The medical community can sometimes be confusing to the general public; patients see a person in scrubs wearing a name tag with an acronym and are often unsure what the person does. To help shine some light on the differences between CNAs and MAs, let’s take a closer look at these two careers:

CNA Overview

CNAs work under the supervision of registered nurses and are on the frontline of patient care. On a daily basis, they perform tasks such as:

• Taking vital signs
• Bathing patients
• Grooming patients
• Helping patients walk
• Providing emotional care to patients
• Acting as liaison between patients and the nursing staff

MA Overview

MAs generally report directly to medical office managers, doctors and other health care practitioners. They typically work in a medical office setting or clinic and are responsible for duties such as:

• Updating patient’s medical records
• Completing insurance forms
• Arranging laboratory services for patients
• Scheduling hospital admissions for patients
• Scheduling patient appointments
• Handling bookkeeping
• Answering telephones

In clinical settings, MAs will sometimes also help take patient vital signs, obtain patient medical histories and are responsible for preparing exam room instruments and supplies.

Similarities

Both certified nursing assistants and medical assistants must work with the public. In this capacity, they need to act professional at all times. In a medical setting, they will be exposed to a wide variety of emotions such as fear, anger, sadness and apprehension daily.

CNAs and MAs are also subject to the following healthcare regulations:

• Joint Commission on Accreditation of Healthcare Organization (JCAHO)
• Health Insurance Accountability and Portability Act (HIPAA)
• Occupational Safety and Health Administration (OSHA)

Differences: Health Care Setting

Medical assistants are required to work in facilities where a doctor is present, such as a clinic or doctor’s office. Conversely, certified nursing assistants can work under the supervision of an RN or LPN. This allows them to work in many diverse settings to include:

• Nursing homes
• Community care facilities
• Long-term care facilities
• Hospitals
• Home healthcare settings

CNAs also have more freedom when it comes to patient care due to their certification. During the course of their career, CNAs have the opportunity to take on-going certification classes. This will afford them the opportunity to have additional responsibilities.

Differences: Training

Depending on the state’s requirements, CNAs undergo between 100 to 180 hours of training. The coursework includes class room training and hands-on clinical applications. At the conclusion of their training, prospective CNAs are required to successfully pass a CNA certification exam that tests the student’s competencies.

Medical assistants are trained in medical terminology, clinical and diagnostic procedures as well as typing, accounting and insurance processing. Training programs are regulated by the Accrediting Bureau of Health Education Schools.

Formal training for MAs is not always required; some medical assistants receive on-the-job training. MAs that begin their career this way will typically attend training sessions and work directly with an experienced medical assistant.

Earnings

The job forecast for CNAs and MAs is positive due to the increased need for healthcare workers in America. The lowest paid medical assistants earn approximately $20,000, while the highest-paid MAs make just over $30,000, notes the US Department of Labor.

A CNAs income ultimately depends on where they work. The highest-paid CNAs usually work in hospitals and nursing homes, while CNAs working as home-health aides are typically paid the least. The pay ranges from around $20,000 to just over $30,000 depending on location.

Due to the increased need for long-term care in America, the Department of Labor projects at 19% growth in employment opportunities for nurse’s aides through 2018.

What does this mean for you? This means that after training and passing the CNA exam, you stand a very strong chance of finding a job.

What to Expect

As a CNA, you will have direct patient contact daily. Your tasks may vary depending on what institution you work at; however, your typical duties will include helping patients eat, bathe and dress, as well as taking vital signs, helping patients to ambulate and reporting any change in the patient’s medical condition to other nursing staff.

Because patients need 24-hour care, you may be required to work a variety of different shifts. Most CNAs work full-time and as a new nurse’s aide you might have to work holidays and weekends, depending on the scheduling needs of your place of employment.

Where to Find Work

Nursing Homes/Community Care Facilities

Because Americans are living longer, the need for long-term care facilities, such as nursing homes is dramatically increasing. In fact, almost half of CNAs that are employed in America are working in some type of long-term care facility.

