Training, Certifications, Skills, Advancement: Nursing, Psychiatric & Home Health Aides

In many cases, a high school diploma or equivalent is necessary for a job as a nursing or psychiatric aide. However, a high school diploma generally is not required for jobs as home health aides. Hospitals may require previous experience as a nursing aide or home health aide. Nursing care facilities often hire inexperienced workers, who must complete a minimum of 75 hours of mandatory training and pass a competency evaluation as part of a State-approved training program within 4 months of their employment. Aides who complete the program are known as certified nurse assistants (CNAs) and are placed on the State registry of nursing aides. Some States also require psychiatric aides to complete a formal training program. However, most psychiatric aides learn their skills on the job from experienced workers.

Nursing and psychiatric aide training is offered in high schools, vocational-technical centers, some nursing care facilities, and some community colleges. Courses cover body mechanics, nutrition, anatomy and physiology, infection control, communication skills, and resident rights. Personal care skills, such as how to help patients to bathe, eat, and groom themselves, also are taught.

Some employers provide classroom instruction for newly hired aides, while others rely exclusively on informal on-the-job instruction by a licensed nurse or an experienced aide. Such training may last from several days to a few months. Aides also may attend lectures, workshops, and in-service training.

The Federal Government has guidelines for home health aides whose employers receive reimbursement from Medicare. Federal law requires home health aides to pass a competency test covering a wide range of areas: Communication; documentation of patient status and care provided; reading and recording of vital signs; basic infection-control procedures; basic bodily functions; maintenance of a healthy environment; emergency procedures; physical, emotional, and developmental characteristics of patients; personal hygiene and grooming; safe transfer techniques; normal range of motion and positioning; and basic nutrition.

A home health aide may receive training before taking the competency test. Federal law suggests at least 75 hours of classroom and practical training, supervised by a registered nurse. Training and testing programs may be offered by the employing agency but must meet the standards of the Center for Medicare and Medicaid Services. State regulations for training programs vary.

The National Association for Home Care offers national certification for home health aides. The certification is a voluntary demonstration that the individual has met industry standards. Some States also require aides to be licensed.

Aides must be in good health. A physical examination, including State-regulated tests such as those for tuberculosis, may be required. A criminal background check also is usually required for employment.

Applicants should be tactful, patient, understanding, emotionally stable, and dependable and should have a desire to help people. They also should be able to work as part of a team, have good communication skills, and be willing to perform repetitive, routine tasks. Home health aides should be honest and discreet, because they work in private homes. They also will need access to their own car or public transportation to reach patientsí homes.

For some individuals, these occupations serve as entry-level jobs, as in the case of high school and college students who may work while also attending school. In addition, experience as an aide can help individuals decide whether to pursue a career in health care. Opportunities for advancement within these occupations are limited. Aides generally need additional formal training or education in order to enter other health occupations. The most common health care occupations for former aides are licensed practical nurse, registered nurse, and medical assistant.