Listen to and record patients’ health concerns and report that information to nurses
- Measure patients’ vital signs, such as blood pressure and temperature
- Serve meals and help patients eat
Some nursing assistants may also dispense medication, depending on their training level and the state in which they work.
In nursing homes, assistants are often the principal caregivers. They have more contact with residents than other members of the staff. Because some residents stay in a nursing home for months or years, assistants may develop close relationships with their patients.
Orderlies may do some of the same tasks as nursing assistants, although they do not usually provide healthcare services. They typically do the following:
- Transport patients, such as taking a hospital patient to an operating room
- Clean equipment and facilities
Nursing assistants held about 1.5 million jobs in 2012. Orderlies held about 54,600 jobs in 2012. More than half of all nursing assistants work in nursing and residential care facilities. Most orderlies work in hospitals.
The industries that employed the most nursing assistants in 2012 were as follows:
|Nursing care facilities (skilled nursing facilities)||42%|
|Hospitals; state, local, and private||26|
|Residential care facilities||14|
|Home health care services||4|
The industries that employed the most orderlies in 2012 were as follows:
|Hospitals; state, local, and private||73%|
|Nursing care facilities (skilled nursing facilities)||13|
|Ambulatory health care services||4|
|Residential care facilities||3|
The work of nursing assistants and orderlies can be strenuous. They spend much of their time on their feet as they take care of many patients or residents.
They wear uniforms to protect their clothing and to promote cleanliness.
Injuries and Illnesses
Because they frequently lift people and do other physically demanding tasks, on-the-job injuries are more common for nursing assistants and orderlies than for most other occupations. They are typically trained in how to properly lift and move patients, which can reduce the risk of injury.
Most nursing assistants and orderlies work full time. Because nursing homes and hospitals provide care at all hours, nursing assistants and orderlies may need to work nights, weekends, and holidays.
Nursing assistants must complete a state-approved education program and must pass their state’s competency exam. Orderlies generally have at least a high school diploma.
Education and Training
Nursing assistants must complete a state-approved education program in which they learn the basic principles of nursing and complete supervised clinical work. These programs are found in high schools, community colleges, vocational and technical schools, hospitals, and nursing homes.
In addition, nursing assistants typically complete a brief period of on-the-job training to learn about their specific employer’s policies and procedures.
Orderlies typically have at least a high school diploma and receive a short period of on-the-job training.
Licenses, Certifications, and Registrations
After completing a state-approved education program, nursing assistants take a competency exam. Passing this exam allows them to use state-specific titles. In some states, a nursing assistant or aide is called a Certified Nursing Assistant (CNA), but titles vary from state to state.
Nursing assistants who have passed the exam are placed on a state registry. Nursing assistants must be on the state registry to work in a nursing home.
Some states have other requirements, as well, such as continuing education and a criminal background check. Check with state boards of nursing or health for more information.
In some states, nursing assistants can earn additional credentials, such as becoming a Certified Medication Assistant (CMA). As a CMA, they can give medications. Nursing assistants may also choose to become certified in a specialty area, such as geriatrics.
Orderlies do not need a license, however, many jobs require a Basic Life Support certification which shows they are trained to provide CPR.
Communication skills. Nursing assistants and orderlies must be able to communicate effectively to address patients’ or residents’ concerns. They also need to relay important information to other healthcare workers.
Compassion. Nursing assistants and orderlies provide care for the sick, injured, and elderly. Doing so requires a compassionate and empathetic attitude.
Patience. The routine tasks of cleaning, feeding, and bathing patients or residents can be stressful. Nursing assistants and orderlies must be patient to provide quality care.
Physical stamina. Nursing assistants and orderlies spend much of their time on their feet. They should be comfortable performing physical tasks, such as lifting or moving patients.
The median annual wage for nursing assistants was $24,420 in May 2012. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $18,300, and the top 10 percent earned more than $35,330.
The median annual wage for orderlies was $23,990 in May 2012. The lowest 10 percent earned less than $17,730, and the top 10 percent earned more than $36,390.
Most nursing assistants and orderlies work full time. Because nursing homes and hospitals provide care at all hours, nursing aides and orderlies may need to work nights, weekends, and holidays.
Employment of nursing assistants is projected to grow 21 percent from 2012 to 2022, faster than the average for all occupations. Employment of orderlies is projected to grow 17 percent from 2012 to 2022, faster than the average for all occupations.
As the baby-boom population ages, many nursing assistants and orderlies will be needed to care for elderly patients in long-term care facilities, such as nursing homes. In addition, growing rates of several chronic conditions and of dementia will lead to increased demand for patient care.
Demand for nursing assistants may be constrained by the fact that many nursing homes rely on government funding. Cuts to programs, such as Medicare and Medicaid, may affect patients’ ability to pay for nursing home care. However, patient preferences and shifts in federal and state funding are increasing the demand for home and community-based long-term care, which should lead to increased opportunities for nursing assistants working in home health and community rehabilitation services.
Job prospects for nursing assistants who have completed a state-approved education program and passed their state’s competency exam should be good, particularly in home health care services and community-based care settings. Because of the emotional and physical demands of this occupation, many nursing assistants and orderlies choose to leave the profession to get more training or another job. This creates opportunities for jobseekers.