The multitude of opportunities to care for the elderly is valuable insurance for your future employment prospects, even in the midst of a troubled economy. Nursing homes are a great resource for CNAs that are looking to begin their careers in healthcare.

Many CNAs are also employed in community care facilities. These residential care facilities care for elderly patients and for people with special needs. The clinical setting is similar to nursing homes; however, these patients will typically require fewer needs than patients do in nursing homes.

Home Health Aide

Working as a CNA home health aide is another growing opportunity for CNAs. As a home health aide, you will be responsible for taking care of patients in their homes. Many home health aides will be responsible for a variety of patients at several different locations.

Working in this environment will require you to have a strong sense of independence. As the population in nursing homes increases, the home health aide path will continue to be an excellent career opportunity for CNAs.

Hospitals

CNAs employed in hospital settings will be exposed to a wide variety of assignments. As a CNA in a hospital, you will be responsible for several patients at the same time. A strong proficiency in multitasking is essential to be successful in this environment.

Another benefit to working in a hospital is that you may be exposed to several diverse specialties within the hospital. For example, a CNA working on a Medical/Surgical floor will observe different clinical procedures than a CNA employed on an Oncology or a Maternity unit.

CNA Wages

How much money you earn as a CNA will ultimately depend on a variety of factors such as the type of institution that you are employed at as well as in what part of the country you work. Since the cost of living varies in America, this will be factored into your pay.

Here are a few examples of typical hourly rates:

• Nursing homes -                   $10-$13
• Community care facilities -  $9-$12
• Hospitals -                             $11-$14
• Home health aides -              $8-$10

Making a Difference: I find that if you go into this line of work, you should have a strong desire to make a difference in the lives of others, it is a driving force behind the good CNA.   Making a difference starts with attitude straight out of the gate.  If you are loud and obnoxious no one is really going to want to work with you let alone have you care for him or her.   In nursing home situations, often times it is the elderly who occupy these facilities and they are older and may not like a lot of ‘In your face’ attitude.  Don’t talk to them as if they are children and don’t bully or boss them.  You are working with adults not naughty children and they deserve respect and consideration.  A calm soothing attitude and a smile can often times turn an ugly situation into a more pleasant one for the resident or patient.

Toilet Talk and Family Members: I once worked with an aide who got in trouble for discussing something with another aide, who was helping her, they had the resident on the toilet and this aide started relating a story concerning someone else.  Unaware of the fact, that the daughter of the resident on the toilet could hear every word being said, she automatically assumed that the aide was being verbally abusive to her mother.  The daughter complained and the aide apologized for her slip up and promised the daughter that her mother was in completely safe hands with her.  The daughter was not satisfied with this.  It did not matter to the daughter that this aide had no negative marks in her employment jacket, not even for being late; her employment history was a sparkling example of what a good CNA was.  However, because of one incident and a related story she was suspended and eventually terminated from her position in that nursing home.  Moral of the story, it does not matter how good of a CNA you are, one related story at the wrong time can be the end of your career.  Therefore, thinking before speaking is the most important thing you can do to be a good CNA.

Respect: Often times what sets a good CNA apart from other, CNA’s is their ability to care for their residents and patients as if they were family, because family receives, better care and have boundaries.  The good CNA will be firm but respectful at all times. He or she will be approachable but not a push over.  They know their job and each and every one of their residents.  They know what gets them going and what won’t get them to budge for nothing.  They help the families; they are respectful to family members and always professional and polite.  They smile even when they are tired, they try to answer questions to the best of their ability and won’t lie to family members and they know the scope of their duties.

