What They Do: Nursing assistants help provide basic care for patients in hospitals and residents of long-term care facilities.
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.
How to Become One: 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.
Salary: The median annual wage for nursing assistants is $30,310. The median annual wage for orderlies is $29,990.
Job Outlook: Overall employment of nursing assistants and orderlies is projected to grow 5 percent over the next ten years, about as fast as the average for all occupations.
Related Careers: Compare the job duties, education, job growth, and pay of nursing assistants and orderlies with similar occupations.
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:
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:
Nursing assistants and orderlies work as part of a healthcare team under the supervision of licensed practical or licensed vocational nurses and registered nurses.
Nursing assistants hold about 1.3 million jobs. The largest employers of nursing assistants are as follows:
| Nursing care facilities (skilled nursing facilities) | 34% |
| Hospitals; state, local, and private | 32% |
| Continuing care retirement communities and assisted living facilities for the elderly | 10% |
| Home healthcare services | 6% |
| Government | 4% |
Orderlies hold about 46,200 jobs. The largest employers of orderlies are as follows:
| Hospitals; state, local, and private | 84% |
| Ambulatory healthcare services | 6% |
| Government | 2% |
The work of nursing assistants and orderlies may be strenuous. They spend much of their time on their feet as they care for patients.
Nursing assistants and orderlies have one of the highest rates of injuries and illnesses of all occupations. These workers frequently move patients and have other physically demanding tasks. They typically get training in how to properly lift people, which can reduce the risk of injuries.
Although most nursing assistants and orderlies work full time, some work part time. Because nursing and residential care facilities and hospitals provide care at all hours, nursing assistants and orderlies may need to work nights, weekends, and holidays.
Get the education you need: Find schools for Nursing Assistants and Orderlies near you!
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.
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.
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).
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.
The median annual wage for nursing assistants is $30,310. 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 $23,880, and the highest 10 percent earned more than $44,240.
The median annual wage for orderlies is $29,990. The lowest 10 percent earned less than $23,970, and the highest 10 percent earned more than $46,470.
The median annual wages for nursing assistants in the top industries in which they work are as follows:
| Government | $37,310 |
| Hospitals; state, local, and private | $35,870 |
| Nursing care facilities (skilled nursing facilities) | $29,970 |
| Continuing care retirement communities and assisted living facilities for the elderly | $29,900 |
| Home healthcare services | $29,280 |
The median annual wages for orderlies in the top industries in which they work are as follows:
| Government | $36,950 |
| Hospitals; state, local, and private | $30,010 |
| Ambulatory healthcare services | $29,620 |
Although most nursing assistants and orderlies work full time, some work part time. Because nursing and residential care facilities 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 5 percent over the next ten years, about as fast as the average for all occupations.
About 220,200 openings for nursing assistants and orderlies are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.
See all nursing jobs.
As the baby-boom population ages, nursing assistants and orderlies will be needed to help care for an increasing number of older people who have chronic or progressive diseases, such as heart disease and diabetes.
Demand for nursing assistants may be constrained by financial pressures on nursing homes, which might lead some facilities to close or reduce staff. However, increased opportunities are expected in home- and community-based settings as patient preferences and shifts in federal and state funding generate demand for care in these settings.
| Occupational Title | Employment, 2021 | Projected Employment, 2031 | Change, 2021-31 | |
|---|---|---|---|---|
| Percent | Numeric | |||
| Nursing assistants and orderlies | 1,389,900 | 1,454,800 | 5 | 64,900 |
| Nursing assistants | 1,343,700 | 1,406,400 | 5 | 62,700 |
| Orderlies | 46,200 | 48,300 | 5 | 2,200 |
For more information about nursing assistants and orderlies, visit
National Network of Career Nursing Assistants
For more information about state requirements, visit
A portion of the information on this page is used by permission of the U.S. Department of Labor.