Hi, Older student nurse here with 10 years plus experience working as a CNA and HHA...My personal belief is that ALL perspective nursing students should have to have a CNA license or HHA title with minimum 6 months experience prior to or as a condition of entering a nursing program. This is because there are so many students that have no concept of the realities of nursing, especially nursing care and dealing with patients and families on a psychological level. This alone would weed out 20% of applicants before they drop nursing programs after they see what reality is like. Just my $.02 cents. As far as working as a companion, HHA or CNA: know the difference in terms of expectations, requirements and levels of care you can legally deliver. It's quite different and I've even worked for agencies that confuse the two. With a CNA you are operating under a nurse's license legally. In home care I've been sent to cases that required wound care with no staff RN on board so I refused those cases due to liability issues. I agree that working as a CNA can be low-pay, back breaking work. It really does open your eyes in many ways not just to how screwy our medical system is but how difficult it can be not just working with the sick but also difficult coworkers and families, etc. Also, you have to remember exactly why YOU are there to begin with: the patients are incapable of caring for themselves for physical and psychological reasons (often both) and the families either cannot do so or do not want to do so. It can be very sad. I also think nursing students should be trained on Alzheimer's dementia care, because you will be seeing tons of that. Bed sores and elder abuse can be issues, too. I used to think that I could save the world but the reality now is to follow my care plans to a T, safely and hopefully provide some comfort and happiness along the way. Private duty is sometimes better pay with less stress, agencies charge clients $23-30/hr. but pay CNAs $10-12 where I live. Now I work private duty cases and will now work for less than $15/hr, PERIOD. I did find an agency I worked for that paid $12/hr around the clock for live-ins and time and a half for over time so if I worked 3-24s I'd usually make $700 clear, but those are cases where you are up all night and running all day. Still, it was better than agencies paying a flat rate of $110/day...which is RIDICULOUS. I also screen cases to make sure it's something I can legally handle. Families will often minimalize the care needed, i.e, Grandma sometimes has "accidents" and is "forgetful" when in reality she is late stage 6 Alzheimer's and completely bed-bound. I also will not tolerate abuse form families and clients--especially physical. I once had a demented client try to punch me in the face and then I finished my shift and resigned. Unfortunately a lot of seniors I've encountered have underlying psych issues besides forms of dementia that were never addressed and escalate as they age. I love helping people but I'm not losing an eye or limb to do it. I also fully establish care plans and responsibilities before I start because I cannot tell you how many families think that in addition to Grandmas 24-hr care I am also the family personal babysitter, shopper, chef and laundry worker. Good luck, you will lean a lot!