Today’s health-care environment relies on teams of professionals to provide the best possible care to patients. Busy doctors and nurses depend on a number of other professionals to handle certain tasks and ensure that patients are safe, comfortable and correctly diagnosed. Often, these tasks fall to certified nursing assistants, or CNAs, and Patient Care Technicians, or PCTs.

These healthcare professionals work in a variety of settings, typically hospitals and nursing homes and for home health agencies, providing a wide range of health-care services. Although there are similarities between the two positions, the specific scope of work is determined by individual states. In some states, CNA and PCT are used interchangeably because the responsibilities are the same. In other states, the two roles are vastly different, and each has its own responsibilities and functions.

What Is the Difference Between a PCT and a CNA?

A CNA works under the supervision of a physician, Registered Nurse (RN) or Licensed Practical Nurse (LPN), helping with patient healthcare needs. Among the most common CNA tasks are taking and monitoring vital signs, assisting with hygiene, assisting with meals, helping with transfers to and from bed, and helping patients walk or use wheelchairs. Basically, the CNA's primary task is to keep a patient comfortable and safe.

CNAs, who may also be called Nursing Assistants or, as in Ohio, State Tested Nurses Aides, are an important part of the healthcare delivery system. They often serve as the eyes and ears of nurses and doctors, observing, documenting and reporting on patients and communicating with the other team members. They answer call lights and check in on patients to make sure they have what they need, and help keep hospital rooms clean and organized. In some cases, CNAs help with basic medical procedures as well, such as changing wound dressings.

Patient care technicians perform many of the same duties as CNAs, with the addition of basic medical procedures. In addition to monitoring vital signs, helping with hygiene and patient movements, and answering call lights, patient care technicians might help patients with specific exercises, administer IVs, draw blood, use an EKG to monitor heart activity, conduct basic lab tests and monitor the nutritional value of patient diets. Like CNAs, PCTs work under the supervision of a physician or licensed nurse, but depending on where they work, they may be charged with medical tasks only, while CNAs handle basic patient assistance and care tasks.

Becoming a CNA

To become a CNA, you must complete an approved training course and pass a competency exam that includes both written and clinical portions. Federal law requires that all CNA training programs include similar content, regardless of where you study, so even if you earn your certification in one state, your training will be valid in any other state where you wish to work. Training programs may be offered by a community college, medical facility, independent training center or the Red Cross (in 13 states).

Depending on where you live, you may be able to begin training to become a CNA as young as age 16. Some states allow high school juniors and seniors to take CNA training courses before graduation, allowing them to begin their careers even before they finish high school. Some vocational or technical high schools, for example, offer a healthcare track that ends with CNA certification at the same time as a high school diploma. Other states require CNAs to be at least 18 before beginning a training program. In any case, you do not have to be a high school graduate to be a CNA, but it does help to have a diploma or GED if you want to move into higher positions; it’s a requirement if you plan to parlay your CNA experience into a nursing career.

The length of CNA training courses varies by state, from just 75 hours of training to over 210 hours. It’s important to choose a program that is approved by your state, otherwise you won’t be able to be licensed to work. Regardless of the program you select, though, you can expect to learn the skills necessary to provide excellent patient care, including how to assist with bathing, dressing, feeding, and toileting; how to transfer and position patients; how to help patients walk or exercise; and how to properly monitor vital signs, observe patients and report symptoms. You can also expect to receive training in anatomy and physiology, infection control, communication, mental health, cultural diversity and patient rights, as well as the legal and ethical aspects of healthcare, such as how to protect patient privacy and confidentiality.

Upon completion of the CNA training course, you must pass your state’s certification exam. The length of the exam varies by state, but typically includes sections on safety and infection control, your role as a nurse’s aide, how to promote and maintain the function and health of your patients, basic nursing care, mental health and patient rights. The exam also consists of a practical skills portion, which tests your hands-on skills in any number of up to 30 skills. The test differs by state and individual, but you can count on having to take a test of your hand-washing abilities. Other practical skills you may need to demonstrate include taking and recording vital signs, and positive interaction with patients – i.e., how you introduce yourself and explain what you are doing.

