CNA Schooling: Do You Need a Degree to Be a Nursing Assistant?

Key Takeaways

A CNA does not need a college degree, but must complete a state-approved training program and pass a competency exam to join the state registry. Programs typically run four to 12 weeks and combine classroom instruction with clinical training. Certification renews every two years, which requires working a paid CNA position and completing continuing education.

Do You Need a Degree to Become a CNA?

No. Unlike most nursing jobs, a CNA does not require a college degree. You do need a certificate or diploma from a CNA program covering patient personal care, infection prevention, vital signs, communication, mental health, and other basic care.

How You Earn CNA Certification

After completing your training program, you take a competency exam. Once you pass, you are placed on a state registry as a CNA, licensed nursing assistant, or similar title depending on the state, and you are ready to work.

Certification matters because it signals you have the knowledge to care for patients safely, from taking vital signs to handling emergencies. Nursing homes and Medicare and Medicaid facilities cannot employ a nurse aide unless that person is on the state registry, and getting on the registry requires completing an approved course.

Certification requirements

Each state sets its own criteria, all of which include passing a state-approved exam. Washington State, for example, requires at least 85 hours of training in an approved program (the federal minimum is 75 hours, but states can require more), a passing score on the competency exam, a completed statement covering physical and mental status and felony convictions, and seven hours of HIV/AIDS training. Expect similar requirements elsewhere. Confirm your program is state-approved by checking directly with the health or nursing board that oversees training and certification.

Specialty certification

Beyond general certification, you can earn credentials in specialized areas to expand your opportunities and potentially raise your pay. These usually require education and experience beyond initial certification, set by the certifying organization. Common options include CNA II (offered by some state boards for advanced training 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), and Medication Aide Certification (National Council of State Boards of Nursing).

Certification endorsements

If you move, you may not have to retake the competency exam. Some states let you apply for an endorsement, where the new state accepts your existing credentials as meeting its qualifications. To be eligible, you generally need to meet training and work-experience requirements and hold an active CNA license from another state.

The Certification Exam

The exam is typically administered by a third party at 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; others use different exams. Most include a multiple-choice section and a manual skills test. For the skills test, you perform a set number of actions, usually about five, evaluated by a registered nurse. The skills test is scenario-based, so you complete tasks in a logical progression rather than at random.

Both parts run the same day. In many cases you have about two hours for the multiple-choice section and 25 to 45 minutes for the clinical skills. Exam topics often include where to take a patient's pulse, infection control, data collection and reporting, handling family visits, when to notify a charge nurse, patients' cultural needs, patient rights, law and ethics in patient care, handling mood and behavior changes, and the health problems wrinkled bedsheets can cause.

A few tips: if you make a mistake during the skills exam, do not panic, since you can usually correct an error once per skill. Be sure to demonstrate the critical element of each skill, and prepare with a practice test to get familiar with the question format and the time allotted.

What You'll Learn

Your program combines coursework and hands-on clinical training. It covers working in homes, hospitals, and nursing facilities, and caring for patients with common conditions like diabetes, respiratory issues, and cognitive impairment. You learn to administer oral and topical medications, help patients bathe, take vital signs, administer oxygen, provide special care for the elderly and for infants, remove peripheral and indwelling catheters, provide emergency care beyond CPR, control infections, and help with personal care.

You also learn to protect yourself from injury. CNAs are on their feet most of the day doing physical work, and injuries tend to be repetitive rather than acute. Training covers proper body mechanics, safe transfer and lifting procedures, and maintaining a safe, clean environment.

How Long a Program Takes

Most CNA programs run four to 12 weeks, split between instructional hours and clinical practice. A typical 120-hour program over six weeks might include four weeks in class and two weeks in a clinical setting, depending on state guidelines. Programs often accommodate working students and family schedules, with day, evening, and weekend classes available.

Online Programs

Many schools advertise online CNA classes, but few if any let you complete the entire program remotely, because the work relies on person-to-person interaction and skills best learned in the classroom, lab, and clinical practice. Hybrid programs let you finish some assignments online while attending labs and on-campus training, with clinical work usually done at a local nursing home or hospital on a schedule the school coordinates.

Before enrolling, check with your state board to confirm which online programs are approved, since an unapproved program leaves you ineligible for the certification exam. Read program details carefully. Oregon, for instance, has two CNA levels, and some online programs train for only one.

Cost

Community colleges, vocational schools, and organizations like the American Red Cross offer CNA programs, with tuition typically ranging from a few hundred dollars to about $3,000. By comparison, a two-year associate's degree in nursing runs roughly $3,600 a year. Some hospitals and nursing homes provide low-cost or no-cost programs to new employees, giving you the education to certify while the institution gains a qualified worker. After your program, you pay a fee to take the certification exam plus any administrative fees your state requires, so check with your state board for exact costs.

Paying for School

If you attend an accredited vocational school or community college, you may qualify for federal financial aid. Accreditation means your school meets education standards, which you can verify through the U.S. Department of Education database. Complete the FAFSA to determine eligibility, and your school's financial aid office can help with the application.

Prerequisites

Most programs require a high school diploma or GED and a school transcript. Some also require an entrance exam and a criminal background check.

Accreditation

Diploma CNA programs are not eligible for accreditation. But if you later pursue an LPN or RN, both your CNA school and program should be accredited; otherwise you may not qualify for financial aid or be able to transfer credits.

Job Market

The BLS projects CNA employment will grow about 2% from 2024 to 2034, roughly in line with the average for all occupations, driven by an aging population and more patients with chronic illnesses. Prospects are strong in home health care and community-based care, alongside hospitals and assisted living facilities. Your daily experience varies by setting: home health care offers a calmer pace but sometimes lower pay; hospitals tend to pay more and offer good benefits and exposure to varied departments, though patients are discharged quickly; and nursing and long-term care facilities let you build lasting relationships with patients, which many CNAs find the most satisfying part of the job.

Advancing Your Career

Many CNAs stay for the patient relationships, but others go back to school. If you want a related career, consider becoming a Licensed Practical Nurse (the next level up, with more responsibility and slightly higher pay), an occupational therapy assistant (helping patients regain physical skills under an occupational therapist), or a personal care aide (helping patients with everyday tasks and providing companionship, often in the home).

Continuing Education

Federal law requires at least 12 hours of continuing education annually, and states can require more or specify topics. Common subjects include HIV/AIDS, elderly patient care, resident rights, bloodborne pathogens, infection control, domestic violence, and preventing medical errors. Check your state board for required hours and whether any can be completed online. Some employers cover the cost or provide the courses.

Renewing Your Certification

Active status on the state registry lasts two years. To renew, federal regulations require working at least eight hours during each two-year period in a paid position consistent with the CNA role. If your certification lapses, you must apply for recertification, which can be costly: some states let you retake only the competency exam, while others require both the training and the exam. Your state board can provide the details.