Nursing Assistants and Orderlies


Quick Facts: Nursing Assistants and Orderlies
2017 Median Pay $27,510 per year 
$13.23 per hour
Typical Entry-Level Education  
Work Experience in a Related Occupation None
On-the-job Training  
Number of Jobs, 2016 1,564,300
Job Outlook, 2016-26 11% (Faster than average)
Employment Change, 2016-26 177,700

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Nursing Assistants and Orderlies Career, Salary and Education Information

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.

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Duties of Nursing Assistants and Orderlies

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 for Nursing Assistants and Orderlies

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.

Injuries and Illnesses

Because they frequently lift people and do other physically demanding tasks, nursing assistants and orderlies have a higher rate of injuries and illnesses than the national average. They are typically trained in how to properly lift and move patients, which can reduce the risk of injuries.

Work Schedules

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.


How to Become a Nursing Assistants and Orderlies

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 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).

Important Qualities

Communication skills. Nursing assistants and orderlies must communicate effectively to address patients’ or residents’ concerns. They also need to relay important information to other healthcare workers.

Compassion. Nursing assistants and orderlies assist and 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 have patience to complete these tasks.

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.


salaries for Nursing Assistants and Orderlies

The median annual wage for nursing assistants was $27,520 in May 2017. 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 $20,680, and the highest 10 percent earned more than $38,630.

The median annual wage for orderlies was $27,180 in May 2017. The lowest 10 percent earned less than $20,240, and the highest 10 percent earned more than $40,610.

 

In May 2017, the median annual wages for nursing assistants in the top industries in which they worked were as follows:

Government: $32,860

Hospitals; state, local, and private: $29,260

Nursing care facilities (skilled nursing facilities): $26,700

Home healthcare services: $25,940

Continuing care retirement communities and assisted living facilities for the elderly: $25,880

 

In May 2017, the median annual wages for orderlies in the top industries in which they worked were as follows:

Government: $29,030

Ambulatory healthcare services: $28,540

Hospitals; state, local, and private: $27,630

Nursing care facilities (skilled nursing facilities): $23,380

Continuing care retirement communities and assisted living facilities for the elderly: $23,110

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.


Job Outlook for Nursing Assistants and Orderlies

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.

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. In addition, 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 

The low pay and high emotional and physical demands cause many workers to leave the occupation, and they will have to be replaced. This creates opportunities for jobseekers.

Employment projections data for Nursing Assistants and Orderlies, 2016-26

Employment, 2016: 1,564,300

Projected Employment, 2026: 1,742,100

Change, 2016-2026: +11%, +177,800


Careers Related to Nursing Assistants and Orderlies

Dental Assistants

Dental assistants perform many tasks, ranging from providing patient care and taking x rays to recordkeeping and scheduling appointments. Their duties vary by state and by the dentists’ offices where they work.

Home Health Aides and Personal Care Aides

Home health aides and personal care aides help people with disabilities, chronic illnesses, or cognitive impairment by assisting in their daily living activities. They often help older adults who need assistance. In some states, home health aides may be able to give a client medication or check the client’s vital signs under the direction of a nurse or other healthcare practitioner.

Licensed Practical and Licensed Vocational Nurses

Licensed practical nurses (LPNs) and licensed vocational nurses (LVNs) provide basic nursing care. They work under the direction of registered nurses and doctors.

Medical Assistants

Medical assistants complete administrative and clinical tasks in the offices of physicians, hospitals, and other healthcare facilities. Their duties vary with the location, specialty, and size of the practice.

Occupational Therapy Assistants and Aides

Occupational therapy assistants and aides help patients develop, recover, improve, as well as maintain the skills needed for daily living and working. Occupational therapy assistants are directly involved in providing therapy to patients; occupational therapy aides typically perform support activities. Both assistants and aides work under the direction of occupational therapists.

Physical Therapist Assistants and Aides

Physical therapist assistants, sometimes called PTAs, and physical therapist aides work under the direction and supervision of physical therapists. They help patients who are recovering from injuries and illnesses regain movement and manage pain.

Psychiatric Technicians and Aides

Psychiatric technicians and aides care for people who have mental illness and developmental disabilities. Technicians typically provide therapeutic care and monitor their patients’ conditions. Aides help patients in their daily activities and ensure a safe, clean environment.

Registered Nurses

Registered nurses (RNs) provide and coordinate patient care, educate patients and the public about various health conditions, and provide advice and emotional support to patients and their family members.

Veterinary Assistants and Laboratory Animal Caretakers

Veterinary assistants and laboratory animal caretakers care for animals by performing routine tasks under the supervision of scientists, veterinarians, and veterinary technologists and technicians.

OccupationENTRY-LEVEL EDUCATION2017 MEDIAN PAY
Home Health Aides and Personal Care AidesHigh school diploma or equivalent$23,130
Licensed Practical and Licensed Vocational NursesPostsecondary nondegree award$45,030
Medical AssistantsPostsecondary nondegree award$32,480
Occupational Therapy Assistants and Aides$56,690
Psychiatric Technicians and Aides$29,330
Physical Therapist Assistants and Aides$46,920
Registered NursesBachelor's degree$70,000
Dental AssistantsPostsecondary nondegree award$37,630
Veterinary Assistants and Laboratory Animal CaretakersHigh school diploma or equivalent$26,140

Citation:
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Nursing Assistants and Orderlies, 
on the Internet at https://www.bls.gov/ooh/healthcare/nursing-assistants.htm