Once you pass the exam and receive your CNA license, it is valid for up to two years. Some states require continuing education to maintain certification. In addition, depending on the state, you may need to undergo a background check and be certified in CPR in order to be licensed.

Becoming a PCT

Becoming a patient care technician is typically a longer process than becoming a CNA, as it involves more clinical and laboratory functions. Depending on the program you select, it can take anywhere from eight to 12 months to complete the training. In some states, you must already have a CNA license to begin PCT training, while other programs offer concurrent CNA and PCT licensing programs. Generally speaking, if you live in a state where PCTs do not perform the same tasks as CNAs do, the training is limited to clinical functions, including drawing blood, performing catheterization, wound care, administering EKGs, operating dialysis equipment and performing basic emergency medical care, such as using splints. And like the CNA training, PCT training also focuses on anatomy and physiology, communication, ethics, infection control and documentation.

Upon completion of their training, prospective PCTs must pass an exam administered by the National Center for Competency Testing to earn a general certification. Depending on where they work and the specific duties they perform, some states require additional certification and licensing; for example, those working with dialysis patients must be licensed to do so, while others may need licenses for such things as EKG and phlebotomy tasks. Most employers also require basic life support and CPR certification.

Pay and Job Growth

Demand for CNAs and PCTs is expected to be strong over the next decade, according to the U.S. Bureau of Labor Statistics. Between 2016 and 2026, employment is expected to grow by 11 percent, which is faster than average, thanks in large part to the country’s aging population. The BLS predicts that employment opportunities will be most plentiful in the home healthcare and community health and rehabilitation service fields, as more adults opt to “age in place” and federal and state funding programs shift toward these types of services.

Salaries for CNAs and PCTs are similar, despite the differences in job descriptions. According to PayScale, a CNA earns an average of $11.08 per hour, while the BLS reports a median salary of about $27,000 per year. The highest paid CNAs earn more than $38,000 per year, while the lowest paid earn less than $20,000. Experience doesn’t have much of an impact on the earning potential for CNAs, and in fact, most do not have more than 10 years of experience, as generally speaking, the majority move on to other roles. In fact, many younger CNAs use their experience in the field as a stepping stone to a nursing career.

PCTs earn a median hourly rate of $13.15 per hour, for an annual salary of $29,944. Those working in dialysis centers tend to earn slightly more. Much like a CNA, experience doesn’t equate with a higher salary for a PCT, and most have 10 years of experience or less. It’s not uncommon for PCTs to leverage their education and experience into becoming Registered Nurses, Licensed Practical Nurses and dialysis technicians.

One of the major benefits of working as either a PCT or CNA is that it allows you to begin your medical career on the ground floor and gain experience, often while you are still in high school or college. Generally speaking, it’s only about $1,500 to become licensed, including the course and examination, and some employers will even cover the cost or reimburse you for any classes or courses if you commit to working for a certain time. Because demand for these professionals is so high, many hospitals and nursing homes are willing to train new assistants.

Is It Right for You?

Both CNAs and PCTs are important to the health-care delivery system. In fact, they are arguably the professionals who are closest to patients, and often the first to notice changes to condition or worsening health problems. Doctors and nurses depend on their assistants to report what they observe, as these observations could be vital to saving someone’s life.

Working in this field requires many of the same qualities as in any other medical profession. Both PCTs and CNAs must be compassionate and empathetic, and able to be patient and professional even in challenging situations. Most employers look for assistants who are adaptable and flexible, good communicators, and able to effectively prioritize and manage their time. Demonstrable skills in delivering patient care are also important. During the interview process, you can expect to answer behavioral-based questions about how you make decisions and solve problems, as well as explain how you would respond to specific situations, such as when a co-worker is mistreating a patient or there is a patient emergency. It’s also important that you are able to care for patients from a wide range of backgrounds, and with many different conditions. Many CNAs and PCTs provide care for patients who are at the end of their lives, and thus must be able to provide comfort and compassionate care to those in their final days – and often to their family members as well. At the same time, a sense of humor is also an oft-mentioned requirement for this field, as it’s a good way to relax and relieve tension.