To become a CNA (certified nursing assistant), you complete a state-approved nursing assistant education program and pass your state's competency exam. Once you pass, you're placed on your state's registry, and you must be on that registry to work in a nursing home. Programs run in high schools, community colleges, vocational schools, hospitals and nursing homes.
It's one of the quickest ways into healthcare work. The catch is that the rules, and even the job title, change from state to state.
Facts here come from the US Bureau of Labor Statistics (BLS) Occupational Outlook Handbook, read on 26 October 2026. It's a careers guide, not care or health advice.
CNA jobs and pay at a glance
| Measure | BLS figure |
|---|---|
| Median pay, nursing assistants (May 2025) | $42,260 a year |
| Median pay, nursing assistants and orderlies | $41,870 a year, $20.13 an hour |
| Nursing assistant jobs in 2025 | About 1.5 million |
| Projected growth, assistants and orderlies 2025 to 2035 | 3%, about as fast as average |
| Openings each year, assistants and orderlies | About 203,300 on average |
Pay figures are as of October 2026, from BLS's May 2025 data. That openings number is the one to notice: it means employers are hiring constantly.
Getting certified, step by step
- Find a state-approved nursing assistant program. It covers the principles of nursing and includes supervised clinical work.
- Complete the classroom hours and the clinical placement.
- Pass your state's competency exam. This is what lets you use your state's title.
- Get listed on the state registry. You need to be on it to work in a nursing home.
- Meet any extra state rules, such as a criminal background check or continuing education.
- Do your employer's on-the-job training, which BLS says is usually brief and covers that employer's own policies.
The title isn't the same everywhere
This surprises a lot of people searching for "CNA". BLS says that in some states a nursing assistant is called a Certified Nursing Assistant, but titles vary by state. So if a job ad in another state uses a different name, it may be the same role. What matters is that you passed the competency exam and you're on the registry.
Some states also let experienced nursing assistants add a credential such as Certified Medication Assistant (CMA), which allows them to dispense medications. That's a useful step up if your state offers it.
Where CNAs work and where pay is highest
Skilled nursing facilities employ the most nursing assistants, about 36 in every 100. Hospitals employ about 32 in every 100. But government employers pay the most at the median.
| Employer type | Median pay, May 2025 |
|---|---|
| Government, excluding state and local education and hospitals | $47,050 |
| Nursing care facilities (skilled nursing facilities) | $43,000 |
| Hospitals; state, local and private | $42,310 |
| Continuing care retirement communities and assisted living | $39,490 |
| Home healthcare services | $38,040 |
Those are BLS medians as of October 2026. If you can get on with a government facility, it's worth applying there as well as to local nursing homes.
Choosing a training program
Because the competency exam is run by your state, the program has to be approved by that same state. Check the approval before you pay for anything. Ask how many hours are classroom and how many are clinical, where the clinical placement takes place, and whether the fee covers the exam itself.
Hospitals and nursing homes run programs too, which can be a smart way in if you already know where you want to work. Community colleges and vocational schools are the other common choice, and they often fit around a day job.
What the job is really like
Be honest with yourself about the physical side. BLS says nursing assistants and orderlies have one of the highest rates of injuries and illnesses of all occupations, mainly from moving patients. You'll be on your feet for most of a shift, and training in how to lift people safely is part of the job.
Facilities run around the clock, so nights, weekends and holidays are common. Most nursing assistants work full time, and some work part time, which makes it a job you can fit around study.
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It's also worth knowing how the role differs from an orderly's. BLS says orderlies typically need a high school diploma and a short period of on-the-job training, don't need a licence, and mostly work in hospitals. Nursing assistants do the state program and exam, and that extra step is what opens up nursing homes and the registry.
Using CNA work as a stepping stone
Plenty of people start as a CNA while they decide whether nursing is for them. The registry listing, the clinical experience and the shift work all count when you apply for nursing programs later. It's also worth knowing which skills nursing home nurses rely on, because you'll see them in action every day. And when you write your CV, list your certifications clearly; our guide to putting CPR certification on a resume shows the format.
My verdict
If you want to work in healthcare quickly, a CNA program is one of the fastest ways in, and the demand is huge, with about 203,300 openings a year. Pick a state-approved program in the state where you'll work, because the exam and registry are state-run. Go in knowing it's physically hard work. And if pay matters, apply to government facilities too, since they had the highest median.
Frequently asked questions
How long does it take to become a CNA?
It depends on your state's program. You complete a state-approved education program with classroom and clinical work, then pass the competency exam, which for most people takes weeks or months rather than years.
What do you need to become a CNA?
Completion of a state-approved nursing assistant program and a pass on your state's competency exam. Some states also require a background check or continuing education.
What is the CNA registry?
Once you pass the competency exam, you're placed on your state's registry. BLS says you must be on it to work in a nursing home.
How much do CNAs make?
BLS reports a median of $42,260 a year for nursing assistants in May 2025, as of October 2026. Government employers had the highest median, at $47,050.
Is CNA the same title in every state?
No. BLS says some states use Certified Nursing Assistant, but titles vary by state.
Can a CNA give medications?
In some states, nursing assistants can earn a Certified Medication Assistant credential, which allows them to dispense medications.
