A Licensed Nursing Assistant is not higher than a Certified Nursing Assistant; rather, the two titles describe the exact same professional role and scope of practice, with the terminology simply varying depending on the state in which you work. For example, states like New Hampshire and Vermont formally use the designation LNA, while the vast majority of other states use CNA, yet both require the same foundational training hours, identical clinical competencies, and the passing of a state-approved evaluation exam. Both LNAs and CNAs operate under the direct supervision of licensed nurses, focusing on fundamental patient care tasks such as assisting with activities of daily living, measuring vital signs, and monitoring patient comfort. Neither title grants the authority to administer medications, formulate nursing care plans, or perform advanced clinical procedures. When evaluating medical hierarchy, a true step up in responsibility, education, and pay above a CNA or LNA is a Licensed Practical Nurse (LPN) or a Registered Nurse (RN).