SAFE
Nearly all of the job is physical contact work in unpredictable bodies and rooms: bathing, toileting, repositioning, transferring with a gait belt or Hoyer lift, feeding residents who choke, changing linens, walking someone who may fall. No robot does this at price, and the paperwork slice AI could take — charting vitals, intake/output logs, shift notes — is a small fraction of the hours. The real threat to this occupation is wage suppression and understaffing, not replacement.
Roughly flat across the period, with year-to-year wobble.
Median pay $29,660 → $42,260 +14.0% in real terms
This line is counted by the Bureau of Labor Statistics — the one figure on this page that isn't a judgement of ours. Headcount moves on demand, offshoring, demographics and the business cycle, and automation is one term among several, often not the loudest.
So a falling line is not evidence that AI did it, and a rising one is not evidence that it won't. Both happen in this register: some occupations resist automation and shrink anyway, others are highly automatable and keep growing. The marked year is 2020.
BLS projection, 2024–2034
+2.3% 1,441,500 → 1,474,000 on the projections basis
Hard to automate, and growing
The work resists current AI and the BLS projects +2.3% more of these jobs by 2034. Note that safe does not mean well paid — several of the fastest-growing resistant occupations are among the lowest paid on the register.
Different clocks. The score is what current AI could do to this work today. The projection is how many of these jobs will exist in 2034. Everything between the two — how fast employers actually adopt, whether demand grows in the meantime — is why they can point opposite ways without either being wrong.
~204,100 openings a year on average, including replacing people who leave.
Ward AideNurse AideHealth AideWard HelperHospice AideNurse SitterNursing AideGericare AideHospital AidePatient SitterWard AttendantBirth AttendantMedication AideNurse AssistantHealth Care AideNurse TechnicianHospital CorpsmanNurse's AssistantNursing AssistantNursing AttendantNursing Home AideClinical AssistantHospital AttendantInstitutional Aide
Holding it up: embodiment . Weakest point: judgment & accountability .
Tasks largely resist digitisation The automatable slice — vitals entry into the EHR, I&O totals, ADL flowsheets — is maybe 30-45 minutes of a 12-hour shift, while incontinence care, bed baths, two-person transfers, and hand-feeding a dysphagia resident spoonful by spoonful cannot be decomposed into steps a machine executes, which is why this sits at 16 rather than in the mixed band.
Hands-on in uncontrolled environments You work inside another person's body space in rooms you don't control: kneeling on a bathroom floor to clean a resident who has soiled themselves, catching someone whose knees buckle mid-transfer, turning a 250-pound contracted patient every two hours, absorbing scratches and bites from residents with dementia — there is no version of this performed at a screen, so 20 is the only score available.
Certification preferred, not legally required CNA certification is a real state credential with a registry, 75+ federally mandated training hours under OBRA '87, and a competency exam, and you can be listed for abuse or neglect — but you practice under delegated nursing authority, the RN owns the care plan and the assessment, and no malpractice claim names you as the responsible clinician, which caps this at 9 instead of the 14+ a licensed nurse gets.
Meaningful discretion Most of your shift runs on the assignment sheet and care plan — turn schedules, mechanical-lift-only orders, thickened liquids, fall precautions — and the consequential decisions get escalated to the charge nurse; the 8 reflects the discretion that genuinely is yours: deciding this transfer needs a second person today, judging that a resident's confusion is new enough to report now, calling it before a skin breakdown becomes a stage two.
The verdict above describes this occupation as a whole. Almost nobody does the typical version of a job — tick what's actually in your week and see how your own mix sits.
Your task mix speaks to task resistance (16/20 here) — how much of the day's work current AI already does. That is the dimension the boxes above are about.
It cannot move the other three. Liability shield (9/20) is whether the law requires a licensed human to sign. Trust premium (15/20) is whether buyers specifically pay for a person. Judgment and accountability (8/20) is whether the role exists to own consequential calls. Those are facts about the occupation's standing, not about which tasks are in your week — a paralegal who does only trial exhibits still holds no licence. Together they are 32 of this occupation's 68 points (47%).
