Career Advancement Options for CNAs

How to Increase Your Salary and Advance Your Career in Nursing

CNAs who want to delve into other branches of the nursing field could find potential job growth, increased pay, added responsibilities, and opportunities to explore areas of healthcare that interest them as they pursue higher nursing degrees. Learn more about the educational and training paths available to CNAs.

Career Advancement for Certified Nursing Assistants

CNAs pursue their career through a combination of practical, working experience and certificate or degree programs that help develop a deeper understanding of the practice of nursing. Below is an example of the path to becoming a registered nurse.

1. CNA 1: Certificate programs prepare students to become CNA 1, certified and registered through the state.
2. Entry-Level Job: CNA 1 can assist in many healthcare facilities, but not hospital settings.
3. CNA 2 and 3: Further training to work in hospitals as a CNA 2 and labs as a CNA 3.
4. Associate/Bachelor's Degree: Undergo educational and clinical experience in an associate or bachelor's degree program in nursing.
5. NCLEX: Take this exam through the National Council of State Boards of Nursing and become a nationally registered and certified nurse.
6. Registered Nurse: Work in various healthcare settings with teams of healthcare professionals.

CNA Levels: What Do They Mean for Career Advancement

CNA training proceeds in three levels. CNAs who complete a basic training course and take a state certification test are CNA 1, and additional training establishes them as CNA 2 and CNA 3. Each level brings additional responsibility and a new work environment where CNAs can assist nurses and other healthcare professionals.

CNA 1

Duties & Responsibilities

Certified nursing aides who complete an entry-level training course are qualified to assist licensed practical nurses or registered nurses working in various healthcare facilities, though not in hospitals. CNA 1s perform healthcare tasks, such as taking patient vitals and measurements and other daily care needs, and communicate information between nurses and patients.

Work Environment

• Skilled nursing facility
• Long-term care center
• Assisting living facility

How to Become One

Because CNA 1 programs teach the basics of healthcare work, students have a large workload that consists of classroom and lab work as well as clinical requirements. Students then must pass an exam administered by the state, which includes a written and a practical component.

CNA 2

Duties & Responsibilities

After completing the basic training to become a CNA 1, students take additional courses to learn about working under nurses in acute care and hospital settings. They perform the same patient care duties as a CNA 1 under the direction of a licensed practical nurse or registered nurse.

Work Environment

• Skilled nursing facility
• Long-term care center
• Assisting living facility
• Hospital
• Acute or urgent care facility

How to Become One

CNA 2 programs require a CNA 1 license before a student can apply to the program. Students then train in classroom, lab and clinical settings to build on their CNA 1 knowledge and prepare them for their responsibilities in the more stressful environment of a hospital. Students who complete CNA 2 training may need to take additional tests before their CNA license is upgraded in the state registry.

CNA 3

Duties & Responsibilities

Sometimes referred to as a patient care technician, this level of CNA training prepares students to perform specialized nursing aid in several different departments, such as phlebotomy or repertory tests. A CNA 3 may be trained to run an electrocardiogram or perform other tests.

Work Environment

• Skilled nursing facility
• Long-term care center
• Assisting living facility
• Hospital
• Acute or urgent care facility
• Blood banks
• Laboratories

How to Become One

CNA 3 training programs teach students specialized terminology and skills involving medical devices or testing techniques. Students narrow the scope of their studies to learn the procedures that are a part of everyday work in their healthcare divisions, such as phlebotomy or acute care.

Top 5 Careers for CNAs Looking for Advancement

Nursing specializations are wide-ranging and diverse, and CNAs interested in advancing in the field can typically find a potential career that aligns with their interests. Below are a few of the most common careers a CNA could pursue in the nursing field, along with the skills, education and training necessary to succeed in each career.

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Licensed Practical Nurse (LPN)

Licensed practical nurses work under the direction of doctors and registered nurses. They provide basic medical care and discuss healthcare strategies with patients. They also keep records of patients' health and communicate information between doctors, registered nurses and patients.

