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1.1: Ur*t>  Service Occupations: Cleaning, Food, Health, and Personal ISBN 0-16-043062-3  Reprinted from the Occupational Outlook Handbook, 1994-95 Edition U.S. Department of Labor Bureau of Labor Statistics  9 78 160 430626  Bulletin 2450-15 Federal Reserve Bank of St. Louis  O , .  ....  !JW»»a  *... ... •  • ■: ‘  __ >  mm * < Hr  • --  .  '  IlillPil "-:-i  9lAnimal Caretakers, Except Farm (D.O.T. 410.674-010, -022; 412.671-010, .674-014; 418.381- 010, .674-010, 677-010; and 449.671-010)  Nature of the Work Most people like animals. But, as pet owners can attest, it is hard work taking care of them. Animal caretakers, sometimes called animal attendants, feed, water, groom, bathe, and exercise animals and clean and repair their cages. They also play with the animals, provide companionship, and observe behavioral changes that could indicate illness or injury. Kennels, animal shelters, pet stores, stables, veterinary facilities, laboratories, and zoological parks all house animals and employ caretakers. Job titles and duties vary by employment setting. Kennel staff usually care for small companion animals like dogs and cats. Beginning attendants perform basic tasks, such as cleaning cages and dog runs. Experienced attendants may give basic treat­ ment and first aid, bathe and groom animals and clean their ears and teeth. People who specialize in maintaining dogs’ appearance are called “dog groomers.” Some groomers work in kennels and others operate their own grooming business. Caretakers also sell pet food and supplies, teach obedience classes, help with breeding, or prepare animals for shipping. In addition to providing the basic maintenance of the animals, caretakers in animal shelters screen applicants for animal adoption, vaccinate newly admitted animals, and euthanize (put to death) seri­ ously ill, severely injured, or unwanted animals. Pet store caretakers provide basic care, sell pet supplies, and give advice to customers. Workers in stables saddle and unsaddle horses, give them rubdowns, and walk them through a cool-off after a ride. They also feed and groom the horses, muck out stalls, polish saddles, clean and or­ ganize the tack room, and store supplies and feed. Experienced staff also train horses. Veterinary hospitals employ three types of caretakers; Veterinary technician, veterinary assistant, and animal attendant. Veterinary technicians, also known as animal health technicians, are the most skilled. They keep records, take specimens, perform laboratory tests, prepare animals and instruments for surgery, take and develop radiographs, dress wounds, and assist veterinarians with examina­ tions and surgery. However, they do not diagnose ailments, pre­ scribe medication, or perform surgery. Veterinary assistants feed and bathe animals, administer medica­ tion as prescribed by a veterinarian, and help veterinarians and the veterinary technicians treat animals. For example, the assistant may hold the animal while the technician gives it an injection. Animal attendants clean cages, exercise animals, and monitor the animals for symptoms of illnesses. This is the most basic job and is frequently performed by part-time workers. Laboratories also have three levels of animal caretakers: Labora­ tory animal technologist, laboratory animal technician, and assis­ tant laboratory animal technician. The highest level, laboratory animal technologist, supervises the daily care and maintenance of the animals by the technician and assistant; they may also assist in surgical care and other laboratory procedures. The laboratory animal technician provides the daily care of the animals—giving prescribed medications, taking specimens, performing laboratory tests, and assisting with minor surgery. Technicians also keep daily records of the animals’ diets, behavior, and health. Assistant labora­ tory animal technicians clean cages and feed animals. Zookeepers prepare the diets, clean the enclosures, and monitor the behavior of exotic animals. Keepers sometimes assist in research studies on their wards. Depending upon the species, the keepers  2 Federal Reserve Bank of St. Louis  it.S J  may also train the animals. An example is the elephant keeper who teaches the pachyderm to hold up its foot so that the veterinarian may examine the sole. In addition, keepers may put on shows and give lectures to the public. Working Conditions People who love animals get satisfaction from working with and helping animals. However, some of the work may be physically de­ manding and unpleasant. Caretakers have to clean animal cages and lift heavy supplies like bales of hay. Also, the work setting is often noisy. Some duties like euthanizing a hopelessly injured or aged animal may be emotionally stressful. Animal caretakers can be exposed to bites, kicks, and disease from the animals they attend. Caretakers may work outdoors in all kinds of weather. Hours are irregular. Animals have to be fed every day, so caretakers rotate week-end shifts. In some animal hospitals and animal shelters an attendant is on duty 24 hours a day, which means night shifts. Most full-time caretakers work about 40 bours a week, some work 50 hours a week or more. Caretakers of show and sports animals travel to competitions. Employment Animal caretakers held about 103,000 jobs in 1992. Most were em­ ployed in veterinary facilities and boarding kennels. Other employ­ ers were animal shelters, stables, pet stores, grooming shops, zoolog­ ical parks, and local, State, and Federal agencies. One out of every 6 caretakers is self- employed. More than a third work part time. Training, Other Qualifications, and Advancement Most animal caretakers working in kennels, pet stores, animal shel­ ters, and stables are trained on the job. There are few formal training programs, but the American Boarding Kennel Association offers a home-study program for kennel technicians. Some States require certification of caretakers who euthanize animals. Training may be through a veterinarian or a State Humane Society. Otherwise, there are no formal training requirements in these settings; nonetheless, many employers look for people with some experience with animals. Caretakers start by cleaning cages and advance to giving medication  Kennel staff usually care for small companion animals.  For sale by the U.S. Government Printing Office Superintendent of Documents, Mail Stop: SSOP, Washington, DC 20402-9328 ISBN 0-16-043062-3  and grooming. Most dog groomers learn their trade through on-thejob training, but a few grooming schools do exist. Dog groomers may receive professional registration or certifica­ tion from the National Dog Groomers Association of America. The American Boarding Kennels Association accredits kennels and of­ fers a Certified Kennel Operator program, both of which show pro­ fessional competency. Forty-two States require veterinary technicians to be licensed; this is the only animal caretaker position requiring licensure. Licen­ sure requirements in most States include graduation from an ac­ credited animal technology program. In 1992, there were 63 associ­ ate programs and 5 bachelor’s degree programs accredited by the American Veterinary Medicine Association. Courses include animal pharmacology, veterinary physiology and anatomy, animal care and management, radiography, anesthetic nursing and moni­ toring, parasitology, animal husbandry, chemistry, biology, applied mathematics, communications, and the humanities. In States with­ out education requirements for veterinary technicians, veterinarians may employ applicants with a strong science background and train them on the job; however, most veterinarians prefer graduates of formal academic programs. There are no formal education requirements for animal attend­ ants and veterinary assistants in veterinary facilities. They are trained on the job. The American Association for Laboratory Animal Science (AALS) tests and certifies three levels of caretakers—technologists, technicians, and assistants. To be eligible to take the certification ex­ amination, laboratory animal technologists must have 6 years of training, 4 years of which may be college-level courses in the life sci­ ences and at least 2 years of laboratory experience. Laboratory animal technicians need 3 years of experience in a laboratory. They may substitute 2 years of education in college-level life sciences for 2 years of experience. Laboratory animal assistants must have 1 year of work experience or 6 months of experience and 6 months of col­ lege-level life science education. Large zoological parks may require their keepers to have a bache­ lor’s degree in biology, animal science, or a related field. They also require experience with animals, preferably as a volunteer in a zoo or as a paid keeper in a smaller zoo. Advancement varies with employment setting. Kennel caretakers may be promoted to kennel supervisor, assistant manager, and man­ ager. Caretakers with enough capital may open up their own ken­ nels. Pet store caretakers may become store managers. In laborato­ ries, assistant laboratory animal technicians may advance to laboratory animal technician, then to technologist; however, the technologist position requires a college-level background in the life sciences. Caretakers in animal shelters may become a humane agent, animal control officer, assistant shelter manager, or shelter director. The Humane Society of the United States offers a 2-week course for animal shelter and control personnel. Job Outlook Employment of animal caretakers is expected to grow faster than the average for all occupations through the year 2005 as the popula­ tion and economy expand. The number of dogs and cats has in­ creased significantly over the last 10 years, and is expected to con­ tinue to increase. Despite growth in demand for animal caretakers, the overwhelm­ ing majority of jobs will result from the need to replace workers leaving the field. Many animal caretaker jobs that require little or no training have work schedules which tend to be flexible; therefore, it is an ideal first job for people entering the labor force as well as for students and others looking for temporary or part-time work. Be­ cause these workers have a weak attachment to the occupation, turnover is quite high and the overall availability of jobs should be very good. Much of the work of these animal caretakers is seasonal, particularly during vacation periods. The best prospects should be for graduates of training programs in veterinary technology. Many employers complain of a shortage of Federal Reserve Bank of St. Louis  formally trained veterinary technicians. Job opportunities for certi­ fied laboratory animal technicians and technologists are also good. As concern for animal welfare increases, so will the need for certi­ fied personnel in laboratories. The outlook for zookeepers is not so favorable. Jobseekers will face keen competition because of expected slow growth in zoo capacity, low turnover, and the fact that the oc­ cupation attracts many candidates. Additional opportunities will occur in kennels as owners increas­ ingly focus on the business aspects of the kennel and hire managers to operate the animal care department. Earnings In 1992, median weekly earnings for animal caretakers who usually worked full time were about $250, according to limited data. Gener­ ally, veterinary technicians, laboratory animal technologists, and zookeepers earn more than other animal caretakers. Related Occupation Other occupations working with animals include agricultural and biological scientists, veterinarians, retail sales workers in pet stores, gamekeepers, game-farm helpers, poultry breeders, ranchers, and artificial-breeding technician. Sources of Additional Information For more information on animal caretaking and the animal shelter and control personnel training program, write to: Animal Caretakers Information, The Humane Society of the United States, Companion Animals Division, Suite 100, 5430 Grosvenor Lane, Bethesda, MD 20814.  To obtain a listing of grooming schools or the name of the nearest certified dog groomer in your area, send a stamped self-addressed envelope to: ^National Dog Groomers Association of America, Box 101, Clark, PA 16113.  For information on training and certification of kennel staff and owners, contact:  American Boarding Kennel Association, 4575 Galley Rd., Suite 400-A, Colorado Springs, CO 80915.  For information on certification for laboratory animal techni­ cians and technologists, write to: lif- American Association for Laboratory Animal Science (AALAS), 70 Timber Creek Dr., Suite #5, Cordova, TN 93018.  Barbers and Cosmetologists (D.O.T. 330; 331; 332; 333; 339.361, .371)  Nature of the Work Acquiring the right “look” has never been easy. It requires that per­ fect hairstyle, exquisite nails, a neatly trimmed beard, or the proper make-up to accent your coloring. As people increasingly demand styles that are better suited to their individual characteristics, they rely on barbers and cosmetologists more and more. Although tastes and fashions change from year to year, the basic job of barbers and cosmetologists remains the same—to help people look their best. Barbers cut, trim, shampoo, and style hair. Many people still go to a barber for just a haircut, but an increasing number seek more personalized hairstyling services. Barbers trained in these areas work in barber shops and styling salons, many of which are consid­ ered to be “unisex” because they serve both men and women. It is not uncommon for a barber to color or perm a customer’s hair. In addition, barbers may fit hairpieces, provide hair and scalp treat­ ments, shave male customers, or give facial massages. In most States, barbers are licensed to perform all the duties of cosmetolo­ gists except skin care and nail treatment. Cosmetologists primarily shampoo, cut, and style hair. These workers, who are often called hairstylists, also may advise patrons 3  on how to care for their hair. Frequently, they straighten or perma­ nent wave a customer’s hair to keep the style in shape. Cosmetolo­ gists may also lighten or darken hair color. In addition, most cosme­ tologists are trained to give manicures and scalp and facial treatments, provide makeup analysis for women, and clean and style wigs and hairpieces. Related workers include manicurists, who clean, shape, and polish customer’s fingernails and toenails; makeup artists, who apply makeup; electrologists, who remove hair from skin by electrolysis; and estheticians, who cleanse and beautify the skin. Cosmetologists offer all of the services that barbers do except shaving men. In addition to their work with customers, barbers and cosmetolo­ gists are expected to keep their work area clean and their hairdress­ ing implements sanitized. They may make appointments and keep records of hair color and permanent wave formulas used by their regular patrons. Some sell hair products and other cosmetic sup­ plies. Barbers and cosmetologists who operate their own salons also have managerial duties that include hiring, supervising, and firing workers, as well as keeping records and ordering supplies. Working Conditions Barbers and cosmetologists generally work in clean, pleasant sur­ roundings with good lighting and ventilation. Good health and stamina are important because these workers must stand a great deal. Prolonged exposure to some hair and nail chemicals may be hazardous and cause irritation, so special care must be taken when working with these chemicals. Full-time barbers and cosmetologists may work more than 40 hours a week. This often includes evenings and weekends, when beauty and barber shops and salons are busiest. Although weekends and lunch periods are generally very busy, bar­ bers and cosmetologists may have some time off during slack peri­ ods. Employment Barbers and cosmetologists held about 746,000 jobs in 1992; 9 of every 10 were cosmetologists. Most worked in beauty salons, barber shops, or department stores, and a few were employed by hospitals, hotels, and prisons. About 4 out of every 5 barbers and about half of all cosmetologists are self employed. Almost all cities and towns have barbershops and hair salons, but employment is concentrated in the most populous cities and states. Hairstylists usually work in cities and suburbs, where the greatest demand for their services exists. Stylists who set fashion trends with their hairstyles usually work in New York City, Los Angeles, and other centers of fashion and the performing arts. One of every 3 barbers and cosmetologists works part time. The abundance of part-time jobs attracts many persons who want to combine a job with family, school, or other responsibilities.  