Sample Career Ladder/Lattice for Long-term Health Care
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1 Click on a job title to see examples of descriptive information about the job. Click on a link between job titles to see the critical development experiences needed to move to that job on the pathway. Registered Nurse (RN) Licensed Practical Nurse (LPN) Certified Nurse Assistant (CNA) Home Health Aide Personal and Home Care Aide Direct Support Professional Industry Competencies Workplace Competencies Academic Competencies Personal Effectiveness Competencies 1
2 Registered Nurse (RN) Job Title Registered Nurse (RN) Job Level Management Level (Supervisory) Job Description Treats patients and educates patients and public about various medical conditions. Provides advice and emotional support to patients family members. Records patients medical histories and symptoms. Helps perform diagnostic tests, analyze results, operate medical machinery, and administer treatment and medications. Helps with patient follow-up and rehabilitation. Tasks: 1. Maintain accurate, detailed reports and records. 2. Monitor, record and report symptoms and changes in patients' conditions. 3. Record patients' medical information and vital signs. 4. Modify patient treatment plans as indicated by patients' responses and conditions. 5. Consult and coordinate with health care team members to assess, plan, implement and evaluate patient care plans. 6. Order, interpret, and evaluate diagnostic tests to identify and assess patient's condition. 7. Monitor all aspects of patient care, including diet and physical activity. 8. Direct and supervise less skilled nursing or health care personnel or supervise a particular unit. 9. Prepare patients for, and assist with, examinations and treatments. 10. Observe nurses and visit patients to ensure proper nursing care. Education Bachelor s or Associate s degree required. Workforce Preparation Employees in these occupations usually need one or two years of training involving both on-the-job experience and informal training with experienced workers. Work Experience Previous work-related skill, knowledge, or experience is required for these occupations. Licensure/Certification Required. License requirements vary by state. For example, in the state of Virginia, applicants for licensure as a registered nurse must complete high school or GED, complete an approved professional nursing program, have committed no acts which are grounds for disciplinary action, and must pass a written examination. Salary $26.28 hourly; $54,670 annually Employment Outlook 21-35% over the next 10 years, representing faster than average growth. 2
3 Licensed Practical Nurse (LPN) Job Title Licensed Practical Nurse (LPN) Job Level Mid-Level (Supervisory) Job Description Provides care and support to the sick, injured, and disabled under the direction of physicians and registered nurses. Tasks: 1. Observe patients, chart and report changes in patients' conditions, such as adverse reactions to medication or treatment, and take any necessary action. 2. Administer prescribed medications or start intravenous fluids, and note times and amounts on patients' charts. 3. Answer patients' calls and determine how to assist them. 4. Measure and record patients' vital signs, such as height, weight, temperature, blood pressure, pulse and respiration. 5. Provide basic patient care and treatments, such as taking temperatures or blood pressures, dressing wounds, treating bedsores, giving enemas or douches, rubbing with alcohol, massaging, or performing catheterizations. 6. Help patients with bathing, dressing, maintaining personal hygiene, moving in bed, or standing and walking. 7. Supervise nurses' aides and assistants. 8. Work as part of a health care team to assess patient needs, plan and modify care and implement interventions. 9. Record food and fluid intake and output. 10. Evaluate nursing intervention outcomes, conferring with other health care team members as necessary. Education Requires training in vocational schools, related on-the-job experience, or an Associate's degree. May require a Bachelor's degree. Workforce Preparation Employees in these occupations usually need one or two years of training involving both on-the-job experience and informal training with experienced workers. Work Experience Previous work-related skill, knowledge, or experience is required for these occupations Licensure/Certification Required to pass the NCLEX-PN licensing examination. Salary $16.94 hourly; $35,230 annually Employment Outlook 10-20% over the next 10 years, representing average growth. 3
4 Critical Development Experiences: From Licensed Practical Nurse (LPN) to Registered Nurse (RN) Registered Nurse (RN) positions require a Bachelor's or Associate s degree. Positions require training in vocational schools and related on-the-job experience. License is required; requirements vary by state. 1. Prepare patients for, and assist with, examinations and treatments. 2. Direct and supervise less skilled nursing or health care personnel or supervise a particular unit. 3. Order, interpret, and evaluate diagnostic tests to identify and assess patient's condition. 4. Consult and coordinate with health care team members to assess, plan, implement and evaluate patient care plans. 4
