Certified Nursing Assistant Career and Degree Guide

Do I Need a Degree to Become a CNA?

serious young woman with notebook studying laptop screen

Unlike most other nursing jobs, a certified nursing assistant (CNA) doesn’t require a college degree. However, you’ll need to earn a certificate or diploma in a CNA program with training in patient personal care, infection prevention, vital signs, communication, mental health, and other basic care.

How Do I Earn CNA Certification?

After completing your training program, you may need to take a competency certification exam. Once you pass the exam, you’ll be placed on a state registry as a CNA, licensed nursing assistant, or other similar title, depending on the state. Then you’ll be ready to work.

Why is CNA certification important? It signifies that you have gained the right level of knowledge to care for patients. From taking vital signs to knowing what to do in an emergency, CNAs have a lot of responsibility on their shoulders. Certification ensures your knowledge has been tested and tells employers you have the skills to do your job well.

“Achieving this training and qualifying for state certification is important for job prospects,” says Genevieve Gipson, RN, MEd, RNC, and director of the National Network of Career Nursing Assistants and Career Nurse Assistants Programs Inc. “Nursing homes and Medicare and Medicaid facilities can’t use someone as a nurse’s aide unless they’re on the state registry. To get on the state registry, you have to complete an approved course.”

Certification Requirements

To become certified as a nursing assistant, you’ll need to meet state requirements, which will include passing a state-approved CNA exam. Each state has its own criteria, but we’ve provided an example from one state to give you an idea of what you can expect.

The Washington State Department of Health lists the following requirements for certification:

  • At least 85 hours of training in a state-approved CNA program; the federal government requires a minimum of 75 hours, but states can mandate more
  • A passing score on the competency exam
  • Completed statement with information about physical and mental status, felony convictions, and other personal information
  • Seven hours of HIV/AIDS training

Although this is just one state’s requirements, you can expect to see similar stipulations from nursing boards across the country.

Tip: Be sure your CNA education program is state-approved by checking directly with the health or nursing board that oversees training and certification. 

CNA Specialty Certification

While general CNA certification is required in each state, you may also choose to earn additional certification in specialized areas. The additional credentials may help expand your opportunities in an area of interest and potentially increase your salary as a CNA.

Earning a specialty or advanced credential typically requires education and experience beyond your initial CNA certification. The organization responsible for each credential determines these requirements. Some common CNA specialty certifications and their certifying organizations include:

Name of Specialty Certification

Certifying Organization


Offered by some state boards to CNAs with specified advanced training and/or experience

Certified Alzheimer Caregiver

National Certification Board for Alzheimer Care

Certified Hospice and Palliative Nursing Assistant

Hospice and Palliative Nurses Association

Certified Wound Care Associate

American Board of Wound Management

Medication Aide Certification

National Council of State Boards of Nursing Inc.

CNA Certification Endorsements

CNA certification requirements differ for CNAs who have worked in other states. If you move, you may not be required to take another competency exam. Some states will allow you to apply for a certification endorsement.

This involves your new state approving, or “endorsing,” your existing credentials as sufficient to meet the qualifications for CNA certification there. To be eligible for an endorsement, you’ll need to meet training and work experience requirements and hold an active CNA license from another state.

What Should I Know About the Certification Exam?

The CNA certification exam is typically administered by a third party in various test centers throughout your state. Some states use the National Nurse Aide Assessment Program (NNAAP), developed by the National Council of State Boards of Nursing (NCSBN) to measure competency for nursing assistants. Other states use different exams.

Most exams include a multiple-choice section and a manual skills test. For the skills test, you’ll be asked to perform a certain number of manual actions—usually about five—that will be evaluated by a registered nurse. The skills test is “scenario-based,” meaning you’ll complete tasks in a logical progression, instead of at random.

A Two-Part Test

Both parts of the exam are administered on the same day. In many cases, you’ll have about two hours to complete the multiple-choice section and 25 to 45 minutes to demonstrate clinical skills.