1. Develop healthcare communication skills
   Because LPNs are a source of patient information for doctors and convey doctors' information to patients, cultivating the ability to communicate with many different people is essential. Students should learn common healthcare terminology within their chosen field and how to express these terms to people without previous healthcare knowledge.
2. Cultivate a compassionate bedside manner
   LPNs interact with patients extensively and should make all of their patients feel as calm, comfortable, and cared-for as possible.
3. Complete additional training in record keeping and more intensive healthcare functions
   Some of the duties of an LPN include changing dressings, administering and maintaining IVs, and recording patient healthcare information. These tasks require extensive clinical work and trainings so students can practice this delicate, vital work.

Registered Nurse (RN)

Registered nurses plan and administer patient care plans, record patients' medical histories and symptoms and consult and collaborate with other healthcare professionals. They monitor and diagnose patients during the treatment process in a medical facility and also help patients and families manage illnesses or injuries when they are at home.

1. Find an accredited certificate, associate or bachelor's degree in nursing program
   Becoming an RN is a great increase in responsibility. CNAs looking to become RNs should have a lot of experience in their field and expect to study medical terminology, record-keeping, and medical technology more in-depth in registered nursing certificate or degree programs.
2. Prepare for the NCLEX
   The NCLEX is a national nursing certification exam that all registered nursing students must take to work as RNs. The exam tests entry-level nurse skills in promoting, maintaining and restoring health in patients.
3. Pursue specialties in areas of interest within nursing
   RNs can work in a variety of healthcare settings, including hospitals, physicians' offices, nursing facilities, schools and home healthcare services. Pursuing certifications in a particular area of nursing is a great way to specialize and find more specific employment opportunities in this wide-ranging field.

Nursing Home Administrator

CNAs working with senior communities can take on leadership roles as nursing home administrators. These professionals are the liaison between staff, doctors, family members and patients. They handle staffing and bookkeeping duties and ensure their facilities comply with state and federal procedures.

1. Develop excellent communication skills, particularly with elderly patients
   Discussing healthcare options with senior patients may be difficult depending on their mental faculties. A CNA preparing to become a nursing home administrator will be patient and communicate clearly with patients and their families as well as doctors and faculty.
2. Earn a master's degree in healthcare administration or a similar field
   Taking on an administrative role in healthcare requires specialized training and intensive practical study. The ideal healthcare administration degree program will address management principles, leadership skills, and current strategies for resident-centric nursing home care.
3. Keep up to date on healthcare codes on a state and federal level
   Translating state and federal laws into effective practices ensures that residents are cared for compassionately and their rights are protected. Healthcare laws change frequently, and an administrator must prioritize these laws in running their nursing home.

Geriatric Care Manager

Professionals in this area of nursing help develop and implement healthcare plans and long-term care for elderly. They are experts in navigating the healthcare field, connecting clients with healthcare professionals as well as legal and financial advisors. They may also serve as mediators between family members and the elderly patients they are hired to assist.

1. Cultivate communication and mediation skills
   Geriatric care managers work with families to make difficult choices. These people need the help of a calm, professional compassionate expert. The ability to communicate both with an elderly person, members of their family, doctors and legal and financial professionals is an essential component of this job.
2. Explore the intersection of social work, gerontology and psychology
   There are many fields of study that geriatric care managers draw from in performing their jobs, particularly health and human services. In developing the knowledge and experience to pursue this career, CNAs should seek out higher education programs that delve into the many different fields that contribute to this career.
3. Research elder care possibilities and laws
   Families hire geriatric care managers to advise them on legal, financial and healthcare choices. These professionals must know the many options available for their clients.

Nurse Educator or Professor

CNA students and current CNAs looking to advance their nursing careers will encounter a diverse range of teachers in their education programs. Educators work in classrooms and in practical settings, guiding and preparing future nursing professionals. They typically work for nursing schools, but may also teach in hospitals, public health agencies and other professional education associations.