Cosmetologists work in a variety ofsettings to help people look their best. 4 Federal Reserve Bank of St. Louis  Training, Other Qualifications, and Advancement Although all States require barbers and cosmetologists to be li­ censed, the qualifications necessary to obtain a license vary. Gener­ ally, a person must have graduated from a State-licensed barber or cosmetology school, pass a physical examination, and be at least 16 years old. In addition, education requirements vary from State to State—some require graduation from high school while others re­ quire as little as an eighth grade education. In a few States, comple­ tion of an apprenticeship can substitute for graduation from a school, but very few barbers or cosmetologists learn their skills in this way. Applicants for a license usually are required to pass a writ­ ten test and demonstrate an ability to perform basic barbering or cosmetololgy services. Some States have reciprocity agreements that allow licensed bar­ bers and cosmetologists to practice in a different State without addi­ tional formal training. Other States do not recognize training or li­ censes obtained in another State; consequently, persons who wish to become a barber or a cosmetologist should review the laws of the State in which they want to work before entering a training pro­ gram. Public and private vocational schools offer daytime or evening classes in barbering and cosmetology. These programs usually last 6 to 12 months. An apprenticeship program can last from 1 to 2 years. Formal training programs include classroom study, demonstra­ tions, and practical work. Students study the basic services—hair­ cutting, shaving, facial massaging, and hair and scalp treatments— and, under supervision, practice on customers in school “clinics.” Most schools also teach unisex hairstyling and chemical styling. Students attend lectures on barber services, the use and care of in­ struments, sanitation and hygiene, and recognition of certain skin ailments. Instruction also is given in selling and general business practices. There are also advanced courses for experienced barbers in hairstyling, coloring, and the sale and service of hairpieces. Most schools teach hairstyling of men’s as well as women’s hair. After graduating from a training program, students can take the State licensing examination. The examination consists of a written test and, in some cases, a practical test of cosmetology skills. A few States include an oral examination in which the applicant is asked to explain the procedures he or she is following while taking the practi­ cal test. In some States, a separate examination is given for persons who want only a manicurist license or a facial care license. Persons who want to become barbers or cosmetologists must have finger dexterity and a sense of form and artistry. They should enjoy dealing with the public and be willing and able to follow patrons’ in­ structions. Because hairstyles are constantly changing, barbers and cosmetologists must keep abreast of the latest fashions and beauty techniques. Business skills are important for those who plan to oper­ ate their own salons. Many schools help their graduates find jobs. During their first months on the job, new workers are given relatively simple tasks, such as giving shampoos, or are assigned to perform the simpler hairstyling patterns. Once they have demonstrated their skills, they are gradually permitted to perform the more complicated tasks such as giving shaves, coloring hair, or applying a permanent. Advancement usually is in the form of higher earnings as barbers and cosmetologists gain experience and build a steady clientele. Some barbers and cosmetologists manage large salons or open their own after several years of experience. Some teach in barber or cos­ metology schools. Others become sales representatives for cosmetics firms, open businesses as beauty or fashion consultants, or work as examiners for State licensing boards. Job Outlook Overall employment of barbers and cosmetologists is expected to grow faster than the average for all occupations through the year 2005. Population growth, rising incomes, and a growing demand for the services that they provide will stimulate the demand for these workers. Within this occupation, however, different employment trends are expected. Cosmetologists will account for virtually all of the employment growth, reflecting the continuing shifts in con­ sumer preferences to more personalized services and in salons to full-service, unisex establishments. Demand for manicurists and for  cosmetologists who are trained in nail care will be particularly strong. Employment of barbers is expected to decline slightly. The annual number of job openings in cosmetology should be quite large due to the large size of the occupation and expected rapid employment growth. However, there appears to be a large reserve pool of licensed cosmetologists who move into and out of the occu­ pation. Consequently, newly licensed jobseekers in this field are likely to compete for openings with an experienced pool of workers who choose to reenter the labor force. Despite a projected employment decline, a significant number of active barbers should soon retire and need to be replaced. Those who receive training to perform a wide range of services, as most currently do, will improve their chances of finding employment in the growing number of full- service salons. Opportunities for persons seeking part-time barbering and cosme­ tology positions should continue to be good. Earnings Barbers and cosmetologists receive income either from commissions or wages and tips. According to limited information, most full-time barbers and cosmetologists earned between $20,000 and $30,000 in 1992, including tips. Earnings depend on the size and location of the shop, the number of hours worked, customers’ tipping habits, com­ petition from other barbershops and salons, and the barber’s or cos­ metologist’s ability to attract and hold regular customers. Related Occupations Other workers whose main activity consists of improving a patron’s personal appearance include beauty consultants, make-up and wig specialists, and salon and health club managers. Other workers are employed in the cosmetology industry as instructors and beauty supply distributors. Sources of Additional Information Lists of barber schools, by State, are available from: S’National Association of Barber Schools, Inc., 304 South 11th St., Lin­ coln, NE 68502.  A list of licensed training schools and licensing requirements for cosmetologists can be obtained from: S’ National Accrediting Commission of Cosmetology Arts and Sciences, 901 North Stuart St., Suite 900, Arlington, VA 22203. S’Association of Accredited Cosmetology Schools, Inc., 5201 Leesburg Pike, Falls Church, VA 22041. Information about barber and cosmetology schools also is availa­ ble from: S’ Accrediting Commission of Career Schools/Colleges of Technology, 750 1st St. NE., Suite 905, Washington, DC 20002.  For details on State licensing requirements and approved barber or cosmetology schools, contact the State board of barber examiners or the State board of cosmetology in your State capital.  Chefs, Cooks, and Other Kitchen Workers (D.O.T. 311.674-014; 313 except .131; 315.361, .371, and .381; 316.661, .684-010 and -014; 317; 318.687; and 319.484)  Nature of the Work A reputation for serving good food is essential to any restaurant, whether it prides itself on hamburgers and French fries or exotic foreign cuisine. Chefs, cooks, and other kitchen workers are largely responsible for the reputation a restaurant acquires. Some restau­ rants offer a varied menu featuring meals that are time consuming and difficult to prepare, requiring a highly skilled cook or chef. Other restaurants emphasize fast service, offering hamburgers and sandwiches that can be prepared in advance or in a few minutes by a fast-food or short-order cook with only limited cooking skills. Chefs and cooks are responsible for preparing meals that are tasty and attractively presented. Chefs are the most highly skilled, trained, and experienced kitchen workers. Although the terms chef Federal Reserve Bank of St. Louis  and cook are still sometimes used interchangeably, cooks generally have more limited skills. Many chefs have earned fame for both themselves and the restaurants, hotels, and institutions where they work because of their skill in artfully preparing the traditional fa­ vorites and in creating new dishes and improving familiar ones. (For information on executive chefs, see the Handbook statement on res­ taurant and food service managers.) Institutional chefs and cooks work in the kitchens of schools, in­ dustrial cafeterias, hospitals, and other institutions. For each meal, they prepare a small selection of entrees, vegetables, and desserts, but in large quantities. Restaurant chefs and cooks generally prepare a wider selection of dishes for each meal, cooking most individual servings to order. Whether in institutions or restaurants, chefs and cooks measure, mix, and cook ingredients according to recipes. In the course of their work they use a variety of pots, pans, cutlery, and equipment, including ovens, broilers, grills, sheers, grinders, and blenders. They are often responsible for directing the work of other kitchen workers, estimating food requirements, and ordering food supplies. Some chefs and cooks also help plan meals and develop menus. Bread and pastry bakers, called pastry chefs in some kitchens, produce baked goods for restaurants, institutions, and retail bakery shops. Unlike bakers who work at large, automated industrial bak­ eries, bread and pastry bakers need only supply the customers who visit their establishment. They bake smaller quantities of breads, rolls, pastries, pies, and cakes, doing most of the work by hand. They measure and mix ingredients, shape and bake the dough, and apply fillings and decorations. Short-order cooks prepare foods to order in restaurants and coffee shops that emphasize fast service. They grill and garnish hamburg­ ers, prepare sandwiches, fry eggs, and cook French fried potatoes, often working on several orders at the same time. Prior to busy peri­ ods, they may slice meats and cheeses or prepare coleslaw or potato salad. During slow periods, they may clean the grill, food prepara­ tion surfaces, counters, and floors. Specialty fast-food cooks prepare a limited selection of menu items in fast-food restaurants. They cook and package batches of food such as hamburgers and fried chicken, which are prepared to order or kept warm until sold. Other kitchen workers, under the direction of chefs and cooks, perform tasks requiring less skill. They weigh and measure ingredi­ ents, fetch pots and pans, and stir and strain soups and sauces. They clean, peel, and slice potatoes, other vegetables, and fruits and make salads. They also may cut and grind meats, poultry, and seafood in preparation for cooking. Their responsibilities also include cleaning  work areas, equipment and utensils, and dishes and silverware. The number and types of workers employed in kitchens depend partly on the type of restaurant. For example, fast-food outlets offer only a few items, which are prepared by fast-food cooks. Smaller, full-service restaurants that offer casual dining often feature a lim­ ited number of easy-to-prepare items, supplemented by short-order specialties and readymade desserts. Typically, one cook prepares all of the food with the help of a short-order cook and one or two other kitchen workers. Large eating places may have more varied menus and prepare, from start to finish, more of the food they serve. Kitchen staffs often include several chefs and cooks, sometimes called assistant or ap­ prentice chefs or cooks, a bread and pastry baker, and many less skilled kitchen workers. Each chef or cook usually has a special as­ signment and often a special job title—vegetable, fry, or sauce cook, for example. Executive chefs coordinate the work of the kitchen staff and often direct certain kinds of food preparation. They decide the size of servings, sometimes plan menus, and buy food supplies. Working Conditions Many restaurant and institutional kitchens have modern equip­ ment, convenient work areas, and air-conditioning; but others, par­ ticularly in older and smaller eating places, are frequently not as well equipped. Other variations in working conditions depend on the type and quantity of food being prepared and the local laws gov­ erning food service operations. Workers generally must withstand the pressure and strain of working in close quarters during busy pe­ riods, stand for hours at a time, lift heavy pots and kettles, and work 5  mh  I JV*  Work hours in restaurants may include late evening, holiday, and  weekend work. near hot ovens and grills. Job hazards include slips and falls, cuts, and bums, but injuries are seldom serious. Work hours in restaurants may include late evening, holiday, and weekend work, while hours in cafeterias in factories, schools, or other institutions may be more regular. Half of all short-order and fast-food cooks and other kitchen workers worked part time; a third of all bakers and restaurant and institutional cooks worked part time. Kitchen workers employed by public and private schools may work during the school year only, usually for 9 or 10 months. Vaca­ tion resorts may offer only seasonal employment. Employment Chefs, cooks, and other kitchen workers held nearly 3.1 million jobs in 1992. Short-order and fast-food cooks held 714,000 of the jobs; restaurant cooks, 602,000; institutional cooks, 406,000; bread and pastry bakers, 146,000; and other kitchen workers, 1,233,000. About three-fifths of all chefs, cooks, and other kitchen workers worked in restaurants and other retail eating and drinking places. One-fifth worked in institutions such as schools, universities, hospi­ tals, and nursing homes. The remainder were employed by grocery stores, hotels, and many other organizations. Training, Other Qualifications, and Advancement Most kitchen workers start as fast-food or short-order cooks, or in one of the other less skilled kitchen positions that require little edu­ cation or training and that allow them to acquire their skills on the job. After acquiring some basic food handling, preparation, and cooking skills, they may be able to advance to an assistant cook or short- order cook position, but many years of training and experi­ ence are necessary to achieve the level of skill required of an execu­ tive chef or cook in a fine restaurant. Even though a high school di­ ploma is not required for beginning jobs, it is recommended for those planning a career as a cook or chef. High school or vocational school courses in business arithmetic and business administration are particularly helpful. Many school districts, in cooperation with State departments of education, provide on-the-job training and sometimes summer workshops for cafeteria kitchen workers who wish to become cooks. Employees who have participated in these training programs often are selected for jobs as cooks. 