What defines a good CNA and sets them apart from all the rest?  Heart, spirit and the unyielding desire to make a difference.   The good CNA is professional at all times, in manner, attitude and oral conversations.  They are aware of their surroundings at all times and leave personal issues at home.  They are not crass and loud and obnoxious, they are respectful and considerate, some with quiet strength and some with not so quiet strength.  The good CNA knows his or her job and performs it to the best of their ability and above expectation.   Timing is everything for the CNA, it can be a career killer or a career builder, know when the time is for relating personal stories and under no circumstances what so ever, relate such stories in the hearing of a family member, it will not bode well for the aide that does.

Expert Contribution by Kimberly T. CNA EMT-B

HHA’s Responsibilities: Home health aides can be responsible for light housekeeping, bathing, cooking, and running errands as well as companionship. It is not uncommon for a home health aide to sit for an hour with nothing to do while her/his charge naps.  A person seeking employment as a HHA can find it easy enough.  All places that employ the home health aide, provide training and the only certification required is the CPR , as well as other classes the employer deems fit for the HHA.    HHA’s can be subject to the same laws as the CNA regarding patient rights, care and HIPPA laws, when the care and well-being of another human being is involved it is important to have the right tools for the job.

CNA Responsibilities: In some western states like Wyoming, Utah and parts of Colorado, Home Health Agencies use CNA’s in home health care to bridge some of the gap between HHA’s and the nurse.  If an HHA is involved they are usually partnered with a CNA for learning and training at the same time they are taking classes for CNA certification.  CNA’s can take vital signs, change dressings, and works with range of motion exercises for the more infirmed clients.  Often times a CNA’s role in the Home Health field will include the duties of the home health aide as well as the more technical aspects of the job.

What do the CNA and HHA have in common? They both have to have pretty much the same training.  They have to know how to bathe a client, they have to know how to chart or narrate in the clients records.  They have to know how to make the client comfortable, how to turn them and when to turn them. They have to know the steps they need to take in every situation that may arise and they both have to obey HIPPA laws.   They both pretty much do the same job, one with slightly more responsibility than the other.  In some states, HHA’s have to have professional training and they are both required to pass a criminal back ground check.  In other states, a home health aide need only pass a background check.  Check with local state laws.  Both CNA’s and HHA’s are required to have CPR certification, which is usually done at the employer’s expense.  Both have the opportunity to further their education, if they desire to do so, and advance into nursing.

The pay rate between the two varies, the more experience an HHA has the more they can expect in wages, however the CNA will have a slight advantage with the certification and state exams under their belt.  HHA’s have the advantage in the private sector as far as employment goes, where there is no need for medical fulfillment as all of that is already taken care of by the primary care giver.

Being a home health aide is a great way to work one’s way into the medical professional and gives a clearer picture of the time and care it takes to care for another human being.  Some HHA’s find the career so fulfilling they chose not to move on; others climb the ladder and go for the nursing degrees.  Either way it is a win win situation for the dedicated HHA and CNA who want to make a difference in the lives of others.

LPNs typically receive their education and training through a two year college where they are instructed in detail on the functions of the body, medications, and clinical practice. LPNs receive hands on experience in various clinical settings within health care systems including hospitals and nursing homes.  CNAs on the other hand receive their education and training through a two month course at a technical college with clinical experience or a state regulated in facility training program.  CNAs focus more specifically on safety practices during patient care, observing and reporting data and are often trained with emphasis on long term care settings.

LPNs can work in either long term care facilities such as nursing homes, home health care, or a hospital or clinic setting.  They correspond either with the managing nurse or doctor to develop and implement patient care plans.  They are familiar with medications and it is often their duty to administer them to patients.  LPNs are ranked below the RN in the nursing hierarchy and above the CNA.

The roles of an LPN and CNA may differ, particularly with what kind of duties both are allowed to perform

It is the LPNs responsibility to ensure that the CNAs are informed of their tasks and that they have the appropriate resources to implement them.  The benefits of being an LPN often include employer provided access to affordable and high quality health insurance, a wide variety of career settings and job security. LPNs are generally well educated, intelligent professionals with excellent problem solving skills and management abilities.