1. Pursue teaching experience as well as a higher degreeWorking in hospitals and clinics can develop a CNA's knowledge, and a master's or doctoral degree are the preferred credentials for nurse educators, but teaching students is a skill that also must be cultivated. It is important to communicate information clearly to students in classroom, clinical, and professional development settings.
2. Gain practical experience in areas of interestNurse educators typically teach courses in a chosen area of expertise as well as entry-level classes. Imparting practical knowledge from personal experience is a valuable part of a nurse educator's job. Nurse educators also may work part-time in clinical settings to maintain their clinical experience.
3. Consider full- or part-time teaching and research opportunitiesEarning a higher degree can lead to research and publishing opportunities in addition to teaching and clinical work. There are many possible jobs that a nurse educator can hold in addition to teaching part-time, or a nurse educator can choose to focus exclusively on teaching.

Advancing Your Education to Advance Your Career: Benefits to Each Nursing Degree

Basic and advanced nursing education programs award graduates with certificates, undergraduate degrees and advanced degrees. All programs require a high school education or GED, and most have GPA requirements that applicants must meet in order to be accepted. CNAs considering higher education should be working in healthcare settings, gaining experience and learning on the job.

The table below explores different levels of certification within the nursing field, the requirements to apply for different programs, and jobs graduates are qualified for with those certifications or degrees.

CNA Certificate

Prerequisites

• High school diploma or GED
• American Heart Association CPR certification for healthcare providers

Where to Earn One

• Online program
• Vocational and technical school
• Community college

Estimated Timeline

One to six months

Potential Careers

Certified nursing assistant at an assisted living facility, intermediate care facility, or skilled nursing facility.

LPN/LVN Certificate

Prerequisites

• High school diploma or GED
• CNA license (optional)

Where to Earn One

• Community college
• Online program

Estimated Timeline

One year

Potential Careers

Licensed vocational nurse working in acute care facilities, with community health agencies, in long-term care facilities or other healthcare

Associate Degree in Nursing (ADN)

Prerequisites

• High school diploma or GED
• LPN/LPV or paramedic license

Where to Earn One

• Community college
• Vocational and technical school
• Online program

Estimated Timeline

Two years

Potential Careers

Registered nurse

Bachelor of Science in Nursing (BSN)

Prerequisites

• High school diploma or GED
• LPN or LPV license (optional)

Where to Earn One

• Four-year university
• Community college
• Online program

Estimated Timeline

Three to four years

Potential Careers

Registered nurse

Master of Science in Nursing (MSN)

Prerequisites

• Bachelor's degree, either in nursing or another field

Where to Earn One

• Four-year university
• Online program

Estimated Timeline

Two to three years

Potential Careers

• Clinical nurse specialist
• Health systems manager
• Nurse educator
• Consultant
• Researcher
• Nurse leader on an interdisciplinary healthcare team

Doctorate of Nursing Practice (DNP)

Prerequisites

• Bachelor's or Master's degree of Science in nursing
• Working in advance nursing practice

Where to Earn One

• Four-year university
• Online program

Estimated Timeline

Three to five years

Potential Careers

• Nurse leader on an interdisciplinary healthcare team
• Nurse educator
• Nurse practitioner in fields such as family or primary care, pediatrics, and adult-gerontological care

In-Depth: CNA, LPN, and RN Salaries by State

CNAs exploring the nursing field in order to increase their salaries should not only look at the institution that can employ them, but also the state where they will be working. Pursing a nursing career in one state may lead to more financially generous opportunities than finding employment in another.

[State Map]

Is it Time to Advance My Nursing Career? Questions to Ask

The nursing field is challenging and has essential responsibilities at every level of employment. CNAs should carefully consider their commitment to their work before advancing in the nursing field, as it will mean devoting a greater of time, energy, and focus. Below are some questions to help CNAs reflect upon their goals.

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Do I feel comfortable doing work as a CNA?

