Employment fields

Employment field:
Social and human service assistants

49% increase in jobs 2002 - 2012

Home health aides

48% increase in jobs 2002 - 2012

Most jobs are in nursing and residential care facilities, hospitals, and home healthcare services.

Modest entry requirements, low pay, high physical and emotional demands, and lack of advancement opportunities characterize this occupation.

Numerous job openings and excellent job opportunities are expected.

Nature of Work

Nursing and psychiatric aides help care for physically or mentally ill, injured, disabled, or infirm individuals confined to hospitals, nursing care facilities, and mental health settings. Home health aides' duties are similar, but they work in patients' homes or residential care facilities.

Home health aides help elderly, convalescent, or disabled persons live in their own homes instead of in a health facility. Under the direction of nursing or medical staff, they provide health-related services, such as administering oral medications. (Personal and home care aides, who provide mainly housekeeping and routine personal care services, are discussed elsewhere in the Handbook.) Like nursing aides, home health aides may check patients' pulse rates, temperatures, and respiration rates; help with simple prescribed exercises; keep patients' rooms neat; and help patients move from bed, bathe, dress, and groom. Occasionally, they change no sterile dressings, give massages and alcohol rubs, or assist with braces and artificial limbs. Experienced home health aides also may assist with medical equipment such as ventilators, which help patients breathe.

Working conditions

Most full-time aides work about 40 hours a week, but because patients need care 24 hours a day, some aides work evenings, nights, weekends, and holidays. Many work part time. Aides spend many hours standing and walking, and they often face heavy workloads. Because they may have to move patients in and out of bed or help them stand or walk, aides must guard against back injury. Aides also may face hazards from minor infections and major diseases, such as hepatitis, but can avoid infections by following proper procedures.

Employment

Nursing, psychiatric, and home health aides held about 2.0 million jobs in 2002. Nursing aides held the most jobsÑapproximately 1.4 million. Home health aides held roughly 580,000 jobs and psychiatric aides held about 59,000 jobs. Around 2 in 5 nursing aides worked in nursing care facilities, and about one-fourth worked in hospitals. Most home health aides (about one-third) were employed by home healthcare services. Others were employed in social assistance agencies, nursing and residential care facilities, and employment services. More than half of all psychiatric aides worked in hospitals, primarily in psychiatric and substance abuse hospitalsÑalthough some also worked in the psychiatric units of general medical and surgical hospitals. Others were employed in State government agencies; residential mental retardation, mental health, and substance abuse facilities; individual and family services; and outpatient care centers.

Training

In many cases, neither a high school diploma nor previous work experience is necessary for a job as a nursing, psychiatric, or home health aide. A few employers, however, require some training or experience. Hospitals may require experience as a nursing aide or home health aide. Nursing care facilities often hire inexperienced workers who must complete a minimum of 75 hours of mandatory training and pass a competency evaluation program within 4 months of their employment. Aides who complete the program are certified and placed on the State registry of nursing aides. Some States require psychiatric aides to complete a formal training program.

Job Outlook

Numerous job openings for nursing, psychiatric, and home health aides will arise from a combination of fast employment growth and high replacement needs. High replacement needs in this large occupation reflect modest entry requirements, low pay, high physical and emotional demands, and lack of opportunities for advancement. For these same reasons, many people are unwilling to perform the kind of work required by the occupation. Therefore, persons who are interested in, and suited for, this work should have excellent job opportunities.

Overall employment of nursing, psychiatric, and home health aides is projected to grow faster than the average for all occupations through the year 2012, although individual occupational growth rates will vary. Employment of home health aides is expected to grow the fastest, as a result of both growing demand for home healthcare services from an aging population and efforts to contain healthcare costs by moving patients out of hospitals and nursing care facilities as quickly as possible. Consumer preference for care in the home and improvements in medical technologies for in-home treatment also will contribute to faster-than-average employment growth for home health aides.

Earning

Median hourly earnings of nursing aides, orderlies, and attendants were $9.59 in 2002. The middle 50 percent earned between $8.06 and $11.39 an hour. The lowest 10 percent earned less than $6.98, and the highest 10 percent earned more than $13.54 an hour. Median hourly earnings in the industries employing the largest numbers of nursing aides, orderlies, and attendants in 2002 were as follows:

  • Employment services $11.38
  • Local government 10.33
  • General medical and surgical hospitals 10.09
  • Nursing care facilities 9.27
  • Community care facilities for the elderly 8.98

Home health aides receive slight pay increases with experience and added responsibility. Usually, they are paid only for the time worked in the home; normally, they are not paid for travel time between jobs. Most employers hire only on-call hourly workers and provide no benefits.

Median hourly earnings of psychiatric aides were $11.04 in 2002. The middle 50 percent earned between $8.97 and $13.74 an hour. The lowest 10 percent earned less than $7.52, and the highest 10 percent earned more than $16.16 an hour. Median hourly earnings in the industries employing the largest numbers of psychiatric aides in 2002 were as follows:

  • State government $13.14
  • Psychiatric and substance abuse hospitals 11.32
  • General medical and surgical hospitals 11.04