6 Federal Reserve Bank of St. Louis  An increasing number of chefs and cooks are obtaining their training through high school or posthigh school vocational pro­ grams and 2- or 4-year colleges. Chefs and cooks may also be trained in apprenticeship programs offered by professional culinary insti­ tutes, industry associations, and trade unions. An example is the 3year apprenticeship program administered by local chapters of the American Culinary Federation in cooperation with local employers and junior colleges or vocational education institutions. In addition, some large hotels and restaurants operate their own training pro­ grams for cooks and chefs. People who have had courses in commercial food preparation may be able to start in a cook or chef job without having to spend time in a lower skilled kitchen job, and they may have an advantage when looking for jobs in better restaurants and hotels, where hiring standards often are high. Some vocational programs in high schools offer this kind of training, but usually these courses are given by trade schools, vocational centers, colleges, professional associations, and trade unions. Postsecondary courses range from a few months to 2 years or more and are open in some cases only to high school graduates. The Armed Forces also are a good source of training and experience. Although curricula may vary, students usually spend most of their time learning to prepare food through actual practice. They learn to bake, broil, and otherwise prepare food, and to use and care for kitchen equipment. Training programs often include courses in menu planning, determination of portion size and food cost control, purchasing food supplies in quantity, selection and storage of food, and use of leftover food to minimize waste. Students also learn hotel and restaurant sanitation and public health rules for handling food. Training in supervisory and management skills sometimes is empha­ sized in courses offered by private vocational schools, professional associations, and university programs. Culinary courses are given by 550 schools across the nation. The American Culinary Federation accredited 70 of these programs in 1993. Accreditation is an indication that a culinary program meets recognized standards regarding course content, facilities, and qual­ ity of instruction. The American Culinary Federation has only been accrediting culinary programs for a relatively short time, however, and many programs have not yet sought accreditation. Certification provides valuable formal recognition of the skills of a chef or cook. The American Culinary Federation certifies chefs and cooks at the levels of cook, working chef, executive chef, and master chef. It also certifies pastry professionals and culinary educa­ tors. Certification standards are based primarily on experience and formal training. The ability to work as part of a team, a keen sense of taste and smell, and personal cleanliness are important qualifications for chefs, cooks, and other kitchen workers. Most States require health certificates indicating that these workers are free from contagious diseases. Advancement opportunities for chefs and cooks are better than for most other food and beverage preparation and service occupa­ tions. Many acquire higher paying positions and new cooking skills by moving from one job to another. Besides culinary skills, advance­ ment also depends on ability to supervise lesser skilled workers and limit food costs by minimizing waste and accurately anticipating the amount of perishable supplies needed. Some cooks and chefs gradu­ ally advance to executive chef positions or supervisory or manage­ ment positions, particularly in hotels, clubs, or larger, more elegant restaurants. Some eventually go into business as caterers or restau­ rant owners; others may become instructors in vocational programs in high schools, junior and community colleges, and other academic institutions. Job Outlook Job openings for chefs, cooks, and other kitchen workers are ex­ pected to be excellent through the year 2005. Growth in demand for these workers will create many new jobs, but most openings will arise from the need to replace the relatively high proportion of workers who leave this very large occupation each year. There is substantial turnover in many of these jobs because their limited re­ quirements for formal education and training allow easy entry, and the many part-time positions are attractive to persons seeking a  short-term source of income rather than a career. Many of the work­ ers who leave these jobs transfer to other occupations, while others stop working to assume household responsibilities or to attend school full time. Workers under the age of 25 have traditionally filled a significant proportion of the lesser skilled jobs in this occupation. The pool of young workers is expected to continue to shrink through the 1990’s, but then begin to grow. Many employers will be forced to offer higher wages, better benefits, and more training to attract and retain workers in these jobs. Employment of chefs, cooks, and other kitchen workers is ex­ pected to increase faster than the average for all occupations through the year 2005. Since a significant proportion of food and beverage sales by eating and drinking establishments is associated with the overall level of economic activity—workers’ lunches and entertainment of clients, for example—sales and employment will increase with the growth of the economy. Other factors contributing to employment growth will be population growth, rising family and personal incomes, and more leisure time that will allow people to dine out and take vacations more often. Also, as more women join the work force, families increasingly may find dining out a welcome convenience. Employment in restaurants is expected to grow rapidly. As the average age of the population increases, demand will grow for res­ taurants that offer table service and more varied menus—which will require more highly skilled cooks and chefs. The popularity of fresh baked breads and pastries in fine dining establishments should in­ sure continued rapid growth in the employment of bakers. How­ ever, employment of short-order and specialty fast-food cooks is ex­ pected to increase more slowly than other occupations in this group because most work in fast-food restaurants, which are expected to have slower growth than in the past. Employment of institutional and cafeteria chefs and cooks will grow about as fast as the average. Their employment is concentrated in the educational and health services sectors. Although employ­ ment in both sectors is expected to increase rapidly, growth of insti­ tutional and cafeteria cooks will not keep pace. Many high schools and hospitals are trying to make “institutional food” more attrac­ tive to students, staff, visitors, and patients. While some are employ­ ing more highly trained chefs and cooks to prepare more appealing meals, others are contracting out their food services. Many of the contracted companies emphasize fast-food chains and employ short-order and fast- food cooks instead of institutional and cafete­ ria cooks. Earnings Wages of chefs, cooks, and other kitchen workers vary depending on the part of the country and, especially, the type of establishment in which they work. Wages generally are highest in elegant restau­ rants and hotels, and many executive chefs earn over $40,000 annu­ ally. According to a survey conducted by the National Restaurant Association, median hourly earnings of cooks were $6.57, with most earning between $6.00 and $8.00 in 1992. Assistant cooks had me­ dian hourly earnings of $6.00, with most earning between $5.50 and $6.50. According to the same survey, short-order cooks had median hourly earnings of $5.99 in 1992; most earned between $5.00 and $6.75. Median hourly earnings of bread and pastry bakers were $6.25; most earned within the range of $6.00 to $7.00. Salad prepa­ ration workers generally earned less, with median hourly earnings of $5.90; most earned between $5.00 and $6.00. Food preparation workers in fast-food restaurants had median hourly earnings of $4.68, with most earning between $4.25 and $5.30 per hour. Some employers provide uniforms and free meals, but Federal law permits employers to deduct from wages the cost, or fair value, of any meals or lodging provided, and some employers exercise this right. Chefs, cooks, and other kitchen workers who work full time often receive paid vacation and sick leave and health insurance, but part-time workers generally do not receive such benefits. In some large hotels and restaurants, kitchen workers belong to unions. The principal unions are the Hotel Employees and Restau­ rant Employees International Union and the Service Employees In­ ternational Union. Federal Reserve Bank of St. Louis  Related Occupations Workers who perform tasks similar to those of chefs, cooks, and other kitchen workers include butchers and meatcutters, cannery workers, and industrial bakers. Sources of Additional Information Information about job opportunities may be obtained from local employers and local offices of the State employment service. Career information about chefs, cooks, and other kitchen work­ ers, as well as a directory of 2- and 4-year colleges that offer courses or programs that prepare persons for food service careers, is availa­ ble from: 13* The Educational Foundation of the National Restaurant Association, 250 South Wacker Dr., Suite 1400, Chicago, IL 60606.  For information on the American Culinary Federation’s appren­ ticeship and certification programs for cooks, as well as a list of ac­ credited culinary programs, write to: XS" American Culinary Federation, P.O. Box 3466, St. Augustine, FL 32085. For general information on hospitality careers, write to: fS" Council on Hotel, Restaurant, and Institutional Education, 1200 17th St. NW„ Washington, DC 20036-3097.  Dental Assistants (D.O.T. 079.361-018)  Nature of the Work Dental assistants perform a variety of patient care, office, and labo­ ratory duties. They work at chairside as dentists examine and treat patients. They make patients as comfortable as possible in the dental chair, prepare them for treatment, and obtain dental records. Assist­ ants hand dentists instruments and materials and keep patients’ mouths dry and clear by using suction or other devices. Assistants also sterilize and disinfect instruments and equipment; prepare tray setups for dental procedures; provide postoperative instruction; and instruct patients in oral health care. Some dental assistants prepare materials for making impressions and restorations, expose radi­ ographs, and process dental x-ray film as directed by a dentist. They may also remove sutures, apply anesthetic and caries- preventive agents to teeth and gums, remove excess cement used in the filling process, and place rubber dams on the teeth to isolate them for indi­ vidual treatment. Those with laboratory duties make casts of the teeth and mouth from impressions taken by dentists, clean and polish removable ap­ pliances, and make temporary crowns. Dental assistants with office duties arrange and confirm appointments, receive patients, keep treatment records, send bills, receive payments, and order dental supplies and materials. Dental assistants should not be confused with dental hygienists, who are licensed to perform a wider variety of clinical tasks. (See the statement on dental hygienists elsewhere in the Handbook.) Working Conditions Dental assistants work in a well-lighted, clean environment. Han­ dling radiographic equipment poses dangers, but they can be mini­ mized with safety procedures. Likewise, dental assistants wear gloves and masks to protect themselves from infectious diseases like hepatitis. Dental assistants, like dentists, work either standing or sitting. Their work area is usually near the dental chair, so that they can ar­ range instruments, materials, and medication, and hand them to the dentist when needed. Most dental assistants have a 32- to 40-hour workweek which may include work on Saturday or evenings. Employment Dental assistants held about 183,000jobs in 1992. Almost 1 out of 3 worked part time, sometimes in more than one dentist’s office. 7  growth, higher incomes, and greater retention of natural teeth by middle-aged and older people will fuel demand for dental services. Also, dentists are likely to employ more assistants, for several rea­ sons. Older dentists, who are less likely to employ assistants, will leave and be replaced by recent graduates, who are more likely to use one, or even two. In addition, as dentists’ workloads increase, they are expected to hire more assistants to perform routine tasks, so they may use their own time more profitably. Most job openings for dental assistants will arise from the need to replace assistants who leave the occupation. Many assistants leave the job to take on family responsibilities, return to school, or trans­ fer to another occupation. Earnings In 1992, median weekly earnings for dental assistants working full time were about $332. The middle 50 percent earned between $284 and $420 a week. According to the American Dental Association, dental assistants who worked 32 hours a week or more averaged $332 a week in 1991; the average hourly earnings for all dental as­ sistants were $9.20.  