You’ll cover a lot of ground while you’re in a CNA program, and the exam will test you on various aspects of the job. Here are just some of the topics you’ll likely come across on the exam:

  • Where to take a patient’s pulse
  • How to control infections
  • Data collection and reporting
  • How to handle visits from a patient’s family
  • When to notify a charge nurse about a patient’s condition
  • Patients’ cultural needs
  • Patient rights
  • Law and ethics involving patient care
  • How to handle mood and behavior changes in patients
  • What health problems wrinkled bedsheets can cause

Tips for Taking the CNA Certification Exam

  • Don’t panic if you make a mistake or skip a step during the clinical skills exam. You’re usually allowed to correct an error once per skill.
  • Be sure you demonstrate the critical element of a skill.
  • Prepare with a practice test. This allows you to become familiar with the types of multiple-choice questions you may encounter and helps you become comfortable with the time allotted.

What Will I Learn in My CNA Courses?

male certified nursing assistant pushing patient in wheelchair

Your CNA program should include coursework and hands-on clinical training. Courses generally cover how to work in a variety of settings, including patients’ homes, hospitals, and nursing care facilities, and how to care for patients with common conditions, such as diabetes, respiratory issues and cognitive impairment. Students also learn how to:

  • Administer oral and topical medications
  • Help patients bathe
  • Take a patient’s vital signs
  • Administer oxygen
  • Provide special care for the elderly
  • Provide special care for infants
  • Remove peripheral and indwelling catheters
  • Provide emergency care beyond CPR
  • Work to control infections
  • Help patients with personal care

Training for the Physical Part of Your Role

In addition to learning how to care for patients, you’ll learn how to protect yourself from injuries on the job. Working as a CNA requires being on your feet for most of the day and involves physical tasks. This can increase your risk of injury while you’re working to keep others safe.

In addition to learning how to care for patients, you’ll also learn how to protect yourself from injuries on the job.

When injuries do occur, “they’re typically repetitive injuries, not acute injuries,” Gipson says.

To help protect yourself, you’ll receive training on:

  • Proper body mechanics when helping a patient
  • Safe transfer and lifting procedures for patients
  • Maintenance of a safe and clean environment

How Long Does a CNA Program Take?

4-12 weeks

Generally, most certified nursing assistant programs may take between four and 12 weeks. This is broken into instructional hours and clinical practice.

A typical 120-hour CNA program offered over six weeks may include four weeks in class and two weeks in a clinical setting, depending on state guidelines.

Nursing assistant programs typically accommodate a wide range of student schedules. You’ll find flexible programs for students who work full time or have to juggle family responsibilities. Many schools offer day, evening, and weekend classes.

CNA Programs Online

There are plenty of schools that tout online CNA classes, but there are few, if any, in which students can complete their entire education remotely. That’s because much of the job relies on person-to-person interaction and skills that CNAs will best learn in the classroom, lab, and during clinical practice.

Online hybrid programs allow you to complete some assignments online while you attend training in labs and on campus. You’ll most likely do your clinical work at a local nursing home or hospital on a schedule coordinated by the school.

Look for State Approval of Online Programs

Before enrolling, check with your state board to find out which online programs are approved so you’re sure that the curriculum meets state requirements. Without approval, you won’t be eligible to take the CNA certification exam.

Read the program information carefully. For example, Oregon has two CNA levels, and some online programs are only designed to train students for one of these levels.

How Much Could My Education Cost?

Community colleges, vocational schools, and organizations like the American Red Cross offer CNA programs. Tuition for these diploma programs typically range from a few hundred dollars to about $3,000. By comparison, the tuition for a two-year associate’s degree in nursing would be roughly $3,600 a year.

Some hospitals and nursing homes provide cost-efficient or no-cost nursing assistant programs to new employees. This option may provide you with the education to qualify for certification and employment. At the same time, the institution gains a qualified employee.

You may be able to get your CNA training for free. Some hospitals and nursing homes provide free nursing assistant educational programs to new employees.

Once you finish your program, you’ll need to pay a fee to take the certification exam and any additional administrative fees required by your state. These fees can vary, so check with your state board to determine exact costs.

Are There Ways to Help Me Pay for School?

You may be eligible for federal financial aid if you choose to attend an accredited vocational school or community college. Accreditation means your school meets education standards. You can verify a school’s accreditation on a database maintained by the U.S. Department of Education.

