From home health aide or CNA to LPN: the next steps up
Yes, you can go from aide to CNA to LPN, and many people do. Each step pays more and each one uses what you already know: how to help people safely, how to watch for changes, and how to stay calm when a day goes wrong.
Below are the steps aides and CNAs take most often, how long the training usually is, and one thing you can do this week. Rules differ by state, so check with your state before you pay for any program. If you are not sure which step fits your life, tell Carmen your hours and what you want.
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$35,800 a year
Median pay, home health and personal care aides, 2025
BLS Occupational Outlook HandbookNext steps for aides and CNAs
Certified nursing assistant (CNA), if you are a home health aide now
A CNA can work in hospitals and nursing homes as well as in homes, so there are more jobs to choose from. It is also a common first step toward nursing school. Much of the care you already give is the same.
- Pay
- Median $42,260 a year for nursing assistants (BLS, May 2025).
- What it takes
- A state-approved program of at least 75 hours under federal rules (some states require more), then your state's competency exam. Some nursing homes pay for the training if you work for them.
- First step
- Look up your state's nurse aide registry and find the list of approved training programs near you.
Medication aide
In some states, a CNA can take extra training to give certain medications, often in nursing homes or assisted living. It is a short step up that builds on your CNA certificate. Suits CNAs who are careful and good with routines.
- What it takes
- Only offered in some states. You usually need to be a CNA first, then finish a state program and exam.
- First step
- Search your state health department or board of nursing site for "medication aide" to see if your state has it.
Phlebotomist
Draws blood in hospitals, labs and clinics. The training is short and the hours are often steady. Suits people with steady hands who like a clear, repeatable task.
- Pay
- Median $45,230 a year (BLS, May 2025).
- What it takes
- Programs usually take less than a year. Many employers want a certification.
- First step
- Call one community college near you and ask when their next phlebotomy class starts and how much it costs.
Medical assistant
Works in a doctor's office or clinic: takes vital signs, sets up exam rooms, and helps with paperwork and scheduling. Daytime hours are common. Suits aides who want to stop driving between homes or working nights.
- Pay
- Median $45,690 a year (BLS, May 2025).
- What it takes
- Programs take about 1 or 2 years, and some offices train on the job.
- First step
- Ask a clinic you know if they hire medical assistants without a certificate and train them.
Licensed practical nurse (LPN or LVN)
Gives nursing care under an RN or doctor: checks patients, gives many medications, changes dressings and reports changes. This is the step most CNAs mean when they say they want to be a nurse. Your aide experience helps a lot in school and on the job.
- Pay
- Median $64,400 a year (BLS, 2025).
- What it takes
- Certificate and diploma programs typically take about 1 year, then a licensing exam. Some schools offer evening or part-time classes.
- First step
- Find two LPN programs near you and ask each one about the entry test, the prerequisites, and whether they have evening classes.
Registered nurse (RN)
RNs plan and manage patient care and have the widest choice of jobs. You can go straight to an RN program, or become an LPN first and later take an LPN-to-RN bridge program at many community colleges. The bridge lets you keep working as a nurse while you study.
- Pay
- Median $97,550 a year (BLS, May 2025).
- What it takes
- An associate degree (ADN) or bachelor's degree (BSN) in nursing, then the licensing exam. This is the longest path on this list, often several years part time.
- First step
- Ask your local community college which science classes you need before you can apply to the nursing program.
Employer tuition help
Many hospitals, nursing homes and home care agencies help pay for CNA, LPN or RN school, sometimes if you agree to work there for a set time. Under federal tax rules, an employer's education help can be tax-free up to $5,250 a year. Ask before you pay anything yourself.
- What it takes
- Often free or low cost to you. Read any work commitment carefully before you sign.
- First step
- Ask your supervisor or HR this week: "Do you help pay for school, and what are the rules?"
Specific moves, step by step
What carries over, what to build, a 90-day plan and your résumé rewritten for each one.
Sample conversation
How a conversation with Carmen starts
Carmen asks before she suggests. An illustrative example, not a real person.
I've been a CNA for three years. I want to be an LPN but I have two kids and I work days.
Three years as a CNA gives you a real head start in LPN school. Does your job help pay for school at all?
I don't know. I never asked.
That is the first thing to find out, because it can change which program makes sense. Would evening classes or weekend classes work better for you?
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Questions & answers
- How long does it take to go from CNA to LPN?
- LPN certificate and diploma programs typically take about one year, according to the BLS. Some part-time or evening programs take longer. You also need to pass the licensing exam after you finish.
- What can I do after being a CNA?
- Common next steps are medication aide (in some states), phlebotomist, medical assistant, patient care technician, LPN and RN. Many CNAs also move into jobs in hospitals, which often pay more than home care.
- Can I work while I go to LPN school?
- Many students do, especially in evening or part-time programs. Tell your employer early. Some will change your schedule or help pay for school.
- Do I need to be a CNA before becoming an LPN?
- Not always, but some programs ask for it or give you an advantage for it. Check the rules of the programs near you.
More for home health aides and cnas
Change careers
Sources
- BLS Occupational Outlook Handbook: Home Health and Personal Care Aides
- BLS Occupational Outlook Handbook: Nursing Assistants and Orderlies
- BLS Occupational Outlook Handbook: Licensed Practical and Licensed Vocational Nurses
- BLS Occupational Outlook Handbook: Registered Nurses
- BLS Occupational Outlook Handbook: Phlebotomists
- BLS Occupational Outlook Handbook: Medical Assistants
- 42 CFR 483.152: Requirements for approval of a nurse aide training and competency evaluation program
- IRS: Frequently asked questions about educational assistance programs
Last checked September 29, 2026.