Embodiment (20/20) is also a property of the work rather than the worker, but we don't tag individual tasks as physical or not, so the picker can't tell you anything about it. That's a limit of this tool, not a claim.
Did we get the list right? Tell us what's missing — the tasks are written from the outside, and you're reading this from the inside.
The moves above are yours to make. This is the other half: what would have to change in the world for the occupation itself to score higher. None of it is in any one person's gift, but it is where the floor actually comes from. Scores here are not a one-way ratchet. Only two of the five dimensions — task resistance and embodiment — track what machines can do. The other three track law, what buyers will pay for, and who is answerable, and those move in both directions, often in response to the same pressure AI creates. If every lever below landed, this occupation would score around 83/100, still SAFE.
Enforcement of the CMS 2024 minimum staffing final rule (2.45 nurse-aide hours per resident day, 24/7 RN) plus state ratio laws in the mold of California's AB 394 extended to certified aides, so a facility's Medicare certification and survey standing depend on a counted number of credentialed human aide hours that no software substitution can satisfy
Growth of private-pay and consumer-directed home care (Medicaid self-direction, VA Veteran-Directed Care) where the family selects and retains a named aide and explicitly refuses monitoring-and-check-in substitution; union contracts such as SEIU 775's training-and-wage boards that market a credentialed named caregiver
Ambient charting and sensor-based vitals absorbing the documentation slice, leaving a residual day that is almost entirely contact work and judgment under ambiguity — a genuine two-tier shift, though the routine tier is only a small share of hours here so the headroom is small
Formal recognition of aide-initiated escalation in survey and payment protocols — INTERACT 'Stop and Watch' or sepsis change-of-condition tools written into facility policy so a documented aide report triggers mandatory nurse assessment, making the aide the accountable first detector rather than an informal reporter
State nurse aide registry rules that make the individual CNA's credential the recordable unit for abuse/neglect findings and for countersigning AI-generated vitals and I&O entries in the EHR — i.e. the aide, not the sensor, owns the chart entry
Fall-risk and transfer decisions (one-person vs two-person, mechanical lift vs gait belt) delegated in writing to the aide at point of care under safe-patient-handling laws, with the aide's assessment being the operative call when a sensor or care plan disagrees
The limit. Embodiment is already maxed and task_resistance is near ceiling, so realistic upside is a handful of points from staffing-mandate and escalation-role changes. Note that none of these address the actual live risk: understaffing and wage suppression can hollow out the job's conditions while every displacement score stays high.
| New York-Newark-Jersey City, NY-NJ | 79,480 | $49,270 +17% |
| Chicago-Naperville-Elgin, IL-IN | 45,850 | $46,940 +11% |
| Los Angeles-Long Beach-Anaheim, CA | 43,090 | $47,380 +12% |
| Philadelphia-Camden-Wilmington, PA-NJ-DE-MD | 30,680 | $46,220 +9% |
| Boston-Cambridge-Newton, MA-NH | 26,130 | $47,590 +13% |
| Washington-Arlington-Alexandria, DC-VA-MD-WV | 25,520 | $45,730 +8% |
| Miami-Fort Lauderdale-West Palm Beach, FL | 23,490 | $38,010 -10% |
| Dallas-Fort Worth-Arlington, TX | 23,420 | $38,530 -9% |
| San Jose-Sunnyvale-Santa Clara, CA | 5,350 | $56,840 +35% |
| San Francisco-Oakland-Fremont, CA | 11,790 | $56,080 +33% |
| Seattle-Tacoma-Bellevue, WA | 16,530 | $51,990 +23% |
We have no reported case of a named organisation automating this occupation. Not one deployment, not one announcement.
That is worth saying out loud next to a score of 68. The verdict above is about what the work exposes — what current AI could do to these tasks. It is not a claim that anyone has done it. For this occupation those two things have come apart completely: the capability argument is on this page, and the evidence column is empty.
Has AI actually changed your work? One tap, anonymous, and the running tally is public. Nothing else is asked of you.
Rather than check back: get the digest and we'll tell you what changed — or watch a single occupation from its own page.