The National Nursers United union is ranked in the top 10 nursing process step for a nursing home worker in the United States, according to data obtained by ABC News.
The union ranks the nursing home and its employees as a step below the American Medical Association, which has been calling for the elimination of nursing home care and nursing home practices.
The National Nurser Health Care Foundation, a group of more than 1,000 nurses, said in a report that it ranks nursing homes in the bottom 10 on each of the steps it lists.
“While nursing homes have a history of poor care and lack of access to necessary health care, we know that their care is a critical part of our national health care system,” said Dr. Amy C. Krieger, the foundation’s president and CEO.
“We believe that nursing homes must be held to a higher standard of care to be truly accountable for the well-being of their residents and staff.”
The American Medical Society has called for the abolition of nursing homes.
The group said in January that the nursing homes were the nation’s biggest employer and are responsible for some 1.3 million jobs.
The nursing home industry, which employs about 4.5 million people, employs more than half of all nurses in the country, according the American Nursing Association.
The average wage of a nursing aide in the U.S. is $26,000 a year, according U.N. figures.
Nursing homes employ about 13,500 people in the state of Texas, more than two-thirds of which are employed in nursing homes, according data compiled by the Texas Nursing Home Association.
Nurses have a reputation for being tough on their patients and the nursing staff, who must work as much as 60 hours a week, in order to maintain a low turnover rate.
Nurse training is a requirement in many states and has become a hot-button issue, with a number of states banning or reducing the requirement.
Some have also enacted a nurse training tax credit.
The Texas Nursing Association estimates that the state’s tax credit for nursing home nurses is about $8.7 million annually.
Nurals are required to complete a program called the nursing care evaluation, or NCEE, before being hired.
They must pass this program, and other competencies such as literacy, communication and personal hygiene, and pass a clinical examination, which can include an assessment of their physical and mental condition, according information posted on the Nursing Home Professionals Network website.
The NCEE is a two-part process.
The first part consists of a clinical exam that includes a physical exam and a mental health interview.
The second part consists a written examination and an assessment to determine if the nursing aide meets the state-mandated NCEE.
The state also has a nurse licensing board that vets nursing aides.
Nuns are required by law to complete at least six months of training, including two years of basic nursing, and four years of advanced nursing.
Nationally, the average nursing home tenure for a nurse is five years, according a study by the University of Washington.
The study found that nearly two-dozen states had at least one year of nursing experience requirements for nursing homes and that four states had more than four years.
“I have been working in nursing for a decade and have never had a nurse who did not pass the NCEE,” said one former nurse.
“I think it is an opportunity for nurses to become better in their care.”
But some nursing home staff say they can’t get the nursing license they need.
“They are taking away the ability to do their job properly and to take care of their patients,” said the former nursing home resident.
“The nurse who’s supposed to care for us has no idea what she’s doing.”
Many nurses say they have been discouraged from pursuing their nursing career after the state began requiring nursing home nursing certification last year.
“This is one of the worst times in my career,” said another former nurse who worked in a nursing facility in Tennessee.
“This is the worst.
The nurses are not prepared for the job.”ABC News’ Laura McAndrew contributed to this report.