5 Certified Nurse Assistant (CNA) Job Title Certified Nurse Assistant (CNA) Job Level Mid-level (Non-supervisory) Job Description Provides the majority of hands-on care, helping residents perform activities of daily living and performing clinical tasks. Typically works in nursing homes. Tasks: 1. Perform activities of daily living such as eating, dressing, bathing, and toileting. 2. Reposition and turn immobile patients. 3. Perform clinical tasks such as range of motion exercises and blood pressure readings. 4. Clean rooms and change linens. 5. Observe patients conditions, measure and record food and liquid intake/output and vital signs, and report changes to professional staff. 6. Answer patients call signals. Education These occupations usually require a high school diploma and may require some vocational training or jobrelated course work. In some cases, an Associate's or Bachelor's degree could be needed. Workforce Preparation Employees in these occupations need anywhere from a few months to one year of working with experienced employees. Work Experience Some previous work-related skill, knowledge, or experience may be helpful in these occupations, but usually is not needed. Licensure/Certification Licensure required if working in nursing homes. License requirement varies by state. For example, in the state of Virginia, applicants for certification as nurse aides (C.N.A.) must meet character requirements, show evidence of having completed an approved educational or training program, and pass a clinical competency evaluation in written or oral form. Salary $10.31 hourly; $21,440 annually Employment Outlook 21-35% over the next 10 years, representing faster than average growth. 5
6 Critical Development Experiences: From Certified Nurse Assistant (CNA) to Licensed Practical Nurse (LPN) Licensed Practical Nurse (LPN) positions require training in vocational schools, related on-the-job experience, or an Associate's degree. Required to pass the NCLEX-PN licensing examination. 1. Observe patients, chart and report changes in patients' conditions, such as adverse reactions to medication or treatment, and take any necessary action. 2. Supervise nurses' aides and assistants. Critical Development Experiences: From Certified Nurse Assistant (CNA) to Registered Nurse (RN) Registered Nurse (RN) positions require a Bachelor's or Associate s degree. Positions require training in vocational schools and related on-the-job experience. License is required; requirements vary by state. 1. Prepare patients for, and assist with, examinations and treatments. 2. Direct and supervise less skilled nursing or health care personnel or supervise a particular unit. 3. Order, interpret, and evaluate diagnostic tests to identify and assess patient's condition. 4. Consult and coordinate with health care team members to assess, plan, implement and evaluate patient care plans. 6
7 Home Health Aide Job Title Home Health Aide Job Level Entry-level (Non-supervisory) Job Description Provides assistance with activities of daily living to elderly or other people with disabilities. Performs clinical tasks and may help set up medical equipment. Typically works in peoples homes and other community-based settings. Tasks: 1. Providing personal assistance, medical attention, emotional support, or other personal care to others such as coworkers, customers, or patients. 2. Maintain records of patient care, condition, progress, or problems to report and discuss observations with supervisor or case manager. 3. Provide patients with help moving in and out of beds, baths, wheelchairs or automobiles, and with dressing and grooming. 4. Change bed linens, wash and iron patients laundry and clean patients quarters. 5. Entertain, converse with, or read aloud to patients to keep them mentally healthy and alert. 6. Check patient s pulse, temperature and respiration. Education These occupations usually require a high school diploma and may require some vocational training or jobrelated course work. In some cases, an Associate's or Bachelor's degree could be required. Workforce Preparation Work Experience Some previous work-related skill, knowledge, or experience may be helpful in these occupations, but usually is not needed. Employees in these occupations may need anywhere from a few months to one year of working with experienced employees. Licensure/Certification Applicants for home care aide licensure must meet training requirements of Federal law that are required to work in licensed home health agencies. Home health agencies provide verification that the individual meets the federal requirements. Salary $9.04 hourly; $18,800 annually Employment Outlook 36+% over the next 10 years, representing much faster than average growth. 7
8 Critical Development Experiences: From Home Health Aide to Certified Nurse Assistant (CNA) CNA positions usually require a high school diploma and may require some vocational training or job-related course work. Employees in these occupations need anywhere from a few months to one year of working with experienced employees. Licensure required if working in nursing homes. License requirement varies by state. For example, in the state of Virginia, applicants for certification as nurse aides (C.N.A.) must meet character requirements, show evidence of having completed an approved educational or training program, and pass a clinical competency evaluation in written or oral form. 1. Observe patients conditions, measure and record food and liquid intake/output and vital signs, and report changes to professional staff. 2. Perform clinical tasks such as range of motion exercises and blood pressure readings. 3. Reposition and turn immobile patients. 8