Being a CNA is challenging, but for current CNAs interested in greater responsibility, a good time to progress professionally is when they feel comfortable with the routine of their current position.

What are my salary goals?

With the greater responsibilities that nursing professionals take on, there is an increase in pay as well. Nurse salaries differ by states and healthcare facilities as well as by the area of nursing CNAs wish to pursue.

What areas of nursing have the greatest staffing need?

Skilled, professional, dedicated nurses are highly employable, but employment opportunities vary by job title, location, and employer. Pursuing an aspect of nursing with a shortage of employees increases the chances of getting hired after completing a higher education program.

How much am I willing to sacrifice for career advancement?

Earning a bachelor's, master's, or doctorate in nursing can take years. While there are nurse education-based loans and scholarships available privately and through the U.S. Department of Health and Human Resources and many programs have degree time frames for part-time students, it is still a huge commitment of time and money. Carefully consider taking on this commitment.

Is there a area of nursing I know I want to study?

Because nursing is such a wide field and there are so many possible nursing careers, knowing what specific discipline to pursue can help direct educational program choices. It is also easier to find jobs when an applicant has clear, narrow certifications.

Am I willing to change locations for a certain program or job?

It can help employment opportunities to attend a program in the community a student wants to work in, as they will most likely be assigned to local clinical work through their program. Learning online is another way to learn certifications and gain greater knowledge and experience.

Advice from the Field: Expert Tips for Career Growth

Elena Pettycrew graduated from University of Portland in 2014 with a BSN and has been working as a registered nurse on a general medical unit at Salem Hospital in Oregon for two years.

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What did you initially look for in a nursing program?

I looked for Bachelor's of Science in Nursing (BSN) programs that were competitive and offered a variety of clinical placements.

What made you interested in pursuing a degree beyond CRN certification?

I wanted to pursue a BSN because it affords me the most responsibility of any undergraduate nursing degree; focuses on leadership, communication, and critical thinking; and is the direction that the nursing profession is leaning towards. Hospitals and other employers generally prefer to hire BSN nurses both due to the holistic nature of the degree and because there is a goal (put forward by the Institute of Medicine) to have 80% BSN nurses by 2020.

What opportunities have you found in your degree program and in your clinical experience that shaped your career path?

I started my career in a new graduate nursing program, and through this program led a quality improvement project that I have since presented in various forms at the hospital where I work and at a local conference. This project sparked my interest in research, and I am now the co-chair of my hospital's Evidence Based Practice Council. I am also my unit's Diabetes Champion and a member of my unit's Specialty Practice Team (which focuses on unit-wide quality improvement projects), among other things. The shared leadership model that my hospital uses gave me a passion for research, education, and leadership, all of which led to a future goal to advance my degree and become a Clinical Nurse Specialist or another type of advanced practice nurse.

Additional Career Resources for Nurses

American Association of Colleges of Nursing
Students in college nursing programs can find financial aid and other support for their education through this organization.

American Association of Legal Nurse Consultants
For registered nurses interested in legal nurse consulting, this membership organization is a way to network, explore professional development and education resources, and find certification through the American Legal Nurse Consultant Certification Board.

National Association of Long Term Care Administrator Boards
State boards that are members of this national organization develop standards, resources, and tools to assist administrators of nursing home and assisted living communities.

National Association of School Nurses
This membership organization supports school nurses in their mission to promote and maintain student health.

National Council of State Boards of Nursing
This nonprofit membership organization is the regulatory body for all nursing programs in the United States and administers standard licensing exams such as the NCLEX.

National Association of Licensed Practical Nurses
This professional organization fosters high standards of education, certification, professional development, and care in the field of licensed practical nursing.

National Student Nurses' Association
Currents students in registered nursing programs can find professional development mentorship, education resources, and career guidance through this membership organization

Red Cross CNA Training
There are Red Cross CNA training programs in various cities in thirteen states; other programs are available in individual states.