Nursing Assistants and Orderlies

What Nursing Assistants and Orderlies Do


Nursing assistants, sometimes called nursing aides, help provide basic care for patients in hospitals and residents of long-term care facilities, such as nursing homes. Orderlies transport patients and clean treatment areas.



Nursing assistants 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 also may dispense medication, depending on their training level and the state in which they work.
In nursing homes and residential care facilities, nursing assistants are often the principal caregivers. They have more contact with residents than other members of the staff. Nursing assistants often develop close relationships with their patients because some residents stay in a nursing home for months or years.
Orderlies typically do the following:

  • Help patients to move around the facility, by doing such tasks as pushing wheelchairs
  • Clean equipment and facilities
  • Change linens
  • Stock supplies



Work Environment


Nursing assistants and orderlies work in nursing and residential care facilities and in hospitals. They are frequently physically active and may need to help lift or move patients.

Nursing assistants held about 1.5 million jobs in 2016. The largest employers of nursing assistants were as follows:
Nursing care facilities (skilled nursing facilities) 40%
Hospitals; state, local, and private 26
Continuing care retirement communities and assisted living facilities for the elderly 11
Home healthcare services 5
Government 4

Orderlies held about 54,000 jobs in 2016. The largest employers of orderlies were as follows:
Hospitals; state, local, and private 74%
Nursing care facilities (skilled nursing facilities) 9
Ambulatory healthcare services 6
Government 3
Continuing care retirement communities and assisted living facilities for the elderly 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.



How to Become a Nursing Assistant or Orderly


Nursing assistants must complete a state-approved education program and must pass their state’s competency exam to become certified. 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 competency exam are placed on a state registry. They 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.

Orderlies do not need a license, however, many jobs require a basic life support (BLS) certification, which shows they are trained to provide cardiopulmonary resuscitation (CPR).



Pay


The median annual wage for nursing assistants was $28,540 in May 2018.

The median annual wage for orderlies was $28,060 in May 2018.

  The median annual wage for nursing assistants was $28,540 in May 2018. 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 $21,290, and the highest 10 percent earned more than $39,560.
The median annual wage for orderlies was $28,060 in May 2018. The lowest 10 percent earned less than $21,010, and the highest 10 percent earned more than $41,460.
In May 2018, the median annual wages for nursing assistants in the top industries in which they worked were as follows:


Government $33,800
Hospitals; state, local, and private $30,050
Nursing care facilities (skilled nursing facilities) $27,840
Home healthcare services $27,290
Continuing care retirement communities and assisted living facilities for the elderly    $27,200

In May 2018, the median annual wages for orderlies in the top industries in which they worked were as follows:

Ambulatory healthcare services $29,780
Government $29,490
Hospitals; state, local, and private $28,430
Continuing care retirement communities and assisted living facilities for the elderly $24,340
Nursing care facilities (skilled nursing facilities)     $23,830



Job Outlook

Overall employment of nursing assistants and orderlies is projected to grow 11 percent from 2016 to 2026, faster than the average for all occupations. As the baby-boom population ages, nursing assistants and orderlies will be needed to assist and care for elderly patients.

Employment of nursing assistants is projected to grow 11 percent from 2016 to 2026, faster than the average for all occupations. Employment of orderlies is projected to grow 8 percent from 2016 to 2026, about as fast as the average for all occupations.
As the baby-boom population ages, nursing assistants and orderlies will be needed to assist and care for elderly patients in long-term care facilities, such as nursing homes. Older people are more likely than younger people to have disorders such as dementia, or to live with chronic diseases, such as heart disease and diabetes. More nursing assistants will be needed to care for patients with these conditions.