CNAs also work in a variety of health care settings, though the most popular are home health care, long term care and hospital facilities. A CNA has limited training with medications and it is not in their scope of practice to administer them, though additional training can be offered by employers, which qualifies them for this task. The focus of CNA tasks are effective communication between the patient and the superior nursing staff.  The CNA is a crucial element for observing changes in patient behaviors and status as they work closer with the patient and see them on a more frequent basis. The CNA is also largely responsible for the patient’s safety and needing their basic needs during their stay at the facility. Some benefits of being a CNA include job security and flexibility.  It is typically very easy to relocate and find a willing employer as a CNA.  CNAs are often extremely caring people which exceptional interpersonal skills and are truly the foundation of the nursing team.

Expert Contribution by: Heather Martens CNA
Heather has been working as a CNA for over five years, she is currently a full time nursing student and plans to graduate as a Registered Nurse in the year 2012.

CNAs work independently throughout the day, as well as working along side their supervising RN or LPN.  A broad overview of CNA work focuses on assisting with personal hygiene, comfort, nutrition, safety, elimination needs, and exercise of the client.  The basic skills of the CNA include taking pulses, respiration rates, and temperatures and blood pressures.

CNA's may not give injections or take blood without additional training

As each facility that employs CNAs is different, it is very important to receive a written job description specific to your employer.  If your employer does not provide you with this during orientation, simply ask for one and they will comply.  Be sure that when you are interviewing for a position as a CNA you are clear about your abilities and that your employer is informed if there is something in the job description with which you are not familiar.  Never accept employment with a facility which asks you to act beyond your legal limits as a CNA.  Doing this could result in you losing your certification, as well as jeopardizing the safety and well being of the clients you care for.

There are things which are never included in the CNA job description, and you will not be able to perform these tasks without additional education and training.  These jobs include administering medications, inserting catheters or needles into the body, taking oral orders from doctors, using sterile technique, informing family of a patients diagnosis, making medical assessments or prescribing drugs, and supervising other CNAs or nursing staff. It is also of vital importance not to ignore a taks given to you by your supervising RN or LPN.  If you do not understand a task, feel that it is outside your job description, or feel uncomfortable performing the task inform your supervisor and outline the reasons why you feel you cannot perform the task. Ignoring a task could be life threatening to a patient and could result in your losing your job or even a lawsuit.

Expert Contribution by: Heather Martens CNA
Heather has been working as a CNA for over five years, she is currently a full time nursing student and plans to graduate as a Registered Nurse in the year 2012.

The pay range of CNAs who have just finished their training and are new to the health care setting generally varies between $9.25 and $12.75 per hour.  Many facilities offer pay incentives for overnight shifts which can be up to an extra dollar per hour or more.  Also, depending on the facility, you may be able to work overtime hours which would increase the amount that you earn to time and one half.  Other pay incentives for CNAs include paid holidays and vacation time which are generally offered after a probationary employment period of about three months.  Holiday and vacation pay generally accrues at a rate specified by the employer accumulating up to two weeks on average of paid days off.

For an experienced CNA, or one who has received additional training either independently or through their employer, the rate of pay usually starts at a higher amount.  Whereas a newly hired CNA with no previous experience may make anywhere from $20,000 to $30,000 per year, a seasoned CNA with significant amounts of previous experience could potentially earn any where from $28,000 to $35,000 per year.  Additional benefits of experienced CNA often include the potential to earn additional amounts of paid time off, as well as having seniority within the company which allows them to have preference over which shifts they would like to work.

Finally, employment location probably has the most significant influence over the annual salary of a CNA.  Working in various states, or working in a rural compared to an urban area, can weigh heavily on the amount of money you can expect to make.  A CNA working in Los Angeles, California may have income potential up to $22.00 per hour or more, while a CNA working in rural Wisconsin would be more likely to make around $9.50 to $10.00 per hour.  The demand for CNAs  and the cost of living in the area of employment have a lot to do with the dramatic fluctuation seen in these two scenarios.

