How to Get Started in jobguidedaily.com: A Step-by-Step Plan
A practical route into frontline patient care work: state-approved training, the competency exam and registry listing, then applications that get answered.
Oct 26, 2026 · 7 min read
Getting started usually means choosing one of two entry doors into patient care. Nursing assistants typically must complete a state-approved education program and pass their state's competency exam, while orderlies typically need at least a high school diploma or equivalent (U.S. Bureau of Labor Statistics, 2025). Both work under the supervision of licensed practical or vocational nurses and registered nurses (U.S. Bureau of Labor Statistics, 2025).
This plan walks through the order those pieces go in: confirm what your state requires, train, test, get listed on the registry, then apply. Requirements, job titles and timelines differ by state, so check your own state's rules before you pay for anything.
Your step-by-step path to a first role
- Pick your entry door this week. Nursing assistant roles usually require approved training plus a competency exam; orderly roles usually require a high school diploma or equivalent and no license, though employers might ask for CPR or basic life support certification (U.S. Bureau of Labor Statistics, 2025). If you want to start working sooner, orderly and aide roles are the shorter route; home health and personal care aide roles typically need a high school diploma or equivalent and short-term on-the-job training (U.S. Bureau of Labor Statistics, 2025).
- Look up your own state's rules. ONET OnLine's Training & Credentials tool lets you search state-specific training programs, certifications and licenses for nursing assistants by state or ZIP code (ONET OnLine, U.S. Department of Labor, undated). Note the title your state uses — in some states it is Certified Nursing Assistant, but titles vary by state (U.S. Bureau of Labor Statistics, 2025).
- Enrol in a state-approved program. Confirm the program appears on your state's approved list before paying. State pages typically describe completing a state-approved training course and then passing the certification exam before being placed on the state's nurse aide registry (nurse.org, undated).
- Book the competency exam as soon as you finish. Certification generally involves a written or oral exam plus a skills evaluation, and both must be passed within a set period after program completion (Vivian Health, undated). In New York, for example, students pass the state health department's certified nurse assisting exam administered by Prometric, which then issues the certificate and enters the person into the state registry (New York State Education Department, undated).
- Confirm your registry listing and save proof. Passing places you on a state registry, and you must be on it to work in a nursing home (U.S. Bureau of Labor Statistics, 2025). States provide verification — Louisiana's nurse aide registry, for instance, offers printable verification of registry listings maintained to Centers for Medicare and Medicaid Services requirements (Louisiana Department of Health, undated).
- Clear the extras employers check. Some states add continuing education and a criminal background check (U.S. Bureau of Labor Statistics, 2025). Get CPR or basic life support certification if your target employers list it.
- Write one page and apply in batches. Describe the work in the language of the job: bathing patients, helping with toileting and dressing, turning, repositioning and transferring patients, measuring vital signs, serving meals and helping patients eat, and reporting concerns to nurses (U.S. Bureau of Labor Statistics, 2025). State your shift availability plainly — facilities provide care at all hours, so nights, weekends and holidays are common (U.S. Bureau of Labor Statistics, 2025).
- Follow up within five working days. Call or email the hiring contact, confirm your registry number is on file, and ask what their orientation covers — workers in these roles typically get training in proper lifting to reduce injury risk (U.S. Bureau of Labor Statistics, 2025).
What to prepare before you apply
- Proof of high school completion or equivalent, since that is the typical entry-level education for orderlies and for home health and personal care aides (U.S. Bureau of Labor Statistics, 2025).
- Your training completion certificate from the state-approved program, scanned as a PDF.
- Registry verification, printed or saved — several states publish printable proof of registry listing (Louisiana Department of Health, undated).
- A current CPR or basic life support card if your target employers ask for one (U.S. Bureau of Labor Statistics, 2025).
- Government photo ID and any documents your employer's background check will need, as some states require a criminal background check (U.S. Bureau of Labor Statistics, 2025).
- Two references with current phone numbers — a clinical instructor and a supervisor from any customer-facing or care work.
- A written availability statement listing the nights, weekends and holidays you can cover, plus a short example of communicating with a distressed patient, since communication skills are among the qualities listed for these roles (U.S. Bureau of Labor Statistics, 2025).
Where to look for openings
| Channel | How to use it |
|---|---|
| Career pages of nursing care facilities | The largest employer group for nursing assistants (U.S. Bureau of Labor Statistics, 2025) — set alerts on three or four near you. |
| Hospital careers portals | Search both "nursing assistant" and "orderly" or "patient care technician", as titles vary by state. |
| Continuing care retirement communities and assisted living | Another of the largest employer groups (U.S. Bureau of Labor Statistics, 2025); many post only on their own sites. |
| Home healthcare agencies | Also among the largest employers (U.S. Bureau of Labor Statistics, 2025), often with part-time and shift-based openings. |
| Government job portals | Government is a major employer of nursing assistants (U.S. Bureau of Labor Statistics, 2025); check state, county and veterans' facility systems. |
| Healthcare staffing agencies | Useful for per-diem shifts that build experience while you apply for permanent roles. |
| Your training program's placement office and your state workforce office | Both hold local employer contacts that never reach national boards. |
Frequently asked questions
Do I need certification to work in a nursing home?
Yes. Nursing assistants who pass the competency exam are placed on a state registry, and you must be on the registry to work in a nursing home (U.S. Bureau of Labor Statistics, 2025). Confirm your listing is live before you start interviewing.
How long do I have to pass the exam after training ends?
Certification generally involves a written or oral exam plus a skills evaluation, both of which must be passed within a set period after program completion (Vivian Health, undated). The window differs by state, so get the exact deadline in writing from your program or state registry.
What should I expect to be paid?
Pay is usually hourly, with shift differentials common for nights, weekends and holidays, since facilities operate at all hours (U.S. Bureau of Labor Statistics, 2025). The Bureau of Labor Statistics publishes a median annual and hourly wage for nursing assistants in its Quick Facts table, updated with each annual OEWS release — check the current published figure rather than any fixed number (U.S. Bureau of Labor Statistics, 2025).
Can I use my certification in another state?
Reciprocity processes vary and generally still involve passing exam components before you are added to the new state's registry (Vivian Health, undated). Contact the registry in the state you are moving to before you apply for jobs there.
Is there a credential that increases what I can do?
In some states nursing assistants may earn an additional Certified Medication Assistant credential that allows them to dispense medications (U.S. Bureau of Labor Statistics, 2025). Availability depends on the state, so check your state's requirements through O*NET's Training & Credentials tool (O*NET OnLine, U.S. Department of Labor, undated).