9 Personal and Home Care Aide Job Title Personal and Home Care Aide Job Level Entry-level (Non-supervisory) Job Description Provides assistance with activities of daily living to elderly or other people with disabilities. Performs clinical tasks and house keeping duties. Typically works in peoples homes and other community-based settings. Tasks: 1. Perform health care related tasks, such as monitoring vital signs and medication, under the direction of registered nurses and physiotherapists. 2. Administer bedside and personal care, such as ambulation and personal hygiene assistance. 3. Prepare and maintain records of client progress and services performed, reporting changes in client condition to manager or supervisor. 4. Perform housekeeping duties, such as cooking, cleaning, washing clothes and dishes, and running errands. 5. Care for individuals and families during periods of incapacitation, family disruption or convalescence, providing companionship, personal care and help in adjusting to new lifestyles. 6. Instruct and advise clients on issues such as household cleanliness, utilities, hygiene, nutrition and infant care. 7. Plan, shop for, and prepare nutritious meals, or assist families in planning, shopping for, and preparing nutritious meals. 8. Participate in case reviews, consulting with the team caring for the client, to evaluate the client's needs and plan for continuing services. Education Require a high school diploma and may require some vocational training or job-related course work. In some cases, an Associate's or Bachelor's degree required. Workforce Preparation Work Experience Some previous work-related skill, knowledge, or experience may be helpful in these occupations, but usually is not needed. Employees in these occupations need anywhere from a few months to one year of working with experienced employees. Licensure/Certification None required. Salary $8.34 hourly; $17,340 annually Employment Outlook 36+% over the next 10 years, representing much faster than average growth. 9
10 Critical Development Experiences: From Personal and Home Care Aide to Certified Nurse Assistant (CNA) CNA positions usually require a high school diploma and may require some vocational training or job-related course work. Employees in these occupations need anywhere from a few months to one year of working with experienced employees. Licensure required if working in nursing homes. License requirement varies by state. For example, in the state of Virginia, applicants for certification as nurse aides (C.N.A.) must meet character requirements, show evidence of having completed an approved educational or training program, and pass a clinical competency evaluation in written or oral form. 1. Observe patients conditions, measure and record food and liquid intake/output and vital signs, and report changes to professional staff. 2. Perform clinical tasks such as range of motion exercises and blood pressure readings. 3. Reposition and turn immobile patients. 10
11 Direct Support Professional Job Title Direct Support Professional Job Level Entry-level (Non-supervisory) Job Description Provides support to people with intellectual or developmental disabilities that need personal care and other assistance in order to be self-sufficient. Provides assistance in their homes, jobs, neighborhoods, and communities. Tasks: 1. Provides care, supervision and training to individuals with developmental disabilities in their home, habitation, day program, vocational program, community, work and/or social environments. 2. Assists individuals to work, make appointments, and engage in recreational outings. 3. Provides supports to people served by developing and implementing Individualized Support Plans to assist people in achieving their personal goals and to meet their needs and desires. 4. Maintains supports of the people served by providing choices for activities, work, and living arrangements. 5. Assists people served in completion of activities of daily living, including toileting, grooming, dressing, housekeeping, eating, medication administration, bathing and transportation as needed. 6. Completes required documentation and assists with information gathering for Personal Outcome Measures and assessments. 7. Maintains a clean, orderly, and safe environment for people served by following safety and infection control procedures. 8. Attends scheduled staff meetings and required training sessions. Education High school diploma or equivalent usually required. Workforce Preparation Work Experience Previous work-related skill, knowledge, or experience is helpful. Licensure/Certification None required. Salary $11.56 hourly; $24,037 annually Employment Outlook 36+% over the next 10 years, representing much faster than average growth. 11
12 Critical Development Experiences: From Direct Support Professional to Certified Nurse Assistant (CNA) CNA positions usually require a high school diploma and may require some vocational training or job-related course work. Employees in these occupations need anywhere from a few months to one year of working with experienced employees. Licensure required if working in nursing homes. License requirement varies by state. For example, in the state of Virginia, applicants for certification as nurse aides (C.N.A.) must meet character requirements, show evidence of having completed an approved educational or training program, and pass a clinical competency evaluation in written or oral form. 1. Observe patients conditions, measure and record food and liquid intake/output and vital signs, and report changes to professional staff. 2. Perform clinical tasks such as range of motion exercises and blood pressure readings. 3. Reposition and turn immobile patients. 12
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