The most common next step after earning your CNA is becoming a Licensed Practical Nurse (LPN), though it’s far from your only option. Your CNA experience puts you in a strong position to move into higher-paying roles in nursing, specialize in a specific patient population, or pick up additional certifications that expand what you’re allowed to do on the job. The right path depends on how much time and money you can invest and where you want your career to go.
LPN: The Most Popular Next Step
Most CNAs who want to advance in nursing start by becoming an LPN (called an LVN in California and Texas). LPN programs typically take about one year and combine classroom instruction with clinical training. You’ll generally need a high school diploma and a minimum GPA to get in, though specific requirements vary by program.
The financial jump is significant. LPNs earn a median salary of $62,340 per year, roughly double what most CNAs make. LPNs can administer medications, change wound dressings, monitor patients, and perform tasks that fall outside a CNA’s scope. You’ll work under the supervision of a registered nurse or physician, but your day-to-day responsibilities and autonomy increase considerably. For CNAs who want more clinical responsibility without committing to two or four years of school, this is the fastest route with the clearest payoff.
Registered Nurse: The Bigger Investment
If you’re willing to invest more time, going straight from CNA to RN skips the LPN step entirely and opens up the widest range of career options. There are two main paths: an Associate Degree in Nursing (ADN), which takes about two years, or a Bachelor of Science in Nursing (BSN), which takes four. Some accelerated programs compress these timelines, with certain ADN programs finishing in as little as one year and accelerated BSN programs in under two.
Both degrees qualify you to sit for the RN licensing exam, but they don’t lead to equal outcomes. BSN-prepared nurses earn roughly $16,000 more per year than ADN-prepared nurses on average, and many hospitals prefer or require a BSN for hiring. The median annual wage for RNs overall is $93,600.
Your CNA experience gives you a real advantage in nursing school. You already understand patient care, medical terminology, and how a healthcare team functions. That clinical comfort level makes the transition smoother than it is for students entering nursing programs with no hands-on background.
Patient Care Technician: A Lateral Move With New Skills
Becoming a Patient Care Technician (PCT) is less of a “step up” and more of a step sideways into a broader skill set. PCTs work primarily in hospitals and perform everything a CNA does plus more technical procedures: drawing blood, performing EKGs, inserting catheters, removing stitches, collecting specimens for diagnostic tests, and sometimes operating dialysis equipment.
PCT training programs are relatively short, often a few months, and build directly on what you already know. This is a good option if you want to work in acute care settings like hospitals or dialysis centers and aren’t ready to commit to a nursing degree program yet. The additional technical skills also look strong on a resume if you decide to pursue nursing school later.
Medication Aide: More Responsibility, Less School
If you want to expand your scope without leaving the CNA world entirely, becoming a Medication Aide (sometimes called a Medication Technician) lets you administer medications to patients, a task CNAs aren’t authorized to perform. This credential is available in 36 states, though requirements vary widely.
Training ranges from roughly 20 hours in some states to 140 hours in others. Texas, for example, requires 100 hours of classroom instruction, 30 hours in a skills lab, and 10 hours of clinical experience. Connecticut requires two years of CNA experience in good standing before you can even apply, plus 45 hours of pharmacology training and 80 supervised clinical hours. Most states also require you to pass a competency exam.
Some states give Medication Aides a broader scope than others. In Maine, for instance, certified Medication Aides can perform blood glucose testing and administer insulin. Check your state’s specific rules before pursuing this path, since the credential doesn’t exist everywhere and the duties allowed vary considerably.
Hospice and Palliative Care Specialization
CNAs who are drawn to end-of-life care can earn the Certified Hospice and Palliative Nursing Assistant (CHPNA) credential. This doesn’t require going back to school. Instead, it’s an exam-based certification that validates your expertise in comfort care, pain management support, and working with patients and families during some of the most difficult moments in healthcare.
To qualify, you need 500 hours of hospice or palliative care experience in the past 12 months, or 1,000 hours in the past 24 months, all under the supervision of a registered nurse. If you’re already working in hospice, this credential formalizes your specialization and can make you more competitive for positions at hospice agencies and palliative care programs.
The Management Track
Some CNAs eventually want to move into leadership or administration. That path runs through nursing first. Becoming a nurse administrator typically requires a BSN at minimum, with a Master of Science in Nursing (MSN) making you a stronger candidate. On top of the degree, you’ll generally need two to five years of RN experience before moving into management.
It’s a long road, but your CNA experience counts. Understanding frontline patient care from the ground level gives future administrators a perspective that’s hard to get any other way. If management is your eventual goal, starting with an RN program (ideally a BSN) puts you on the right trajectory.
Paying for Your Next Step
One of the biggest barriers to advancing past your CNA is cost, but many healthcare employers will help cover it. Hospital systems and large nursing home chains frequently offer tuition reimbursement or scholarship programs specifically for CNAs pursuing nursing degrees. Atrium Health (now part of Advocate Health), for example, offers up to $7,500 per year in prepaid tuition, books, and fees for up to three years for CNAs enrolled in eligible nursing programs.
The catch is a work commitment. In Atrium Health’s case, you’re required to work as an RN at their facilities for four consecutive years after getting your license. These arrangements are common across the industry. Before paying out of pocket for school, ask your employer’s HR department what educational assistance programs exist. Many CNAs don’t realize these benefits are available until they ask.
Community colleges also keep costs lower for ADN programs, and federal financial aid (FAFSA) applies to most accredited nursing programs. Some states offer workforce development grants specifically for healthcare workers looking to advance. Between employer programs and financial aid, many CNAs complete LPN or ADN programs with minimal personal expense.