Nursing assistant (CNA): program, competency exam and state registry
Nursing assistants usually finish a state-approved program (at least 75 hours under federal rules for nursing homes), pass the state competency exam and go on the state registry. Orderlies typically need a high school diploma and short on-the-job training.
For: People who want a fast start in patient care and a first step on the nursing ladder; the work is physical and needs patience.
Route 1: Certified nursing assistant (CNA) Most common
Programs are offered in high schools, community colleges, vocational and technical schools, hospitals and nursing homes.
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Start here
Find a state-approved program
BLS
Nursing Assistants and Orderlies — How to Become OneU.S. Bureau of Labor Statistics (OOH)- Checked
- 20 Oct 2026
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75+ hours
Nurse aide training
A state-approved program has at least 75 clock hours of training, including at least 16 hours of supervised practical training.
42 CFR 483.152
42 CFR § 483.152 — Requirements for approval of a nurse aide training and competency evaluation programCode of Federal Regulations (Legal Information Institute, Cornell Law School)- Checked
- 20 Oct 2026
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Exam gate
State competency exam
Passing it lets you use state-specific titles; in some states the title is Certified Nursing Assistant (CNA).
BLS
Nursing Assistants and Orderlies — How to Become OneU.S. Bureau of Labor Statistics (OOH)- Checked
- 20 Oct 2026
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License
State nurse aide registry
Nursing assistants who pass are placed on the state registry; you must be on it to work in a nursing home. Some states add continuing education or a background check.
BLS
Nursing Assistants and Orderlies — How to Become OneU.S. Bureau of Labor Statistics (OOH)- Checked
- 20 Oct 2026
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Goal
Nursing assistant
Some states offer extra credentials, such as Certified Medication Assistant (CMA).
BLS
Nursing Assistants and Orderlies — How to Become OneU.S. Bureau of Labor Statistics (OOH)- Checked
- 20 Oct 2026
Route 2: Keep climbing: CNA → LPN → RN Next steps
Many nurses start as nursing assistants.
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Start here
Working as a CNA
BLS
Nursing Assistants and Orderlies — How to Become OneU.S. Bureau of Labor Statistics (OOH)- Checked
- 20 Oct 2026
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About 1 year
Practical nursing program
BLS
Licensed Practical and Licensed Vocational Nurses — How to Become OneU.S. Bureau of Labor Statistics (OOH)- Checked
- 20 Oct 2026
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Exam gate
NCLEX-PN
NCLEX-PN exam pageNCSBN
NCSBN examinations: registering for the NCLEXNational Council of State Boards of Nursing (NCSBN)- Checked
- 20 Oct 2026
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License
LPN or LVN license
LPN license stepsBLS
Licensed Practical and Licensed Vocational Nurses — How to Become OneU.S. Bureau of Labor Statistics (OOH)- Checked
- 20 Oct 2026
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Goal
Licensed practical nurse, then RN
An LPN may complete an LPN-to-RN program to become a registered nurse.
RN roadmapBLS
Licensed Practical and Licensed Vocational Nurses — How to Become OneU.S. Bureau of Labor Statistics (OOH)- Checked
- 20 Oct 2026
Route 3: Orderly No license
Orderlies do not need a license.
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Start here
High school diploma or equivalent
GED or HiSETBLS
Nursing Assistants and Orderlies — How to Become OneU.S. Bureau of Labor Statistics (OOH)- Checked
- 20 Oct 2026
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On the job
Short on-the-job training
BLS
Nursing Assistants and Orderlies — How to Become OneU.S. Bureau of Labor Statistics (OOH)- Checked
- 20 Oct 2026
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Often asked
CPR or basic life support certification
Jobs might require it.
BLS
Nursing Assistants and Orderlies — How to Become OneU.S. Bureau of Labor Statistics (OOH)- Checked
- 20 Oct 2026
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Goal
Orderly
BLS
Nursing Assistants and Orderlies — Summary (Quick Facts)U.S. Bureau of Labor Statistics (OOH)- Checked
- 20 Oct 2026
State rules
Specific requirements for nursing assistants vary by state, including the title, continuing education and background checks. Check with your state's certifying agency. BLS
View source
Where to go next
Every career page in this cluster: entry, license, BLS pay and outlook.
What the job is, BLS pay and job outlook, and how to become one.