a#*'. -  PH  Most dental assisting programs take less than 1 year to complete. Almost all dental assistants work in private dental offices. Some work in dental schools, private and government hospitals, State and local public health departments, or in clinics. Training, Other Qualifications, and Advancement Most assistants learn their skills on the job, though many are trained in dental assisting programs offered by community and junior col­ leges, trade schools, and technical institutes. Some assistants are trained in Armed Forces schools. Assistants must be a dentist’s “third hand”; therefore, dentists look for people who are reliable, can work well with others, and have manual dexterity. High school students interested in careers as dental assistants should take courses in biology, chemistry, health, and office practices. The American Dental Association’s Commission on Dental Ac­ creditation approved 232 training programs in 1993. Programs in­ clude classroom, laboratory, and preclinical instruction in dental as­ sisting skills and related theory. In addition, students gain practical experience in dental schools, clinics, or dental offices. Most pro­ grams take 1 year or less to complete and lead to a certificate or di­ ploma. Two-year programs offered in community and junior col­ leges lead to an associate degree. All programs require a high school diploma or its equivalent, and some require typing or a science course for admission. Some private vocational schools offer 4- to 6month courses in dental assisting, but these are not accredited by the Commission on Dental Accreditation. Certification is available through the Dental Assisting National Board. Certification is an acknowledgment of an assistant’s qualifi­ cations and professional competence, but usually is not required for employment. In several States that have adopted standards for den­ tal assistants who perform radiologic procedures, completion of the certification examination meets those standards. Candidates may qualify to take the certification examination by graduating from an accredited training program or by having 2 years of full-time experi­ ence as a dental assistant. In addition, applicants must have taken a course in cardiopulmonary resuscitation. Without further education, advancement opportunities are lim­ ited. Some dental assistants working the front office become office managers. Others, working chairside, go back to school to become dental hygienists. Job Outlook Employment of dental assistants is expected to grow faster than the average for all occupations through the year 2005. Population 8 Federal Reserve Bank of St. Louis  Related Occupations Workers in other occupations supporting health practitioners in­ clude medical assistants, physical therapy assistants, occupational therapy assistants, pharmancy assistants, and veterinary techni­ cians. Sources of Additional Information Information about career opportunities, scholarships, accredited dental assistant programs, and requirements for certification is available from: (3T American Dental Assistants Association, 203 N. Lasalle, Suite 1320, Chicago, IL 60601-1225. ISP Commission on Dental Accreditation, American Dental Association, 211 E. Chicago Ave., Suite 1814, Chicago, IL 60611. twDental Assisting National Board, Inc., 216 E. Ontario St., Chicago, IL 60611.  Flight Attendants (D.O.T. 352.367-010)  Nature of the Work It is the job of the flight attendant to see that all passengers have a safe, comfortable, and enjoyable flight. At least 1 hour before each flight, attendants are briefed by the captain on such things as expected weather conditions and special passenger problems. The attendants see that the passenger cabin is in order, that supplies of food, beverages, blankets, and reading ma­ terial are adequate, and that first aid kits and other emergency equipment are aboard and in working order. As passengers board the plane, attendants greet them, check their tickets, and assist them in storing coats and carry-on luggage. Before the plane takes off, attendants instruct passengers in the use of emergency equipment and check to see that all passengers have their seat belts fastened and seat backs forward. In the air, they answer questions about the flight; distribute reading material, pil­ lows, and blankets; and help care for small children, elderly, and disabled persons. They may administer first aid to passengers who become ill. Attendants also serve cocktails and other refreshments and, on many flights, heat and distribute precooked meals. After the plane has landed, flight attendants assist passengers as they leave the plane. They then prepare reports on medications given to passen­ gers, lost and found articles, and cabin equipment conditions. Some flight attendants straighten up the plane’s cabin. Helping passengers in the event of an emergency is the most im­ portant responsibility of the flight attendant. This may range from  reassuring passengers during occasional encounters with strong tur­ bulence to directing passengers in evacuating a plane following an emergency landing. Lead or first flight attendants aboard planes oversee the work of the other attendants while performing most of the same duties. Working Conditions Since airlines operate around the clock year round, attendants may work at night and on holidays and weekends. They usually fly 75 to 85 hours a month. In addition, they generally spend about 75 to 85 hours a month on the ground preparing planes for flight, writing re­ ports following completed flights, and waiting for planes that arrive late. Because of variations in scheduling and limitations on flying time, many attendants have 11 or more days off each month. At­ tendants may be away from their home base at least one-third of the time. During this period, the airlines provide hotel accommodations and an allowance for meal expenses. The combination of free time and discount air fares provides flight attendants the opportunity to travel and see new places. How­ ever, the work can be strenuous and trying. Short flights require speedy service if meals are served. A rough flight can make serving drinks and meals difficult. Attendants stand during much of the flight and must remain pleasant and efficient regardless of how tired they are or how demanding passengers may be. Flight attendants are susceptible to injury because of the job demands in a moving air­ craft. Employment Flight attendants held about 93,000 jobs in 1992. Commercial air­ lines employed the vast majority of all flight attendants, most of whom were stationed in major cities at the airlines’ home bases. A small number of flight attendants worked for large companies that operate their own aircraft for business purposes. Training, Other Qualifications, and Advancement The airlines prefer to hire poised, tactful, and resourceful people who can deal comfortably with strangers. Applicants usually must be at least 19 to 21 years old, but some airlines have higher mini­ mum age requirements. Flight attendants must fall into a specific weight range depending on their height and must have excellent health, good vision, and the ability to speak clearly.  i«asT».  Flight attendants are briefed on weather conditions by the pilot. Federal Reserve Bank of St. Louis  Applicants must be high school graduates. Those having several years of college or experience in dealing with the public are pre­ ferred. More and more attendants being hired are college graduates. Flight attendants for international airlines generally must speak an appropriate foreign language fluently. Most large airlines require that newly hired flight attendants complete 4 to 6 weeks of intensive training in their own schools. The airlines that do not operate schools generally send new employees to the school of another airline. Transportation to the training centers and an allowance for board, room, and school supplies may be pro­ vided. Trainees learn emergency procedures such as evacuating an airplane, operating an oxygen system, and giving first aid. Attend­ ants also are taught flight regulations and duties, and company op­ erations and policies. Trainees receive instruction on personal grooming and weight control. Trainees for the international routes get additional instruction in passport and customs regulations and dealing with terrorism. Towards the end of their training, students go on practice flights. Attendants must receive 12 to 14 hours of training in emergency procedures and passenger relations annually. After completing initial training, flight attendants are assigned to one of their airline’s bases. New attendants are placed in “reserve status” and are called on either to staff extra flights or fill in for at­ tendants who are sick or on vacation. Reserve attendants on duty must be available on short notice. Attendants usually remain on re­ serve for at least 1 year; at some cities, it may take 5 years or longer to advance from reserve status. Advancement takes longer today than in the past because experienced attendants are remaining in this career for more years than they used to. Attendants who no longer are on reserve bid for regular assignments. Because these as­ signments are based on seniority, usually only the most experienced attendants get their choice of base and flights. Some attendants transfer to flight service instructor, customer service director, recruiting representative, or various other adminis­ trative positions. Job Outlook As more career minded people have entered this occupation, turno­ ver—which traditionally has been very high—has declined. Still, most job openings through the year 2005 should flow from replace­ ment needs. Thousands of job openings will arise each year to re­ place flight attendants who transfer to another occupation or who leave the labor force. Employment of flight attendants is expected to grow much faster than the average for all occupations through the year 2005. Growth in population and income is expected to increase the number of air­ line passengers. Airlines enlarge their capacity by increasing the number and size of planes in operation. Since Federal Aviation Ad­ ministration safety rules require one attendant for every 50 seats, more flight attendants will be needed. Competition for jobs as flight attendants is expected to remain very keen because the number of applicants is expected to greatly exceed the number of job openings. The glamour of the airline in­ dustry and the opportunity to travel and meet people attract many applicants. Those with at least 2 years of college and experience in dealing with the public have the best chance of being hired. Employment of flight attendants is sensitive to cyclical swings in the economy. During recessions, when the demand for air travel de­ clines, many flight attendants are put on part-time status or laid off. Until demand increases, few new attendants are hired. Earnings Beginning flight attendants had median earnings of about $13,000 a year in 1992, according to data from the Association of Flight At­ tendants. Flight attendants with 6 years of flying experience had median annual earnings of about $20,000, while some senior flight attendants earned as much as $40,000 a year. Flight attendants re­ ceive extra compensation for overtime and for night and interna­ tional flights. In addition, flight attendants and their immediate families are entitled to reduced fares on their own and most other airlines. Many flight attendants belong to the Association of Flight At­ tendants. Others are members of the Transport Workers Union of 9  America, The International Brotherhood of Teamsters, or other un­ ions. Flight attendants are required to buy uniforms and wear them while on duty. Uniform replacement items are usually paid for by the company. The airlines generally provide a small allowance to cover cleaning and upkeep of the uniforms. Related Occupations Other jobs that involve helping people as a safety professional and require the ability to be pleasant even under trying circumstances in­ clude emergency medical technician, firefighter, maritime crew or camp counselor. Sources of Additional Information Information about job opportunities in a particular airline and the qualifications required may be obtained by writing to the personnel manager of the company. For addresses of airline companies and in­ formation about job opportunities and salaries, contact: O" Future Aviation Professionals of America, 4959 Massachusetts Blvd., Atlanta, GA 30337. (This organization may be called toll free at 1-800-JetJobs.)  Food and Beverage Service Workers (D.O.T. 310.137-010 and .357; 311.472, .477, .674-010, and -018, and .677; 312; 319.474, .677-014, and .687; 350.677-010, -026, -030; and 352.677-018)  Nature of the Work Whether they work in small, informal diners or large, elegant res­ taurants, all food and beverage service workers deal with customers. The quality of service they provide determines in part whether the patron is likely to return. Waiters and waitresses all take customers’ orders, serve food and beverages, prepare itemized checks, and sometimes accept pay­ ments—but the manner in which they perform these tasks varies considerably, depending on where they work. In coffee shops, they are expected to provide fast and efficient, yet courteous, service. In fine restaurants, where gourmet meals are accompanied by attentive formal service, waiters and waitresses serve the meal at a more lei­ surely pace and offer more personal service to patrons. For example, they may recommend a certain kind of wine as a complement to a particular entree, explain how various items on the menu are pre­ pared, or prepare some salads and other special dishes at tableside. Depending on the type of restaurant, waiters and waitresses may perform duties associated with other food and beverage service oc­ cupations in addition to waiting on tables. These tasks may include escorting guests to tables, serving customers seated at counters, set­ ting up and clearing tables, or cashiering. However, larger or more formal restaurants frequently relieve their waiters and waitresses of these additional duties. Bartenders fill the drink orders that waiters and waitresses take from customers seated in the restaurant or lounge, as well as orders from customers seated at the bar. Because some people like their cocktails made a certain way, bartenders occasionally are asked to mix drinks to suit a customer’s taste. Most bartenders must know dozens of drink recipes and be able to mix drinks accurately, quickly, and without waste, even during the busiest periods. Besides mixing and serving drinks, bartenders collect payment, operate the cash register, clean up after customers have left, and may also serve food items to customers seated at the bar. Bartenders who work at service bars have little contact with cus­ tomers. They work at small bars in restaurants, hotels, and clubs where drinks are served only to diners at tables. However, the ma­ jority of bartenders work in eating and drinking establishments where they also directly serve and socialize with patrons. Some establishments, especially larger ones, use automatic equip­ ment to mix drinks of varying complexity at the push of a button. However, bartenders still must be efficient and knowledgeable to prepare drinks not handled by the automatic equipment or mix 10 Federal Reserve Bank of St. Louis  drinks when it is not functioning. Also, equipment is no substitute for the friendly socializing most customers prefer. Bartenders usually are responsible for ordering and maintaining an inventory of liquor, mixes, and other bar supplies. They also ar­ range the bottles and glassware into attractive displays and often wash glassware used at the bar. Hosts and hostesses try to evoke a good impression of the restau­ rant by warmly welcoming guests. They courteously direct patrons to where they may leave coats and other personal items and indicate where they may wait until their table is ready. Hosts and hostesses assign guests to tables suitable for the size of their group, escort them to their seats, and provide menus. Hosts and hostesses are restaurants’ personal representatives to patrons. They try to insure that service is prompt and courteous and the meal enjoyable; they may also adjust complaints of dissatisfied diners. Hosts and hostesses schedule dining reservations, arrange parties, and organize any special services that are required. In some restaurants, they also act as cashier. Dining room attendants and bartender helpers assist waiters, wait­ resses, and bartenders by keeping the serving area stocked with sup­ plies, cleaning tables, and removing dirty dishes to the kitchen. They replenish the supply of clean linens, dishes, silverware, and glasses in the restaurant dining room, and keep the bar stocked with glasses, liquor, ice, and drink garnishes. Bartender helpers also keep the bar equipment clean and wash glasses. Dining room attendants set ta­ bles with clean tablecloths, napkins, silverware, glasses, and dishes and serve ice water, rolls, and butter to patrons. At the conclusion of the meal, they remove dirty dishes and soiled linens from the tables. Cafeteria attendants stock serving tables with food, trays, dishes, and silverware and may carry trays to dining tables for patrons. Counter attendants take orders and serve food at counters. In caf­ eterias, they serve food displayed on counters and steamtables as re­ quested by patrons, carve meat, dish out vegetables, ladle sauces and soups, and fill cups and glasses. In lunchrooms and coffee shops, counter attendants take orders from customers seated at the counter, transmit the orders to the kitchen, and pick up and serve the food when it is ready. They also fill cups and glasses with coffee, soda, and other beverages and prepare fountain specialties such as milkshakes and ice cream sundaes. They often prepare some shortorder items, such as sandwiches and salads, and wrap or place or­ ders in containers to be taken out and consumed elsewhere. Counter attendants also clean counters, write up itemized checks, and accept payment. Fast-food workers take orders from customers standing at coun­ ters at fast-food restaurants. They get the ordered beverage and food items, serve them to the customer, and accept payment. Many fastfood workers also cook and package French fries, make coffee, and fill beverage cups using a drink-dispensing machine.  