Working as a Nursing Assistant in a Hospital vs. Nursing Home

Susan Sinclair, MSN, RN
Published on Nov 16, 2020. Updated on Nov 16, 2020.

Nursing Assistants are most needed in two different care settings: the hospital, where you can work with clients of all ages, and nursing homes, where you will primarily work with aging populations. In this article, we explore the differences between working as a Nursing Assistant in a hospital vs. a nursing home to help you determine which option aligns with your goals as a future Nursing Assistant. 

Anna has always dreamed of helping others—particularly those battling cancer. After recently completing her Nursing Assistant/Aide training and passing the state board exam to become certified, Anna is now ready to start her first job. She is deciding between beginning her career at either a hospital or a nursing home. She has put a lot of effort into Nursing Assistant school, and her ultimate goal is to work with oncology clients—but what setting is the best pathway for her?

We will be breaking down the differences between working as a Nursing Assistant in a hospital and a nursing home, as well as the responsibilities involved for each. 

Regardless of the setting, Nursing Assistants are well-trained in obtaining vital signs, bathing and dressing clients, making beds, and providing personal care. Nursing Assistants help with setting up meals and feeding clients in some cases as well. Nursing Assistants also provide support for transferring clients from beds to wheelchairs and may help with safely ambulating. They are trained in basic CPR and may assist nurses or doctors with procedures. 

Depending on the setting, Nursing Assistants can learn additional skills on the job. This career is perfect for people who are kind, client, attentive, and enjoy helping others.

The Hospital Workplace Setting

The hospital setting is a unique, fast-paced environment, and there are varied tasks that a Nursing Assistant can perform there. Specifically, the Nursing Assistant will gain a lot of practice obtaining vital signs

Since clients tend to be sicker in the hospital and emergencies often occur, performing CPR and other urgent interventions will be required. As a result, in many states, Nursing Assistants must complete additional training to work in a hospital environment.

Reporting any abnormal vital signs or changes in the client’s condition to the nurse is crucial. There are ample opportunities for learning, which is especially helpful if the Nursing Assistant is considering nursing school. 

Occasionally, the Nursing Assistant can cross-train to fulfill unit clerk responsibilities such as organizing charts, answering incoming and outgoing calls, and keeping the client status board up-to-date. They can also learn additional skills such as phlebotomy and obtaining EKGs. Hospitals generally require 12-hour shifts and if the Nursing Assistant is a night owl, there are always night shifts that can be worked or picked up. Working weekends and holidays is also expected. 

The Nursing Assistant can choose to work with a specific client population within a hospital such as pediatrics, oncology, cardiology, or ICU. If the Nursing Assistant has a specialty in mind, gaining experience in the hospital setting is a good way to reach that goal. The hospital provides opportunities to work with various members of the healthcare team on a regular basis such as doctors, residents, nurses, and students, as well as physical, occupational, and speech therapists. Social workers and unit clerks are also members of the hospital team. 

Osmosis illustration of a Nursing Assistant working in a hospital.

The nursing home workplace setting

If the Nursing Assistant enjoys working with the elderly population, a nursing home could be a great fit. Nursing homes are residents’ “home away from home,” and are designed to feel comfortable and nurturing. Nursing Assistants will gain experience assisting with activities of daily living (ADLs), personal care such as bathing and dressing, as well as transfers and ambulation. 

Some nursing homes may train Nursing Assistants to become medication technicians, where they are responsible for administering clients’ medications and monitoring for side effects. This role is overseen by nurses. Some Nursing Assistants are required to take a course and pass an exam, but this varies by state. Adding medication technician training to the Nursing Assistant’s skill set is valuable for resume building and marketability. 

Nursing Assistants generally work eight-hour shifts in the nursing home with holidays and weekend requirements. Like the hospital setting, working in a nursing home is a physical job and requires long hours on your feet. Therefore, it’s important for Nursing Assistants to bring snacks and hydration to stay properly fueled for the shift. 

Nursing Assistants in nursing homes may come into contact with various other members of the healthcare team, such as physical therapists and activity coordinators. They may interact with doctors, but not as frequently as in the hospital setting. Nursing home residents can become like family to the Nursing Assistant, as they are able to build relationships with the same residents over time. 

Osmosis illustration of a Nursing Assistant working in a hospice.

How to choose the right Nursing Assistant workplace setting for you

Deciding between working in a hospital or a nursing home depends on the Nursing Assistant’s unique goals and preferences. Hospitals offer a fast pace, longer shifts, and a wide variety of clinical experiences. A nursing home allows the Nursing Assistant to create a strong rapport with the geriatric population. 

It’s helpful to remember that both settings offer ample opportunities to advance the Nursing Assistant’s career. Working as a Nursing Assistant is a rewarding career in itself, and helping others with basic needs that most people take for granted is an incredibly meaningful experience. 

Anna is now considering nursing school, and has applied to work as a Nursing Assistant for the night shift in a hospital. She is interested in eventually learning phlebotomy on the job. 

No matter what route Nursing Assistants like Anna decide to take, a client-focused career as a Nursing Assistant is a great way to get started in the medical field.

About Susan Sinclair, MSN, RN 

Susan Sinclair is a nurse who currently works in home health. 


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