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Nursing and Psychiatric Aides - What They Do

How to Advance (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.

For some individuals, these occupations serve as entry-level jobs. For example, some high school and college students gain experience working in these occupations while attending school. And experience as an aide can help individuals decide whether to pursue a career in healthcare.

Nursing and psychiatric aides held about 1.5 million jobs in 2008. Nursing aides, orderlies, and attendants held the most jobs—approximately 1.5 million, and psychiatric aides held about 62,500 jobs. About 41 percent of nursing aides, orderlies, and attendants worked in nursing care facilities and another 29 percent worked in hospitals. About 50 percent of all psychiatric aides worked in hospitals. Others were employed in residential care facilities, government agencies, outpatient care centers, and individual and family services.

Job Outlook
Employment is projected to grow faster than the average. Excellent job opportunities are expected.

Job Growth
Overall employment of nursing and psychiatric aides is projected to grow 18 percent between 2008 and 2018, faster than the average for all occupations. However, growth will vary for individual occupations. Employment for nursing aides, orderlies, and attendants will grow 19 percent, faster than the average for all occupations, predominantly in response to the long-term care needs of an increasing elderly population. Financial pressures on hospitals to discharge patients as soon as possible should boost admissions to nursing care facilities. As a result, new jobs will be more numerous in nursing and residential care facilities than in hospitals, and growth will be especially strong in community care facilities for the elderly. Modern medical technology will also drive demand for nursing aides, because as the technology saves and extends more lives, it increases the need for long-term care provided by aides. However, employment growth is not expected to be as fast as for other healthcare support occupations, largely because nursing aides are concentrated in the relatively slower growing nursing and residential care facilities industry sector. In addition, growth will be hindered by nursing facilities’ reliance on government funding, which does not increase as fast as the cost of patient care. Government funding limits the number of nursing aides nursing facilities can afford to have on staff.

Psychiatric aides are expected to grow 6 percent, more slowly than average. Psychiatric aides are a small occupation compared to nursing aides, orderlies, and attendants. Most psychiatric aides currently work in hospitals, but the industries most likely to see growth will be residential facilities for people with developmental disabilities, mental illness, and substance abuse problems. There is a long-term trend toward treating psychiatric patients outside of hospitals, because it is more cost effective and allows patients greater independence. Demand for psychiatric aides in residential facilities will rise in response to increases in the number of older persons, many of whom will require mental health services. Demand for these workers will also grow as an increasing number of mentally disabled adults, formerly cared for by their elderly parents, will need care. Job growth also could be affected by changes in government funding of programs for the mentally ill.

High replacement needs for nursing and psychiatric aides reflect modest entry requirements, low pay, high physical and emotional demands, and limited opportunities for advancement within the occupation. For these same reasons, the number of people looking to enter the occupation will be limited. Many aides leave the occupation to attend training programs for other healthcare occupations. Therefore, people who are interested in, and suited for, this work should have excellent job opportunities.

Median hourly wages of nursing aides, orderlies, and attendants were $11.46 in May 2008. The middle 50 percent earned between $9.71 and $13.76 an hour. The lowest 10 percent earned less than $8.34, and the highest 10 percent earned more than $15.97 an hour.

Median hourly wages of psychiatric aides were $12.77 in May 2008. The middle 50 percent earned between $10.00 and $15.63 an hour. The lowest 10 percent earned less than $8.35, and the highest 10 percent earned more than $18.77 an hour.

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