An STNA is a State Tested Nursing Assistant, a healthcare worker who provides hands-on patient care under the supervision of a registered nurse. The title is specific to Ohio. In every other state, the same role goes by Certified Nursing Assistant, or CNA. The job duties, training, and day-to-day responsibilities are essentially identical, but Ohio has its own state-regulated training and testing process rather than using the national CNA certification.
What an STNA Does Every Day
STNAs handle the most direct, physical aspects of patient care. They help people bathe, dress, shave, use the toilet, and eat meals. They keep patients mobile by assisting with walking and repositioning them in bed to prevent bedsores. They change bedding, sterilize equipment, and monitor vital signs like blood pressure, pulse, and breathing rate, recording those numbers for the nursing team.
Beyond routine care, STNAs serve as the eyes and ears of the medical staff. Because they spend more time with patients than nurses or doctors typically can, they’re often the first to notice changes in a patient’s condition, whether that’s a new skin wound, a shift in mood, or difficulty eating. That observation role makes them essential to the care team even though they work under supervision.
STNA vs. CNA
The practical difference between an STNA and a CNA comes down to geography and regulation. CNA is a nationally recognized certification, meaning a CNA can potentially transfer credentials across state lines (though each state has its own process for reciprocity). STNA is governed entirely by Ohio’s state guidelines. The scope of practice, the types of tasks performed, and the work settings are the same.
If you’re job searching outside Ohio, you’ll want to look for CNA positions instead. If you hold an STNA credential and plan to move, you’ll typically need to apply for reciprocity or meet the new state’s certification requirements.
Training and Certification
Ohio requires STNA training programs to be at least 75 hours, which includes a mix of classroom instruction, skills lab practice, and a minimum of 16 hours of clinical experience in a skilled nursing facility. Some programs allow a portion of the classroom work to be completed online. Many community colleges, vocational schools, and even some nursing homes offer these programs, and they can often be finished in a few weeks.
After completing training, you take a state competency exam with two parts: a written (or oral) knowledge test and a hands-on skills evaluation. During the skills portion, you’ll be asked to demonstrate specific tasks in front of an evaluator. These range from basic hand hygiene and taking a patient’s blood pressure to more involved skills like transferring someone from a bed to a wheelchair using a transfer belt, providing catheter care, feeding a patient who can’t feed themselves, and performing range-of-motion exercises on joints like the shoulder, knee, or ankle. You need to pass both portions to be placed on Ohio’s Nurse Aide Registry.
What STNAs Cannot Do
STNAs work within a defined scope of practice, meaning there are clear limits on what tasks they’re allowed to perform. A good rule of thumb: if you didn’t learn it and demonstrate it during your training program, it’s not within your scope. STNAs cannot perform tasks reserved for licensed practical nurses or registered nurses, such as administering injections, interpreting diagnostic results, or developing care plans. If a supervisor asks you to do something outside your training, you’re expected to speak up rather than attempt it.
Where STNAs Work
Skilled nursing facilities (often called nursing homes) employ the largest share of nursing assistants at about 37%. Hospitals account for roughly 30%, followed by assisted-living facilities at 11%, home health care agencies at 6%, and government agencies at 4%. The variety of settings means you can find work that fits your preferences, whether that’s the faster pace of a hospital or the relationship-building that comes with long-term care.
Because healthcare facilities operate around the clock, STNAs frequently work nights, weekends, and holidays. Both full-time and part-time positions are common, and shift work is the norm rather than the exception.
Pay and Earning Potential
The median annual wage for nursing assistants is $38,200, which works out to about $18.36 per hour. Those in the bottom 10% earn closer to $30,000 a year, while the top 10% make around $48,800. Pay varies by facility type, location, and experience. Hospital positions and roles in metropolitan areas tend to pay more than rural nursing home jobs.
Keeping Your Certification Active
Ohio doesn’t require continuing education hours to maintain your STNA status. Instead, the state uses a work-based requirement: you must perform at least one shift (seven and a half consecutive hours, or eight hours within a 48-hour period) of paid nursing services within every 24-month period. If more than 24 months pass without verified work, you’ll need to either provide documentation proving you did work during that window or retake the training and competency exam to get back on the registry.
Using STNA as a Stepping Stone
Many people enter the STNA role as a first step into healthcare. The training is short, the barrier to entry is low, and the hands-on experience gives you a realistic picture of what patient care actually looks like day to day. That experience is valuable if you’re considering nursing school, physical therapy programs, or other clinical careers. Some employers even offer tuition assistance for STNAs who want to advance their education, making it a practical way to get paid while you figure out your long-term path in healthcare.