Counter attendants take orders and serve food at counters in lunchrooms and coffee shops.  Working Conditions Food and beverage service workers are on their feet most of the time and often have to carry heavy trays of food, dishes, and glassware. During busy dining periods, they are under pressure to serve cus­ tomers quickly and efficiently. The work is relatively safe, but care must be taken to avoid slips, falls, and bums. Although some food and beverage service workers work 40 hours or more a week, the majority are employed part time—a larger pro­ portion than in almost any other occupation. The majority of those working part-time schedules do so on a voluntary basis because the wide range in dining hours creates work opportunities attractive to homemakers, students, and others seeking supplemental income. Many food and beverage service workers are expected to work eve­ nings, weekends, and holidays. Some work split shifts—that is, they work for several hours during the middle of the day, take a few hours off in the afternoon, and then return to their jobs for the eve­ ning hours. Employment Food and beverage service workers held nearly 4.4 million jobs in 1992. Waiters and waitresses held almost 1.8 million of these jobs; counter attendants and fast-food workers, nearly 1.6 million; dining room and cafeteria attendants and bartender helpers, 441,000; bar­ tenders, 382,000; and hosts and hostesses, 223,000. Restaurants, coffee shops, bars, and other retail eating and drink­ ing places employed two-thirds of all food and beverage service workers. Of the remainder, nearly half worked in hotels and other lodging places, and others in bowling alleys, casinos, and country clubs and other membership organizations. Jobs are located throughout the country but are most plentiful in large cities and tourist areas. Vacation resorts offer seasonal em­ ployment, and some workers alternate between summer and winter resorts instead of remaining in one area the entire year. Training, Other Qualifications, and Advancement There are no specific educational requirements for food and bever­ age service jobs. Although many employers prefer to hire high school graduates for waiter and waitress, bartender, and host and hostess positions, completion of high school is generally not re­ quired for fast-food workers, counter attendants, and dining room attendants and bartender helpers. For many persons, a job as a food and beverage service worker serves as a source of immediate income rather than a career. Many entrants to these jobs are in their late teens or early twenties and have a high school education or less. Usually, they have little or no work experience. Many are full-time students or homemakers. Food and beverage service jobs are a ma­ jor source of part-time employment for high school students. Most employers place an emphasis on personal qualities. Food and beverage service workers should be well spoken and have a neat and clean appearance because they are in close and constant contact with the public. They should enjoy dealing with all kinds of people, and a pleasant disposition and sense of humor are important. State laws often require that food and beverage service workers obtain health certificates showing that they are free of contagious diseases. Waiters and waitresses need a good memory to avoid confusing customers’ orders and to recall the faces, names, and preferences of frequent patrons. They also should be good at arithmetic if they have to total bills without the aid of a calculator or cash register. In restaurants specializing in foreign foods, knowledge of a foreign lan­ guage is helpful. Experience waiting on tables is preferred by restau­ rants and hotels which have rigid table service standards. Jobs at these establishments often have higher earnings, but may also have higher educational requirements than less formal establishments. Generally, bartenders must be at least 21 years of age, and em­ ployers prefer to hire persons who are 25 or older. They should be familiar with State and local laws concerning the sale of alcoholic beverages. Most food and beverage service workers pick up their skills on the job by observing and working with more experienced workers. Some employers, particularly some fast-food restaurants, use self-instruc­ tion programs to teach new employees food preparation and service skills through audiovisual presentations and instructional booklets. Federal Reserve Bank of St. Louis  Some public and private vocational schools, restaurant associations, and large restaurant chains also provide classroom training in a gen­ eralized food service curriculum. Some bartenders acquire their skills by attending a bartending school or taking vocational and technical school courses that in­ clude instruction on State and local laws and regulations, cocktail recipes, attire and conduct, and stocking a bar. Some of these schools help their graduates find jobs. Due to the relatively small size of most food-serving establish­ ments, opportunities for promotion are limited. After gaining some experience, some dining room and cafeteria attendants and bar­ tender helpers are able to advance to waiter, waitress, or bartender jobs. For waiters, waitresses, and bartenders, advancement usually is limited to finding a job in a larger restaurant or bar where pros­ pects for tip earnings are better. Some bartenders open their own businesses. Some hosts and hostesses and waiters and waitresses ad­ vance to supervisory jobs, such as maitre d’hotel, dining room su­ pervisor, or restaurant manager. In larger restaurant chains, food and beverage service workers who excel at their work are often in­ vited to enter the company’s formal management training program. (For more information, see the Handbook statement on restaurant and food service managers.) Job Outlook Job openings for food and beverage service workers are expected to be abundant through the year 2005. Most openings will arise from the need to replace the high proportion of workers who leave this very large occupation each year. There is substantial movement into and out of the occupation because the limited formal education and training requirements for these jobs allow easy entry, and the pre­ dominance of part-time jobs is attractive to persons seeking a short­ term source of income rather than a career. Many of these workers simply move to other occupations; others stop working to assume household responsibilities or to attend school. Employment of food and beverage service occupations is ex­ pected to grow as fast as the average for all occupations through the year 2005. Since a significant proportion of food and beverage sales by eating and drinking places is associated with the overall level of economic activity—workers’ lunches and entertainment of clients, for example—sales and employment will increase with the growth of the economy. Growth in demand also will stem from population growth, rising personal incomes, and increased leisure time. Also, as more women join the work force, families may increasingly find din­ ing out a welcome convenience. Growth of the various types of food and beverage service jobs is expected to vary greatly. As the composition of the Nation’s popula­ tion becomes older, diners are expected to patronize full-service res­ taurants increasingly, spurring growth in demand for waiters and waitresses, hosts and hostesses, and dining room attendants. The employment of bartenders is expected to decline as drinking of alco­ holic beverages outside the home—particularly cocktails—contin­ ues to drop. Workers under the age of 25 have traditionally filled a significant proportion of food and beverage service jobs, particularly in fastfood restaurants. The pool of these young workers in the labor force is expected to shrink through the 1990’s, but begin to grow after the year 2000. To attract and retain workers, many employers will be forced to offer higher wages, better benefits, more training, and in­ creased opportunities for advancement and full-time employment. Because potential earnings are greatest in popular restaurants and fine dining establishments, keen competition is expected for the lim­ ited number ofjobs in these restaurants. Earnings Food and beverage service workers derive their earnings from a combination of hourly wages and customer tips. Their wages and the amount of tips they receive vary greatly, depending on the type of job and establishment. For example, fast-food workers and hosts and hostesses generally do not receive tips, so their wage rates may be higher than those of waiters and waitresses, who may earn more from tips than from wages. In some restaurants, waiters and wait­ resses contribute a portion of their tips to a tip pool, which is distrib­ uted among many of the establishment’s other food and beverage 11  service workers and kitchen staff. Tip pools allow workers who nor­ mally do not receive tips, such as dining room attendants, to share in the rewards for a meal well served. In 1992, median weekly earnings (including tips) of full-time waiters and waitresses were about $220. The middle 50 percent earned between $180 and $300; the top 10 percent earned at least $380 a week. For most waiters and waitresses, higher earnings are primarily the result of receiving more in tips rather than higher hourly wages. Tips generally average between 10 and 20 percent of guests’ checks, so waiters and waitresses working in busy, expensive restaurants earn the most. Full-time bartenders had median weekly earnings (including tips) of about $250 in 1992. The middle 50 percent earned from $200 to $330; the top 10 percent earned at least $440 a week. Like waiters and waitresses, bartenders employed in public bars may receive more than half of their earnings as tips. Service bartenders are often paid higher hourly wages to offset their lower tip earnings. Median weekly earnings (including tips) of full-time dining room attendants and bartender helpers were about $210 in 1992. The mid­ dle 50 percent earned between $175 and $275; the top 10 percent earned over $350 a week. Most received over half of their earnings as wages; the rest was their share of the proceeds from tip pools. Full-time counter attendants and fast-food workers had median weekly earnings (including any tips) of about $220 in 1992. The middle 50 percent earned between $170 and $250, while the highest 10 percent earned over $320 a week. Although some counter attend­ ants receive part of their earnings as tips, fast-food workers gener­ ally do not. In establishments covered by Federal law, workers beginning at the minimum wage earn $4.25 an hour. Federal law also permits employers to credit an employee’s tip earnings toward the minimum hourly wage, up to an amount equaling 50 percent of the minimum, and some employers exercise this right. Employers are also permit­ ted to deduct from wages the cost, or fair value, of any meals or lodging provided. However, many employers provide free meals and furnish uniforms. Food and beverage service workers who work full time often receive paid vacation and sick leave and health insurance, but part-time workers generally do not receive such benefits. In some large restaurants and hotels, food and beverage service workers belong to unions. The principal unions are the Hotel Em­ ployees and Restaurant Employees International Union and the Service Employees International Union. Related Occupations Other workers whose jobs involve serving customers and helping them feel at ease and enjoy themselves include flight attendants, butlers, and tour busdrivers. Sources of Additional Information Information about job opportunities may be obtained from local employers and local offices of the State employment service. General information on food and beverage service jobs is availa­ ble from:  patients who have relatively short-term needs. These workers are sometimes called home care aides and personal care attendants. Homemaker-home health aides provide housekeeping services, personal care, and emotional support for their clients. They clean clients’ houses, do laundry, and change bed linens. Aides may also plan meals (including special diets), shop for food, and cook. Home health aides provide personal care services, also known as “hands on” care because they physically touch the patient. These aides may help clients move from bed, bathe, dress, and groom. They may also check pulse, temperature, and respiration; help with simple prescribed exercises; and assist with medication routines. Oc­ casionally, they may change nonsterile dressings, use special equip­ ment such as a hydraulic lift, give massages and alcohol rubs, or as­ sist with braces and artificial limbs. Some accompany clients outside the home, serving as guide, companion, and aide. Homemaker-home health aides also provide instruction and psy­ chological support. For example, they may assist in toilet training a severely mentally handicapped child or just listen to clients talk about their problems. Aides keep records of services performed and of the client’s condition and progress. In home care agencies, homemaker-home health aides are super­ vised by a registered nurse, a physical therapist, or a social worker, who assigns them specific duties. Aides report changes in the cli­ ent’s condition to the supervisor or case manager. Homemakerhome health aides also participate in case reviews, consulting with the team caring for the client—registered nurses, therapists, and other health professionals. Working Conditions The homemaker-home health aide’s daily routine may vary. Aides may go to the same home every day for months or even years. More commonly, however, aides work with a number of different clients, each job lasting a few hours, days, or weeks. Aides often go to four or five clients on the same day. Surroundings differ from case to case. Some homes are neat and pleasant, while others are untidy or depressing. Some clients are an­ gry, abusive, depressed, or otherwise difficult; others are pleasant and cooperative. Homemaker-home health aides generally work on their own with periodic visits by their supervisor. They have detailed instructions explaining when to visit clients and what services to perform. Many aides work part time, and weekend hours are common. Most aides generally travel by public transportation, but some need an automobile. In any event, they are responsible for getting to the client’s home. Aides may spend a good portion of the working day traveling from one client to another.  