NURSING & PSYCHIATRIC AIDES
Source: U.S. Department of Labor
Bureau of Labor Statistics
[Occupational Outlook Handbook, 2010-11 edition]



Nature of the work
Nursing and psychiatric aides help care for physically or mentally ill, injured, disabled, or infirm individuals in hospitals, nursing care facilities, and mental health settings. Nursing aides and home health aides are among the occupations commonly referred to as direct care workers, due to their role in working with patients who need long-term care. The specific care they give depends on their specialty.

Nursing aides, also known as nurse aides, nursing assistants, certified nursing assistants, geriatric aides, unlicensed assistive personnel, orderlies, or hospital attendants, provide hands-on care and perform routine tasks under the supervision of nursing and medical staff. Specific tasks vary, with aides handling many aspects of a patient's care. They often help patients to eat, dress, and bathe. They also answer calls for help, deliver messages, serve meals, make beds, and tidy up rooms. Aides sometimes are responsible for taking a patient's temperature, pulse rate, respiration rate, or blood pressure. They also may help provide care to patients by helping them get out of bed and walk, escorting them to operating and examining rooms, or providing skin care. Some aides help other medical staff by setting up equipment, storing and moving supplies, and assisting with some procedures. Aides also observe patients' physical, mental, and emotional conditions and report any change to the nursing or medical staff.

Nursing aides employed in nursing care facilities often are the principal caregivers and have more contact with residents than do other members of the staff. Because some residents may stay in a nursing care facility for months or even years, aides develop positive, caring relationships with their patients.

Psychiatric aides, also known as mental health assistants or psychiatric nursing assistants, care for mentally impaired or emotionally disturbed individuals. They work under a team that may include psychiatrists, psychologists, psychiatric nurses, social workers, and therapists. In addition to helping patients to dress, bathe, groom themselves, and eat, psychiatric aides socialize with them and lead them in educational and recreational activities. Psychiatric aides may play card games or other games with patients, watch television with them, or participate in group activities, such as playing sports or going on field trips. They observe patients and report any physical or behavioral signs that might be important for the professional staff to know. They accompany patients to and from therapy and treatment. Because they have such close contact with patients, psychiatric aides can have a great deal of influence on their outlook and treatment.

Work environment
Work as an aide can be physically demanding. Aides spend many hours standing and walking, and they often face heavy workloads. Aides must guard against back injury, because they may have to move patients into and out of bed or help them stand or walk. It is important for aides to be trained in and to follow the proper procedures for lifting and moving patients. Aides also may face hazards from minor infections and major diseases, such as hepatitis, but can avoid infections by following proper procedures. Nursing aides, orderlies, and attendants and psychiatric aides have some of the highest non-fatal injuries and illness rates for all occupations, in the 98th and 99th percentiles in 2007.

Aides also perform tasks that some may consider unpleasant, such as emptying bedpans and changing soiled bed linens. The patients they care for may be disoriented, irritable, or uncooperative Psychiatric aides must be prepared to care for patients whose illnesses may cause violent behavior. Although their work can be emotionally demanding, many aides gain satisfaction from assisting those in need.

Most full-time aides work about 40 hours per week, but because patients need care 24 hours a day, some aides work evenings, nights, weekends, and holidays. In 2008 about 24 percent of nursing aides, orderlies, and attendants and psychiatric aides worked part-time.

Training, Other Qualifications, and Advancement
In many cases, a high school diploma or equivalent is necessary for a job as a nursing or psychiatric aide. Specific qualifications vary by occupation, State laws, and work setting. Advancement opportunities are limited.

Education and training
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 bathe, eat, and groom themselves, also are taught. Hospitals may require previous experience as a nursing aide or home health aide. 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.

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.

Licensure and certification
Federal Government requirements exist for nursing aides who work in nursing care facilities. These aides must complete a minimum of 75 hours of State-approved training and pass a competency evaluation. Aides who complete the program are known as certified nurse assistants (CNAs) and are placed on the State registry of nurse aides. Additional requirements may exist, but vary by State. Therefore, individuals should contact their State board directly for applicable information.

Other qualifications. Aides must be in good health. A physical examination, including State-regulated disease tests, 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.
Advancement
Opportunities for advancement within these occupations are limited. Aides generally need additional formal training or education to enter other health occupations. The most common healthcare occupations for former aides are licensed practical nurse, registered nurse, and medical assistant.