Nursing and Psychiatric Aides

There are approximately 1.5 million nursing and psychiatric aides working in the United States. Job growth over the next ten years is expected to climb by 18 percent. This is one of the main reasons nursing programs are becoming so popular lately; these days, there are even online nursing schools. (More information here.) Most of these jobs will be in hospitals or in nursing or residential care facilities. Growth for psychiatric aide positions will be much slower.


Nursing and psychiatric aides work with long-term-care patients who are injured, sick, mentally ill, disabled, or infirm. These patients may be hospitalized or reside in a nursing care or mental health environment.
Nursing aides are also called orderlies. They complete daily tasks assigned by the medical or nursing staff. They work under direct supervision and handle most routine aspects of patient care. Aides might help patients bathe or dress; they may also make beds, help at mealtimes, or deliver messages. Some aides are asked to take a patient’s vital signs, including temperature, respiration and pulse rate, and blood pressure. Patients who have difficulty getting into or out of bed will depend on the nursing aide’s help. In some jobs, aides support medical staff by preparing supplies, equipment, and other necessary items for treatment, and putting these things away following treatment. Aides also notify the supervisor if a patient displays emotional, mental, or physical signs of distress. Nursing care facilities sometimes depend on nursing aides to be the primary caregivers. Because this is long-term care, aides and patients often develop a strong and loving bond.
Psychiatric aides, also called mental health assistants, take care of patients who are emotionally or mentally disturbed. They are members of a team that includes other medical workers such as psychologists or psychiatrists, social workers, psychiatric nurses, or therapists. They provide physical support to help patients bathe, dress, and eat. Even more important, they socialize with their patients and encourage them to participate in recreational or educational endeavors. They might play video games, read patients a book, play cards, or watch a movie with their charges. They alert the supervisor if they have noted any behavioral or physical signs of distress. When patients go to treatment or therapy, the aide often goes as well. For many patients, the psychiatric aide is the most trusted, reliable person in their world.
Nursing and psychiatric aides have, to a large degree, assumed a labor of love. The work is physically strenuous; aides are on their feet during most of their entire shift, sometimes lifting, carrying, or pushing heavy loads. They help patients stand, walk, and get into or out of beds; strains and sprains are frequent risks of this occupation. Following the correct procedure for lifting or supporting patients is important. Aides will be exposed to infectious diseases, not only from their patients but from everyone in the closed environment. Psychiatric aides in particular are at risk of injury from a patient who becomes violent. Nursing and psychiatric aides have a higher risk of non-fatal injury or illness than 98 percent of all employees. While this job is, in many ways, deeply satisfying, aides are also required to clean bedpans, change soiled sheets, and take on other unpleasant tasks.

  • Full-time nurse and psychiatric aides work 40 hours per week. Some work overtime. Twenty-four-hour care facilities may require aides be on a rotating schedule and work some evenings, nights, weekends, and holidays. A quarter of all nursing and psychiatric aides are part- time employees.
  • With the exception of nursing aides employed by nursing homes, a high school diploma or its equivalent is often all that is required for this work. Some facilities have additional requirements. Many high schools, vocational centers, community colleges, and nursing care centers offer training in nutrition, anatomy, physiology, body mechanics, communication skills, disease control, and patient rights.
  • A few states require psychiatric aides to successfully complete formal training. Most are trained on the job, either through formal classroom instruction or informally by more experienced aides or licensed nurses. Some employers offer professional learning opportunities for their employees, such as lectures, in-service training sessions, or workshops.
  • Nursing aides working in nursing care facilities are regulated by the federal government. Aides must complete at least 75 hours of training through a state-approved program and must also pass a competency test. Upon successfully completing these requirements, aides become certified nurse assistants (CNAs). In addition, all aides must pass a state-required disease test and a criminal background check.
  • There is very little opportunity for advancement in this type of work, unless the aide chooses to return to school to become a licensed nurse practitioner or a registered nurse.
  • The median hourly pay for nursing aides is about $12. The midrange is between approximately $10 and $14 per hour. Earners in the top 10 percent make more than $16 per hour.
  • The median hourly pay for psychiatric aides is about $13. Midrange earners receive between $10 and $16 per hour. The highest paid 10 percent earn around $19 per hour.