X3" The Educational Foundation of the National Restaurant Association, 250 South Wacker Dr., Suite 1400, Chicago, IL 60606.  For general information on hospitality careers, write to: O’ Council on Hotel, Restaurant, and Institutional Education, 1200 17th St. NW., Washington, DC 20036-3097.  Homemaker-Home Health Aides (D.O.T. 309.354-010 and 354.377-014)  Nature of the Work Homemaker-home health aides help elderly, disabled, and ill per­ sons live in their own homes instead of in a health facility. Most work with elderly or disabled clients who require more extensive care than spouse, family, or friends can provide. Some homemakerhome health aides work with families in which a parent is incapaci­ tated and small children need care. Others help discharged hospital 12 Federal Reserve Bank of St. Louis  Job prospects are excellent for people seeking work as homemakerhome health aides.  Employment Homemaker-home health aides held about 475,000 jobs in 1992. Most aides are employed by homemaker-home health agencies, home health agencies, visiting nurse associations, residential care fa­ cilities with home health departments, hospitals, public health and welfare departments, community volunteer agencies, and tempo­ rary help firms. Self-employed aides have no agency affiliation or su­ pervision, and accordingly accept clients, set fees, and arrange work schedules on their own. Training, Other Qualifications, and Advancement The Federal Goverment has enacted guidelines for home health aides whose employers receive reimbursement from Medicare. The Federal law requires home health aides to pass a competency test covering 12 areas: Communication skills; observation, reporting, and documentation of patient status and the care or services fur­ nished; reading and recording vital signs; basic infection control procedures; basic elements of body function and changes; mainte­ nance of a clean, safe, and healthy environment; recognition of and procedures for emergencies; the physical, emotional, and develop­ mental characteristics of the patients served; personal hygiene and grooming; safe transfer techniques; normal range of motion and positioning; and basic nutrition. A home aide may also take training before taking the competency test. The Federal law requires at least 75 hours of classroom and practical training supervised by a regis­ tered nurse. Training and testing programs may be offered by the employing agency, but they must meet the standards of the Health Care Financing Administration. Training programs may vary de­ pending upon State regulations. Thirteen States have specific laws on personal care services. The Foundation for Hospice and Home Care offers a National Homemaker-Home Health Aide certification. The certification is a voluntary demonstration that the individual has met industry stan­ dards. Successful homemaker-home health aides like to help people and do not mind hard work. They have a sense of responsibility, com­ passion, emotional stability, and a cheerful disposition. Aides should be tactful, honest, and discreet since they work in private homes. Homemaker-home health aides must be in good health. A physi­ cal examination including State regulated tests like those for tuber­ culosis may be required. Advancement is limited. In some agencies, workers start out per­ forming homemaker duties, such as cleaning. With experience and training, they may take on personal care duties. The most exper­ ienced aides may assist with medical equipment such as ventilators, which help patients breathe. Job Outlook A large number of job openings is expected for homemaker- home health aides, due to very rapid growth and very high turnover. Homemaker-home health aides is expected to be one of the fastest growing occupations through the year 2005—more than doubling in employment size. The number of people in their seventies and beyond is projected to rise substantially. This age group is characterized by mounting health problems that require some assistance. Also, there will be an increasing reliance on home care for patients of all ages. This trend reflects several developments: Efforts to contain costs by moving pa­ tients out of hospitals and nursing facilities as quickly as possible; the realization that treatment can be more effective in familiar sur­ roundings rather than clinical surroundings; and the development of portable medical equipment for in-home treatment. In addition to jobs created by the increase in demand for these workers, replacement needs are expected to produce numerous openings. Turnover is high, a reflection of the relatively low skill re­ quirements, low pay, and high emotional demands of the work. For these same reasons, many people are unwilling to do this kind of work. Therefore, persons who are interested in this work and suited for it should have excellent job opportunities, particularly those with experience or training as homemaker-home health aides or nursing aides. Federal Reserve Bank of St. Louis  Earnings Earnings for homemaker-home health aides vary considerably. Ac­ cording to the National Association for Home Care, home health aides’ average starting hourly wage in July 1992 was $6.31, and the average maximum hourly wage was $8.28. Wages were somewhat higher than these national averages in the Northeast and West and somewhat lower in the Midwest and South. Some aides were paid on a salary or per-visit basis. Most employers give slight pay increases with experience and added responsibility. Aides usually are paid only for the time worked in the home. They normally are not paid for travel time be­ tween jobs. Some employers offer a full package of vacation and sick leave, health and life insurance, and a retirement plan. Others hire only “on-call” hourly workers, with no benefits. Related Occupations Homemaker-home health aide is a service occupation that combines duties of health workers and social service workers. Workers in re­ lated occupations that involve personal contact to help or instruct others include attendants in children’s institutions, childcare at­ tendants in schools, child monitors, companions, nursing aides, nursery school attendants, occupational therapy aides, nursing aides, physical therapy aides, playroom attendants, and psychiatric aides. Sources of Additional Information General information about training and referrals to State and local agencies about opportunities for homemaker-home health aides, a list of relevant publications, and information on national certifica­ tion are available from: iw Foundation for Hospice and Homecare/National Certification Program, 519 C St. NE., Washington, DC 20002.  Human Services Workers (D.O.T. 195.367 except -026 and -030)  Native of the Work “Human services worker” is a generic term for people with various job titles, such as social service technician, case management aide, social work assistant, residential counselor, alcohol or drug abuse counselor, mental health technician, child abuse worker, commu­ nity outreach worker, and gerontology aide. They generally work under the direction of social workers or, in some cases, psycholo­ gists. The amount of responsibility and supervision they are given varies a great deal. Some are on their own most of the time and have little direct supervision; others work under close direction. Human services workers help clients obtain benefits or services. They assess the needs and establish the eligibility of clients for ser­ vices. They examine financial documents such as rent receipts and tax returns to determine whether the client is eligible for food stamps, Medicaid, or other welfare programs, for example. They also inform clients how to obtain services; arrange for transporta­ tion and escorts, if necessary; and provide emotional support. Human services workers monitor and keep case records on clients and report progress to supervisors. Human services workers may transport or accompany clients to group meal sites, adult daycare programs, or doctors’ offices; tele­ phone or visit clients’ homes to make sure services are being re­ ceived; or help resolve disagreements, such as those between tenants and landlords. Human services workers play a variety of roles in community set­ tings. They may organize and lead group activities, assist clients in need of counseling or crisis intervention, or administer a food bank or emergency fuel program. In halfway houses and group homes, they oversee adult residents who need some supervision or support on a daily basis, but who do not need to live in an institution. They review clients’ records, talk with their families, and confer with 13  medical personnel to gain better insight into their background and needs. Human services workers may teach residents to prepare their own meals and to do other housekeeping activities. They also pro­ vide emotional support and lead recreation activities. In mental hospitals and psychiatric clinics, they may help clients master everyday living skills and teach them how to communicate more effectively and get along better with others. They also assist with music, art, and dance therapy and with individual and group counseling and lead recreational activities. Working Conditions Working conditions of human services workers vary. Many spend part of their time in an office or group residential facility and the rest in the field—visiting clients or taking them on trips, or meeting with people who provide services to the clients. Most work a regular 40-hour week, although some work may be in the evening and on weekends. Human services workers in residential settings generally work in shifts because residents need supervision around the clock. The work, while satisfying, can be emotionally draining. Under­ staffing and lack of equipment may add to the pressure. Turnover is reported to be high, especially among workers without academic preparation for this field. Employment Human services workers held about 189,000 jobs in 1992. About one-fourth were employed by State and local governments, prima­ rily in public welfare agencies and facilities for the mentally re­ tarded and developmentally disabled. Another fourth worked in pri­ vate social services agencies offering a variety of services, including adult daycare, group meals, crisis intervention, and counseling. Still another fourth supervised residents of group homes and halfway houses. Human services workers also held jobs in clinics, commu­ nity mental health centers, and psychiatric hospitals. Training, Other Qualifications, and Advancement While some employers hire high school graduates, most prefer ap­ plicants with some college preparation in human services, social work, or one of the social or behavioral sciences. Some prefer to hire persons with a 4-year college degree. The level of formal education of human service workers often influences the kind of work they are assigned and the amount of responsibility entrusted to them. Work­ ers with no more than a high school education are likely to perform clerical duties, while those with a college degree might be assigned to do direct counseling, coordinate program activities, or manage a group home. Employers may also look for experience in other occu­ pations or leadership experience in school or in a youth group. Some enter the field on the basis of courses in social work, psychology, so­ ciology, rehabilitation, or special education. Most employers pro­ vide in-service training such as seminars and workshops.  Human services workers help clients obtain benefits and services. 14 Federal Reserve Bank of St. Louis  Because so many human services jobs involve direct contact with people who are vulnerable to exploitation or mistreatment, employ­ ers try to select applicants with appropriate personal qualifications. Relevant academic preparation is generally required, and volunteer or work experience is preferred. A strong desire to help others, pa­ tience, and understanding are highly valued characteristics. Other important personal traits include communication skills, a strong sense of responsibility, and the ability to manage time effectively. Hiring requirements in group homes tend to be more stringent than in other settings. In 1992, 375 certificate and associate degree programs in human services or mental health were offered at community and junior col­ leges, vocational-technical institutes, and other postsecondary insti­ tutions. In addition, 390 programs offered a bachelor’s degree in human services. A small number of programs leading to master’s degrees in human services administration were offered as well. Generally, academic programs in this field educate students for specialized roles—work with developmentally disabled adults, for example. Students are exposed early and often to the kinds of situa­ tions they may encounter on the job. Programs typically include courses in psychology, sociology, crisis intervention, social work, family dynamics, therapeutic interviewing, rehabilitation, and ger­ ontology. Through classroom simulation internships, students learn interview, observation, and recordkeeping skills; individual and group counseling techniques; and program planning. Formal education is almost always necessary for advancement. In group homes, completion of a 1-year certificate in human services along with several years of experience may suffice for promotion to supervisor. In general, however, advancement requires a bachelor’s or master’s degree in counseling, rehabilitation, social work, or a re­ lated field. Job Outlook Opportunities for human services workers are expected to be excel­ lent for qualified applicants. The number of human services workers is projected to more than double between 1992 and the year 2005— making it among the most rapidly growing occupations. Also, the need to replace workers who retire or stop working for other reasons will create additional job opportunities. However, these jobs are not attractive to everyone because the work is responsible and emotion­ ally draining and most offer relatively poor pay, so qualified appli­ cants should have little difficulty finding employment. Opportunities are expected to be best in job training programs, residential settings, and private social service agencies, which in­ clude such services as adult daycare and meal delivery programs. Demand for these services will expand with the growing number of older people, who are more likely to need services. In addition, human services workers will continue to be needed to provide ser­ vices to the mentally impaired and developmentally disabled, those with substance abuse problems, and a wide variety of others. Faced with rapid growth in the demand for services, but slower growth in resources to provide the services, employers are