Nursing and psychiatric aides help care for physically or mentally ill, injured, disabled, or infirm individuals in hospitals, nursing care facilities, and mental health settings. Home health aides have duties that are similar, but they work in patients' homes or residential care facilities. Nursing aides and home health aides are among the occupations commonly referred to as direct care workers, due to their role in working with patients who need long-term care. The specific care they give depends on their specialty.

Nursing aides also known as nurse aides, nursing assistants, certified nursing assistants, geriatric aides, unlicensed assistive personnel, orderlies, or hospital attendants provide hands-on care and perform routine tasks under the supervision of nursing and medical staff. Specific tasks vary, with aides handling many aspects of a patient's care. They often help patients to eat, dress, and bathe. They also answer calls for help, deliver messages, serve meals, make beds, and tidy up rooms. Aides sometimes are responsible for taking a patient's temperature, pulse rate, respiration rate, or blood pressure. They also may help provide care to patients by helping them get into and out of bed and walk, escorting them to operating and examining rooms, or providing skin care. Some aides help other medical staff by setting up equipment, storing and moving supplies, and assisting with some procedures. Aides also observe patients' physical, mental, and emotional conditions and report any change to the nursing or medical staff.

Nurse aides employed in nursing care facilities often are the principal caregivers, having far more contact with residents than do other members of the staff. Because some residents may stay in a nursing care facility for months or even years, aides develop ongoing relationships with them and interact with them in a positive, caring way.

Home health aides help elderly, convalescent, or disabled persons live in their own homes instead of health care facilities. Under the direction of nursing or medical staff, they provide health-related services, such as administering oral medications. Like nursing aides, home health aides may check patients' pulse rate, temperature, and respiration rate; help with simple prescribed exercises; and help patients to get in and out of bed, bathe, dress, and groom. Occasionally, they change nonsterile dressings, give massages and provide skin care, or assist with braces and artificial limbs. Experienced home health aides, with training, also may assist with medical equipment such as ventilators, which help patients breathe.

Most home health aides work with elderly or disabled persons who need more extensive care than family or friends can provide. Some help discharged hospital patients who have relatively short-term needs.

In home health agencies, a registered nurse, physical therapist, or social worker usually assigns specific duties to and supervises home health aides, who keep records of the services they perform and record each patient's condition and progress. The aides report changes in a patient's condition to the supervisor or case manager.

Psychiatric aides, also known as mental health assistants or psychiatric nursing assistants, care for mentally impaired or emotionally disturbed individuals. They work under a team that may include psychiatrists, psychologists, psychiatric nurses, social workers, and therapists. In addition to helping patients to dress, bathe, groom themselves, and eat, psychiatric aides socialize with them and lead them in educational and recreational activities. Psychiatric aides may play card games or other games with patients, watch television with them, or participate in group activities, such as playing sports or going on field trips. They observe patients and report any physical or behavioral signs that might be important for the professional staff to know. They accompany patients to and from therapy and treatment. Because they have such close contact with patients, psychiatric aides can have a great deal of influence on their outlook and treatment.

Work environment. Work as an aide can be physically demanding. Aides spend many hours standing and walking, and they often face heavy workloads. Aides must guard against back injury because they may have to move patients into and out of bed or help them to stand or walk. It is important for aides to be trained in and to follow the proper procedures for lifting and moving patients. Aides also may face hazards from minor infections and major diseases, such as hepatitis, but can avoid infections by following proper procedures.

Aides also perform tasks that some may consider unpleasant, such as emptying bedpans and changing soiled bed linens. The patients they care for may be disoriented, irritable, or uncooperative. Psychiatric aides must be prepared to care for patients whose illness may cause violent behavior. Although their work can be emotionally demanding, many aides gain satisfaction from assisting those in need.

Home health aides may go to the same patient's home for months or even years. However, most aides work with a number of different patients, each job lasting a few hours, days, or weeks. Home health aides often visit multiple patients on the same day.

Home health aides generally work alone, with periodic visits from their supervisor. They receive detailed instructions explaining when to visit patients and what services to perform. Aides are individually responsible for getting to patients' homes, and they may spend a good portion of the working day traveling from one patient to another. Because mechanical lifting devices available in institutional settings are not as frequently available in patients' homes, home health aides must take extra care to avoid injuries resulting from overexertion when they assist patients.

Most full-time aides work about 40 hours per week, but because patients need care 24 hours a day, some aides work evenings, nights, weekends, and holidays. In 2006, 23 percent of aides worked part time compared with 15 percent of all workers.