Expert Contribution by: Heather Martens CNA
Heather has been working as a CNA for over five years, she is currently a full time nursing student and plans to graduate as a Registered Nurse in the year 2012.

A CNA is a Certified Nursing Assistant.  CNAs are the major action unit of the nursing team.  They are the care providers which work the closest with patients. Because of this, CNAs have the greatest opportunity to discover information about the patients which can be crucial in determining the best course of action regarding their care.  The CNA works directly beneath an LPN or RN from whom orders are received, usually at the beginning of each shift.

If you become a CNA you will have the opportunity to make a real difference in the life of a person suffering from an illness, disease or disability.  This impact alone is the motivation for many people to become a CNA, and is why many people make being a CNA their long term career.  Also, as a CNA you develop many interpersonal skills which help you increase your efficiency in communicating, displaying empathy, and problem solving.   These skills have positive impacts on daily life within and without the workplace.

Obtaining a CNA requires passing a special class which includes clinical experience and taking a certification test administered according to the standards of your state government.  The class usually runs about two days a week for a month and a half to two months.  Job availability is high for CNAs and many people obtain work immediately after passing the state exam.  Also, employers will often reimburse the cost of the state test and at times the cost of the entire course.  Other benefits of being a CNA include a broad opportunity for advancement and the access to free continuing education.  Because being a CNA is the first step to obtaining a LPN or RN license, it is easy for busy people to work full time and take additional courses toward becoming a nurse. If you are planning on becoming a nurse, working as a CNA looks great on a resume.  It shows your prospective employer that you understand the components of the nursing team and that you have exceptional skills in team work and interpersonal communication.  If you do not have goals of becoming a nurse, CNAs can still further their education through free continuing education classes offered though their employer.  In addition to all this, CNAs are needed in many aspects of the health care field making it easier to find a job which suits your lifestyle and matches your personality.

Expert Contribution by: Heather Martens CNA
Heather has been working as a CNA for over five years, she is currently a full time nursing student and plans to graduate as a Registered Nurse in the year 2012.

• Personal homes: Many families hire personal nurses to watch over their loved ones around the clock. CNAs may even live at these residences to provide 24/7 care for an individual needing it. Pay can be better in these situations than working at large institutions, but it truly can be a full-time job, as in around the clock. Also, working with one patient and one patient only has its benefits and drawbacks. It can lead to close personal relationships, but if the patient being worked with is not very social, can be exhausting and frustrating.

• Nursing homes: CNAs are absolutely needed at nursing facilities that provide around the clock, intensive care. Nursing assistants work in shifts and with many patients with a vast array of needs. Working with the elderly presents its own challenges, but for those who enjoy it, is incredibly rewarding. Working at a nursing home allows for more socialization than working at a personal home, both with more patients and with fellow staff. CNAs may get to know patients who stay for even years a time very well, as turnover at nursing homes is much lower than in other sectors.

• Hospitals: At hospitals, CNAs may need more specialized skill depending on what section of the hospital one is working in. CNAs often do prep for surgery, physical therapy, and other procedures. They also handle regular CNA duties like checking in on patients, cleaning rooms and linens, moving patients in and out of bed, transporting patients, feeding patients, etc. Turnover at hospitals is generally very high, so CNAs will not be forging close relationships with patients and will be keeping it strictly medical. CNAs will have many patients to work with, and so must be able to multi-task and have an excellent memory and organizational skills.

• Hospices: One of the tougher areas for many to work in is in the hospice sector. Here, CNAs care for those that are dying or terminally ill at the end of their lives. For those with the reserve to do so, it is rewarding to be able to make someone comfortable and feel cared for as they pass on. Turnover is high, and CNAs will care for individuals in various states of consciousness and incapacitation. Duties are similar to those in other sectors, though there will be fewer patients and those individuals will need to be watched over more closely than some others.

Contributed by: Edward Stern is a blogger for My Dog Ate My Blog and a writer on Online Universities for Guide to Online Schools.