expected to rely in­ creasingly on human services workers rather than other occupations that command higher pay. Job training programs are expected to require additional human services workers as the economy grows and businesses change their mode of production and workers need to be retrained. Human ser­ vices workers help determine workers’ eligibility for public assis­ tance programs and help them obtain services while unemployed. Residential settings should expand also as pressures to respond to the needs of the chronically mentally ill persist. For many years, chronic mental patients have been deinstitutionalized and left to their own devices. Now, more community-based programs and group residences are expected to be established to house and assist the homeless and chronically mentally ill, and demand for human services workers will increase accordingly. Although overall employment in State and local governments will grow only as fast as the average for all industries, jobs for human services workers will grow more rapidly. State and local govern­ ments employ most of their human services workers in correctional and public assistance departments. Correctional departments are growing faster than other areas of government, so human services workers should find their job opportunities increase along with  other corrections jobs. Public assistance programs have been rela­ tively stable within governments’ budgets, but they have been em­ ploying more human services workers in an attempt to employ fewer social workers, who are more educated and higher paid. Earnings According to limited data available, starting salaries for human ser­ vices workers ranged from about $12,000 to $20,000 a year in 1992. Experienced workers generally earned between $ 15,000 and $25,000 annually, depending on their education, experience, and employer. Related Occupations Workers in other occupations that require skills similar to those of human services workers include social workers, community out­ reach workers, religious workers, occupational therapy assistants, physical therapy assistants and aides, psychiatric aides, and activity leaders. Sources of Additional Information Information on academic programs in human services may be found in most directories of 2- and 4-year colleges, available at libraries or career counseling centers. For information on programs and careers in human services, con­ tact:  tw National Organization for Human Service Education, Brookdale Com­ munity College, Lyncroft, NJ 07738. W Council for Standards in Human Service Education, Montgomery Com­ munity College, 340 Dekalb Pike, Blue Bell, PA 19422.  Information on job openings may be available from State employ­ ment service offices or directly from city, county, or State depart­ ments of health, mental health and mental retardation, and human resources.  Janitors and Cleaners and Cleaning Supervisors (D.O.T. 321.137-010, -014; 323.137-010, .687; 350.137-026; 358.687-010; 381.137-010, .687 except -010; 382.664-010; 389.667-010, .683-010; 739.687-198; 891.687-010 and -018; and 952.687-010)  Nature of the Work Janitors and cleaners—also called building custodians—keep office buildings, hospitals, stores, apartment houses, hotels, and other types of buildings clean and in good condition. Some only do clean­ ing; others have a wide range of duties. They may fix leaky faucets, empty trash cans, do painting and carpentry, replenish bathroom supplies, mow lawns, and see that heating and air-conditioning equipment works properly. On a typical day, janitors may wet- or dry-mop floors, vacuum carpets, dust furniture, make minor re­ pairs, and exterminate insects and rodents. In hospitals, where they are mostly known as maids and housekeepers, they may also wash bed frames, brush mattresses, make beds, and disinfect and sterilize equipment and supplies using germicides and sterilizing equipment. In hotels, aside from cleaning and maintaining the premises, they may deliver ironing boards, cribs, and rollaway beds to guests’ rooms. Janitors and cleaners use different equipment, tools, and cleaning materials. For one job, they may need a mop and bucket; for an­ other, an electric polishing machine and a special cleaning solution. Improved building materials, chemical cleaners, and power equip­ ment have made many tasks easier and less time consuming, but janitors must know how to use equipment and cleaners properly to avoid harming floors, fixtures, and themselves. Cleaning supervisors coordinate, schedule, and supervise the ac­ tivities ofjanitors and cleaners. They assign tasks and inspect build­ ing areas to see that work has been done properly. Federal Reserve Bank of St. Louis  They issue supplies and equipment and inventory stocks to ensure adequate supplies. They screen and hire job applicants, and recom­ mend promotions, transfers or dismissals; they also train new and experienced employees. Supervisors may prepare reports concern­ ing room occupancy, hours worked, and department expenses. Some also perform cleaning duties.  Working Conditions Because most office buildings are cleaned while they are empty, many cleaners work evening hours. Some, however, such as school and hospital custodians, work in the daytime. When there is a need for 24-hour maintenance, janitors may be assigned to shifts. Most full-time janitors and cleaners and supervisors worked about 40 hours a week. Part-time cleaners usually work in the evenings and on weekends. Janitors and cleaners usually work inside heated, well-lighted buildings. However, sometimes they work outdoors sweeping walk­ ways, mowing lawns, or shoveling snow. Working with machines can be noisy, and some tasks, such as cleaning bathrooms and trash rooms, can be dirty and unpleasant. Janitors may suffer minor cuts, bruises, and bums from machines, handtools, and chemicals. Janitors and cleaners spend most of their time on their feet, some­ times lifting or pushing heavy furniture or equipment. Many tasks, such as dusting or sweeping, require constant bending, stooping, and stretching.  Employment Janitors and cleaners and cleaning supervisors, held 3,018,000 jobs in 1992. One-third worked part time (less than 35 hours a week). Janitors and cleaners held about 19 jobs out of 20. They worked in every type of establishment. About 1 in 5 worked in a school, includ­ ing colleges and universities. One in five worked for a firm supplying building maintenance services on a contract basis. One in eight worked in a hotel. Others were employed by hospitals, restaurants, operators of apartment buildings, office buildings, and other types of real estate, churches and other religious organizations, manufac­ turing firms, and government agencies. Supervisors held about 1 job in 20. About a third were in hotels, and about one-fifth in hospitals. Others were employed by firms supplying building maintenance services on a contract basis, nurs­ ing care facilities, and educational facilities. Although cleaning jobs can be found in all cities and towns, most are located in highly populated areas where there are many office buildings, stores, and apartment houses.  New technology is expected to have little effect on employment of janitors and cleaners. 15  Training, Other Qualifications, and Advancement No special education is required for most cleaning jobs, but begin­ ners should know simple arithmetic and be able to follow instruc­ tions. High school shop courses are helpful for jobs that involve re­ pair work. Most janitors and cleaners learn their skills on the job. Usually, beginners work with an experienced cleaner, doing routine cleaning. They are given more complicated work as they gain experience. In some cities, programs run by unions, government agencies, or employers teach janitorial skills. Students learn how to clean build­ ings thoroughly and efficiently, how to select and safely use various cleansing agents, and how to operate and maintain machines, such as wet and dry vacuums, buffers, and polishers. Students learn to plan their work, to follow safety and health regulations, to deal with people in the buildings they clean, and to work without supervision. Instruction in minor electrical, plumbing, and other repairs may also be given. Those who come in contact with the public should have a pleasant personality and good communication skills. Em­ ployers usually look for dependable, hard-working individuals who are in good health, follow directions well, and get along with other people. Janitors and cleaners usually find work by answering newspaper advertisements, applying directly to organizations where they would like to work, or contacting State employment service offices. Advancement opportunities for janitorial workers usually are limited in organizations where they are the only maintenance worker. Where there is a large maintenance staff, however, janitors can be promoted to supervisor and to area supervisor or manager. A high school diploma improves the chances for advancement. Some janitors set up their own maintenance business. Supervisors usually move up through the ranks. In many estab­ lishments, supervisors are required to take some in- service training to perfect housekeeping techniques and procedures, and to enhance supervisory skills. Job Outlook Employment ofjanitors and cleaners and cleaning supervisors is ex­ pected to grow about as fast as the average for all occupations through the year 2005 as the number of office buildings, apartment houses, schools, factories, hospitals, and other buildings increases. The need to replace workers who transfer to other occupations or leave the labor force will create most job openings. The occupation of janitors and cleaners is easy to enter since there are few require­ ments for formal education and training, turnover is high, and part­ time and temporary jobs are plentiful. New technology is expected to have little effect on employment of janitors and cleaners. Robots now under development are limited to performing a single cleaning task and may not be usable in many places, particularly cluttered areas such as hotel and hospital rooms. Earnings Janitors and cleaners who usually worked full time averaged about $277 a week in 1992; the middle 50 percent earned between $212 and $374. Ten percent earned less than $176; 10 percent earned more than $477. Cleaning supervisors who usually worked full time averaged about $347 a week in 1992; the middle 50 percent earned between $285 and $497. Ten percent earned less than $228; 10 percent earned more than $690. According to a survey of workplaces in 160 metropolitan areas, janitors had median earnings of $260 for a 40-hour week week in 1992. The middle half earned between $214 and $305 a week. Most building service workers receive paid holidays and vaca­ tions and health insurance. Related Occupations Private household workers have job duties similar to janitors and cleaners. Workers who specialize in one of the many job functions of janitors and cleaners include refuse collectors, floor waxers, street sweepers, window cleaners, gardeners, boiler tenders, pest control­ lers, and general maintenance repairers. 16 Federal Reserve Bank of St. Louis  Sources of Additional Information Information about janitorial jobs may be obtained from a local State employment service office. For information about education and training or starting a janitorial company, contact: ©* Building Service Contractors Association International, 10201 Lee Hwy., Suite 225, Fairfax, VA 22030.  Medical Assistants (D.O.T. 078.361-038 and .364-014; 079.362-010, .364-010, and -014, and .374-018; 355.667-010)  Nature of the Work Medical assistants perform routine clinical and clerical tasks to keep offices of physicians, podiatrists, chiropractors, and optome­ trists running smoothly. Medical assistants should not be confused with physician assistants, who examine, diagnose, and treat pa­ tients, under the direct supervision of a physician. Physician assist­ ants are discussed elsewhere in the Handbook. The duties of medical assistants vary from office to office, de­ pending on office location, size, and specialty. In small practices, medical assistants are usually “generalists,” handling both clerical and clinical duties and reporting directly to an office manager, phy­ sician, or other health practitioner. Those in large practices tend to specialize in a particular area under the supervision of department administrators. Medical assistants perform many clerical duties. They answer telephones, greet patients, update and file patient medical records, fill out insurance forms, handle correspondence, schedule appoint­ ments, arrange for hospital admission and laboratory services, and handle billing and bookkeeping. Clinical duties vary according to State law and include taking medical histories and recording vital signs; explaining treatment procedures to patients; preparing patients for examination; and as­ sisting during the examination. Medical assistants collect and pre­ pare laboratory specimens or perform basic laboratory tests on the premises; dispose of contaminated supplies; and sterilize medical in­ struments. They instruct patients about medication and special di­ ets, prepare and administer medications as directed by a physician, authorize drug refills as directed, telephone prescriptions to a phar­ macy, draw blood, prepare patients for x rays, take electrocardio­ grams, remove sutures, and change dressings. Medical assistants may also arrange examining room instruments and equipment, purchase and maintain supplies and equipment, and keep waiting and examining rooms neat and clean. Assistants who specialize have additional duties. Podiatric medi­ cal assistants make castings of feet, expose and develop x rays, and assist podiatrists in surgery. Ophthalmic medical assistants help ophthalmologists provide medical eye care. They use precision in­ struments to administer diagnostic tests, measure and record vision, and test the functioning of eyes and eye muscles. They also show pa­ tients how to use eye dressings, protective shields, and safety glasses, and insert, remove, and care for contact lenses. Under the direction of the physician, they may administer medications, including eye drops. They also maintain optical and surgical instruments and as­ sist the ophthalmologist in surgery. Working Conditions Medical assistants work in a well-lighted, clean environment. They constantly interact with other people, and may have to handle sev­ eral responsibilites at once. Most full-time medical assistants work a regular 40-hour week. Some work evenings and weekends. Employment Medical assistants held about 181,000 jobs in 1992. Over 70 percent were employed in physicians’ offices, and about 12 percent worked  three levels: Certified Ophthalmic Assistant, Certified Ophthalmic Technician, and Certified Ophthalmic Medical Technologist. Because medical assistants deal with the public, they need a neat, well-groomed appearance and a courteous, pleasant manner. Medi­ cal assistants must be able to put patients at ease and explain physi­ cians’ instructions. They must respect the confidential nature of medical information. Clinical duties require a reasonable level of manual dexterity and visual acuity. Medical assistants may be able to advance to office manager or become ward clerks, medical record clerks, phlebotomists, or EKG technicians in hospitals. Medical assistants may qualify for a wide variety of administrative support occupations, or may teach medical assisting. Some, with additional schooling, enter other health occu­ pations such as nursing and medical technology.  