You’ll have to complete the Free Application for Federal Student Aid (FAFSA) to determine your eligibility for financial aid. Your school’s financial aid office can help with the application process and answer questions.

Are There Prerequisites for a CNA Program?

Most certified nursing assistant programs require candidates to have a high school diploma or GED equivalent and to provide their school transcript. Some schools and programs will also require candidates to pass an entrance exam and a criminal background check.

Will My Program Need to be Accredited?

Diploma CNA programs aren’t eligible for accreditation. However, if you decide to become a licensed practical nurse or registered nurse later, your CNA school and program should both be accredited.

Otherwise, you may not be eligible for financial aid, and you won’t be able to transfer credits between schools.

What’s the Job Market for CNAs?

Average job growth is expected for CNAs through 2032. The U.S. Bureau of Labor Statistics says employment is expected to increase by 4.1%, which is right on target with the national average for all careers, due to factors such as an aging population and more patients with chronic illnesses.

CNA job prospects are expected to be strong in home health care and community-based care. CNAs also work in hospitals and assisted living facilities. Here’s a snapshot of what you can expect on the job in different environments.

home graphic

Home health care: CNAs care for a person in their home. The schedule is less frenetic than in other settings, but you may find the pay is slightly lower.

hospital graphic

Hospitals: CNA jobs in hospitals are highly sought after because they typically offer good benefits, higher pay, and the opportunity to work with a wide range of medical staff. You may also find opportunities to work in different departments, which helps broaden your skill set. However, you won’t develop long-term relationships with patients since most are discharged after a few days.

home graphic

Nursing and long-term care facilities: The need for certified nursing assistants is expected to grow in these settings, especially as baby boomers age and live longer. One of the benefits of working in a nursing home or long-term care facility is getting to know your patients. Many CNAs say this is one of the most satisfying parts of the job.

How Do I Advance in My Career?

Many certified nursing assistants enjoy forming relationships with patients and stay with their jobs. But others go back to school to become nurses or other healthcare professionals.

If you decide to move out of the role but want to work in a similar career, consider these options:

Licensed Practical Nurse (LPN)

LPNs are the next level above CNAs and right below registered nurses (RNs). They also provide patients with basic care. Because of their additional schooling, LPNs have a bit more responsibility than CNAs and earn a slightly higher salary.

Occupational Therapy Assistant

OT assistants work with patients to help them regain and improve physical skills necessary for daily life. They work under the direction of an occupational therapist.

Personal Care Aides

As a personal care aide, you’ll not only help patients with everyday tasks, but you’ll also provide companionship. You may work alongside other healthcare workers in the home of one patient.

Continuing Education

A CNA’s education doesn’t stop when their program ends. Healthcare is a field in which having the most up-to-date knowledge is essential.

Federal law mandates at least 12 hours of continuing education annually for CNAs. States have the authority to require additional hours or specific topics for ongoing training.

In these classes, you’ll learn new information and expand on what you already know.  Some common topics for continuing education courses include:

  • HIV/AIDS for CNAs
  • Elderly patient care
  • Resident rights
  • Bloodborne pathogens
  • Infection control
  • Domestic violence
  • Preventing medical errors

Check with your state board to find out how many hours of continuing education it requires—and whether you can do any of the work online. Some employers may pay for your continuing education or provide the courses themselves to ensure that you remain properly certified.

Renewing Your Certification

Your active status on your state’s CNA registry lasts for two years; then you’ll have to renew your certification. To retain active status, federal regulations require that CNAs work at least eight hours every two-year period in a paid position in which they provide services consistent with the role of a CNA.

If you allow your certification to lapse, you must apply for recertification. Depending on where you live, this could be a costly proposition. Some states allow you to retake the competency exam, but others require that you retake both the required training and the exam. Your state board can provide details on its policy.

If you’re ready to become a CNA, start by finding a state-approved school that’s nearby, convenient and offers a challenging curriculum, quality professors and a class schedule that fits your needs.

anna giorgi

Written and reported by:

Anna Giorgi

Contributing Writer

With professional insight from:

Genevieve Gipson, RN, MEd, RNC

Director of the National Network of Career Nursing Assistants and Career Nurse Assistants Programs Inc.