PCA and Nurse Aide, what's the difference

Nursing Students CNA/MA


Hello All Willing to Read,

I am new to Nursing but have been attending college for some time, I let the military get in the way of it. Anyway, I would like to know if there is a real difference in PCA and Nurse Aide. A local health care office offers PCA or I can take two classes through my current college for Nurse Aide. Want to weigh my options as far as the knowledge I would gain, not necessarily the pay. Thanks if anyone decides to respond.



You would have to speak to someone with knowledge of the two courses to find out the differences and quality of the instruction. Basically a PCA is just a fancy name for a nursing assistant type position. Hospitals may include some facility specific skills that are not normally done by nursing assistants working in long term care facilities and they just use different terminology for the position to lend "something" to the job title. The person may get a higher rate of pay than their counterpart in a long term care facility, but in general, a certified nursing assistant by any other name is basically a certified nursing assistant. Sometimes the hospital version doesn't even have to be certified to get hired. In this case, their wages may not start out as high, but then nursing assistants who are not yet certified, start out at lower wages also.

A CNA has significantly more training than a PCA. A CNA has a taken classes and a test demonstrate their competence, and a PCA is just a job that anyone may apply for. I have been both in the past (both in the state of Washington and Montana), so I would know.

It depends on the facility. Sometimes they are the same job and in some places a PCA is a CNA with additional training while in other places the reverse is true and a PCA is a step below CNA (without certification and/or training). Other common terms for the same type of position are STNA and PCT.

If it's something you are interested in, I'd suggest talking with local facilities where you are interested in working and find out what (if any) distinctions they make and what sort of training they require. In my area, CNA training is regularly offered as a free course from a variety of nursing homes. It only takes about a month to complete and doesn't require a commitment to work for them upon completion.

Specializes in MPCU.

Certified Nursing Assistant (CNA) and State Tested Nursing Assistant and a couple other terms really in effect are licenses. They require 50 hours of theory and 100 hours of supervised clinical in a state approved training program. The certificate also requires continuing education hours to maintain the license.

A Nursing Assistant does not necessarily need to be licensed. It seems that most acute care settings do not require the license, but all long term care facilities require the license. Well, if not all long term facilities those which fall under OBRA.

I am glad someone brought this subject up. I recently went to an open house for a care center in my area (PA) for CNA training. After 4 weeks unpaid training, I will take the exam, I think she said around 120.00 or so. If I stay on to work there they will pay exam fee.

I have read some CNA program cost money, will I be getting the same certificate through this free program at the Care Center, and be able to use this certificate if I decide to at some point go elsewhere?

I have read some CNA program cost money, will I be getting the same certificate through this free program at the Care Center, and be able to use this certificate if I decide to at some point go elsewhere?

Go elsewhere within the state? Yep. And I believe anywhere you work has to pay the testing fee in PA. I'm not sure if that is a national thing or not but I went to nursing school in PA and some of my fellow students had worked as CNAs and their employers had to pay for their training and testing. The programs in my area (WV) don't charge at all for training or testing and I believe that is by law.

If by elsewhere you mean out of state, it depends. Different states have different requirements and while many offer reciprocity, some may not (I don't believe NC does). WV only requires 120 total hours of instruction (that takes between 4 and 6 weeks to complete) with only 55 hours of those 120 hours being clinical instruction. So more than the 50 hours of theory and less than the 100 hours of clinical required where woodenpug lives (and there is no continuing education requirement either). Ohio requires only 75 combined hours of clinical and class time, which is considerably less than WV (also without a continuing education requirement).

Without knowing what state you are in it is difficult to give accurate advice. Every state is different.

The CNA is now required in most states to perform patient care. This certification is generally offered by the Dept of Health or whatever cert/licensing department regulates nurses or other health care providers.

In my state the PCA is an additional 100 - 200 hours of training which I believe meet the requirements for home health as well.

The PCT can be another 500 - 600 hours of training. However, the base education and certification is still the CNA. PCT programs in some states are being redesigned since those doing Phlebotomy may require an additional national and state certification.

Home Health may also have their own certifications but may be under a different state agency that regulates that industry.

Again, I am only stating what I know from one state since there is not a national cert for CNA. However, there is generally reciprocity between states.

The additional hours may open up more doors and some employers are expecting their applicants to be job ready in this tough market.

When looking at the programs:

* See which one definitely will get you the CNA cert from the state.

* Ask what the advantages are for PCA and if either cert can cross easily into Home Health if that is also an option for you.

* Ask for links to the state certification agencies and obtain a syllabus from the school to see if all requirements are met. Sometimes a private employer or agency might give you a class with the bare minimum to meet only their (warm body) needs and leave you hanging when it comes to certification or other opportunities.

* Find out the credentials of the person teaching the class.

* Check out the classroom and lab area.

* Check the job boards to see who is hiring and what certs they expect.

* I would make sure you have CPR if the course does not offer it. Ask if it is included. I would take the CPR for Health Care Providers so it can be used in your nursing program if you don't already have it.

I personally like college based programs since you may have access to a nice lab and can network with the nursing instructors. Generally they will be the most knowledgeable about expectations. If you are in a nursing program, most states may allow you to obtain a CNA cert after the 1st or 2nd semester.

Sidenote: On another thread I noticed someone scolding a CNA for using the term "licensed". I just browsed through my state's DOH website and saw the terms "licensed" and "certified" were used interchangeably when providing some of the CNA information. I can see where there is confusion about this if the state's website provides information presented with both of these terms.

Specializes in Hospital Education Coordinator.

In my state the CNA is certified through the Health Dept upon completion of an approved program. The PCT or PCA is trained on the job. The actual duties may be the same, but the CNA has a certificate and that is more desirable to some employers.

Specializes in MPCU.

Yeah, I gave the national requirements. States may impose stricter regulations. I also did not mention that to acquire the license you must pass a test.

Yeah, I gave the national requirements. States may impose stricter regulations. I also did not mention that to acquire the license you must pass a test.

National requirements? There is not a national certifying board for CNAs at this time and training can vary from what the employer sees appropriate if there is not a state certification to some states that may require as few as 50 hours while others might be 150 - 200 hours for entry level CNA. However, I believe CMS is wanting some type of certification for a CNA or HHA to work in certain patient populations for that patient care agency/facility to be legit. But, the type of patient care provided and supervision required may also dictate the cert which is why home health can provide specific certifications.

Good website that links you to each state's CNA certifying agency and gives the requirements for each. Some also have HHAs and Cert. Med Techs listed.


When you deal with entry level certifications for CNA and HHA in each state it is almost as confusing as the many different EMS certifications.

Specializes in MPCU.

The Omnibus Budget Reconciliation Act of 1987, in part set those standards. Yes, it is a state license, as I clearly stated, with federal requirements. Been there, did that. I remember the painful process as it happened. You see it gets around the whole states rights issue by simply not providing federal matching funds if your state does not comply.

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