Medical assisting is one of the few health occupations open to individuals with no formal training. in offices of other health practitioners such as chiropractors, optom­ etrists, and podiatrists. Others worked in hospitals, nursing homes, and other health care facilities. Training, Other Qualifications, and Advancement Medical assisting is one of the few health occupations open to indi­ viduals with no formal training. Although formal training in medi­ cal assisting is available, such training—while generally preferred— is not always required. Some medical assistants are trained on the job. Applicants usually need a high school diploma or the equivalent. High school courses in mathematics, health, biology, typing, bookkeeping, computers, and office skills are helpful. Vol­ unteer experience in the health care field may also be helpful. Formal programs in medical assisting are offered in vocationaltechnical high schools, postsecondary vocational schools, commu­ nity and junior colleges, and in colleges and universities. Collegelevel programs usually last either 1 year, resulting in a certificate or diploma, or 2 years, resulting in an associate degree. Vocational pro­ grams can take up to 1 year and lead to a diploma or certificate. Courses cover anatomy, physiology, and medical terminology as well as typing, transcription, recordkeeping, accounting, and insur­ ance processing. Students learn laboratory techniques, clinical and diagnostic procedures, pharmaceutical principles and medication administration, and first aid. They are also instructed in office prac­ tices, patient relations, and medical law and ethics. Accredited pro­ grams may include an externship that provides practical experience in physicians’ offices, hospitals, or other health care facilities. Two agencies recognized by the U.S. Department of Education accredit programs in medical assisting: The American Medical As­ sociation’s Committee on Allied Health Education and Accredita­ tion (CAHEA) and the Accrediting Bureau of Health Education Schools (ABHES). In 1993, there were 207 medical assisting pro­ grams accredited by CAHEA and 136 accredited by ABHES. The Joint Review Committee for Opthalmic Medical Personnel has ap­ proved 13 programs in ophthalmic medical assisting. Although there is no licensing for medical assistants, some States require them to take a test or a short course before they can take x rays, draw blood, or give injections. Employers prefer to hire exper­ ienced workers or certified applicants who have passed a national examination, indicating that the medical assistant meets certain standards of competence. The American Association of Medical Assistants awards the Certified Medical Assistant credential; the American Medical Technologists awards the Registered Medical Assistant credential; the American Society of Podiatric Medical As­ sistants awards the Podiatric Medical Assistant Certified credential; and the Joint Commission on Allied Health Personnel in Ophthal­ mology awards the Ophthalmic Medical Assistant credential at Federal Reserve Bank of St. Louis  Job Outlook Employment of medical assistants is expected to grow much faster than the average for all occupations through the year 2005 as the health services industry expands. Employment growth will be driven by growth in the number of group and other health care practices that use support personnel. Medical assistants primarily work in outpatient settings, where fast growth is expected. Most job openings, however, will result from the need to replace experienced assistants who leave the occupation. In view of the high turnover as well as the preference of many physicians for trained personnel, job prospects should be excellent for medical assistants with formal training or experience, particu­ larly those with certification. Earnings The earnings of medical assistants vary widely, depending on expe­ rience, skill level, and location. According to a survey conducted by the Committee on Allied Health Education and Accreditation, the average starting salary for graduates of the medical assistant pro­ grams they accredit was about $15,059 a year in 1992. According to a 1991 survey by the American Association of Med­ ical Assistants, the average annual salary for medical assistants was $18,334. Medical assistants with 2 years of experience or less aver­ aged $13,715, while those with 11 years of experience or more aver­ aged $20,885. Related Occupations Workers in other medical support occupations include medical sec­ retaries, hospital admitting clerks, pharmacy helpers, medical re­ cord clerks, dental assistants, occupational therapy aides, and physi­ cal therapy aides. Sources of Additional Information Information about career opportunities, CAHEA-accredited educa­ tional programs in medical assisting, and the Certified Medical As­ sistant exam is available from: ry The American Association of Medical Assistants, 20 North Wacker Dr., Suite 1575, Chicago, IL 60606-2903.  Information about career opportunities and the Registered Medi­ cal Assistant certification exam is available from: 13“ Registered Medical Assistants of American Medical Technologists, 710 Higgins Rd., Park Ridge, IL 60068-5765.  For a list of ABHES-accredited educational programs in medical assisting, write: O’ Accrediting Bureau of Health Education Schools, Oak Manor Office,  29089 U.S. 20 West, Elkhart, IN 46514.  Information about career opportunities, training programs, and the Certified Ophthalmic Assistant exam is available from: O’ Joint Commission on Allied Health Personnel in Ophthalmology, 2025  Woodlane Dr., St. Paul, MN 55125-2995.  Information about careers for podiatric assistants is available from: O’ American Society of Podiatric Medical Assistants, 2124 S. Austin Blvd.,  Cicero, IL 60650.  17  Nursing Aides and Psychiatric Aides (D.O.T. 354.374-010, .377-010, and .677-010; 355.377-014 and -018, .674-014 and -018, and .677-014)  Nature of the Work Nursing aides and psychiatric aides help care for physically or men­ tally ill, injured, disabled, or infirm individuals confined to hospi­ tals, nursing or residential care facilities, and mental health settings. (Homemaker-home health aides, whose duties are similar but who work in clients’ homes, are discussed elsewhere in the Handbook.) Nursing aides, also known as nursing assistants or hospital at­ tendants, work under the supervision of nursing and medical staff. They answer patients’ call bells, deliver messages, serve meals, make beds, and feed, dress, and bathe patients. Aides may also give massages, provide skin care to patients who cannot move, take tem­ peratures, pulse, respiration, and blood pressure, and help patients get in and out of bed and walk. They may also escort patients to op­ erating and examining rooms, keep patients’ rooms neat, set up equipment, or store and move supplies. Aides observe patients’ physical, mental, and emotional conditions and report any change to the nursing or medical staff. Nursing aides employed in nursing homes are sometimes called geriatric aides. They are often the principal caregivers, having far more contact with residents than other members of the staff do. Since residents may stay in a nursing home for months or even years, aides are expected to develop ongoing relationships with them and respond to them in a positive, caring way. Psychiatric aides are also known as mental health assistants, psy­ chiatric nursing assistants, or ward attendants. They care for men­ tally impaired or emotionally disturbed individuals. They work under a team that may include psychiatrists, psychologists, psychi­ atric nurses, social workers, and therapists. In addition to helping patients dress, bathe, groom, and eat, psychiatric aides socialize with them and lead them in educational and recreational activities. Psychiatric aides may play games such as cards with the patients, watch television with them, or participate in group activities such as sports or field trips. They observe patients and report any signs which might be important for the professional staff to know. If nec­ essary, they help restrain unruly patients and accompany patients to and from wards for examination and treatment. Because they have the closest contact with patients, psychiatric aides have a great deal of influence on patients’ outlook and treatment. Working Conditions Most full-time aides work about 40 hours a week, but because pa­ tients need care 24 hours a day, some aides work evenings, nights, weekends, and holidays. Many work part time. Aides spend many  One-halfof nursing aides work in nursing homes. 18 Federal Reserve Bank of St. Louis  hours standing. Since they may have to move partially paralyzed pa­ tients in and out of bed or help them stand or walk, aides must guard against back injury. Nursing aides often have unpleasant duties; they empty bed pans, change soiled bed linens, and care for disoriented and irritable pa­ tients. Psychiatric aides are often confronted with violent patients. While their work can be emotionally draining, many aides gain sat­ isfaction from assisting those in need. Employment Nursing aides held about 1,308,000 jobs in 1992, and psychiatric aides held about 81,000 jobs. About one-half of all nursing aides worked in nursing homes, and about one-fourth worked in hospi­ tals. Some worked in residential care facilities, such as halfway houses and homes for the aged or disabled, or in private households. Most psychiatric aides worked in State and county mental institu­ tions, psychiatric units of general hospitals, private psychiatric facil­ ities and community mental health centers. Training, Other Qualifications, and Advancement In many cases, neither a high school diploma nor previous work ex­ perience is necessary for a job as a nursing or psychiatric aide. A few employers, however, require some training or experience. Hospitals may require experience as a nursing aide or home health aide. Nurs­ ing homes often hire inexperienced workers who must complete a minimum of 75 hours of mandatory training and pass a competency evaluation program within 4 months of employment. Aides who complete the program are placed on the State registry of nursing aides. Some States require psychiatric aides to complete a formal training program. These occupations can offer individuals an entry into the world of work. The flexibility of night and weekend hours also provides high school and college students a chance to work during the school year. The work is also open to middle-aged and older men and women. Nursing aide training is offered in high schools, vocational-tech­ nical centers, many nursing homes, and community colleges. Courses cover body mechanics, nutrition, anatomy and physiology, infection control, and communication skills. Personal care skills such as the bathing, feeding, and grooming of patients are also taught. Some facilities, other than nursing homes, provide classroom in­ struction for newly hired aides, while others rely exclusively on in­ formal on-the-job instruction from a licensed nurse or an exper­ ienced aide. Such training may last several days to a few months. From time to time, aides may also attend lectures, workshops, and in-service training. Applicants should be healthy, tactful, patient, understanding, emotionally stable, dependable, and have a desire to help people. They should also be able to work as part of a team, and be willing to perform repetitive, routine tasks. Opportunities for advancement within these occupations are lim­ ited. To enter other health occupations, aides generally need addi­ tional formal training. Some employers and unions provide oppor­ tunities by simplifying the educational paths to advancement. Experience as an aide can also help individuals decide whether to pursue a career in the health care field. Job Outlook Job prospects for nursing aides should be very good through the year 2005. Employment of nursing aides is expected to grow much faster than the average for all occupations in response to an empha­ sis on rehabilitation and the long-term care needs of a rapidly grow­ ing population of those 75 years old and older. Employment will in­ crease as a result of the expansion of nursing homes and other long­ term care facilities for people with chronic illnesses and disabling conditions, many of whom are elderly. Also increasing employment of nursing aides will be modem medical technology which, while saving more lives, increases the need for the extended care provided by aides. As a result, nursing and personal care facilities are ex­ pected to grow very rapidly and to provide most of the new jobs for nursing aides. Employment also is expected to grow very rapidly in residential care facilities.  Employment of psychiatric aides is expected to grow faster than the average for all occupations. Employment will rise in response to the sharp increase in the number of older persons—many of whom will require mental health services. Employment of aides in private psychiatric facilities and community mental health centers is likely to grow because of increasing public acceptance of formal treatment for drug abuse and alcoholism, and a lessening of the stigma at­ tached to those receiving mental health care. While employment in private psychiatric facilities may grow, employment in public mental hospitals is likely to be stagnant due to constraints on public spending. Replacement needs will constitute the major source of openings for aides. Turnover is high, a reflection of modest entry require­ ments, low pay, and lack of advancement opportunities. Earnings Median annual earnings of nursing and psychiatric aides who worked full time in 1992 were about $13,800. The middle 50 percent earned between $11,000 and $17,900. The lowest 10 percent earned less than $9,500; the top 10 percent, more than $23,900. According to a University of Texas Medical Branch survey of hospitals and medical centers, the median annual salary of nursing aides, based on a 40 hour week and excluding shift or area differen­ tials, was $15,121 in October 1992. According to the Buck Survey conducted by the American Health Care Association, nursing aides in chain nursing homes had median annual earnings of approximately $11,600 in January, 1993. The middle 50 percent earned between $10,400 and $13,200 a year. Aides in hospitals generally receive at least 1 week’s paid vacation after 1 year of service. Paid holidays and sick leave, hospital and medical benefits, extra pay for late-shift work, and pension plans also are available to many hospital and some nursing home employ­ ees. Related Occupations Nursing aides and psychiatric aides help people who need routine care or treatment. So do homemaker-home health aides, childcare attendants, companions, occupational therapy aides, and physical therapy aides. Sources of Additional Information For information on nursing careers in long-term care, write: American Health Care Association, 1201 L St. NW., Washington, DC 20005.  Information about employment also may be obtained from local hospitals, nursing homes, psychiatric facilities, and State boards of nursing.  they must also keep records of each child’s progress and discuss the children’s progress and needs with the parents. Depending on their experience and educational background, some preschool workers—often called preschool teachers—are re­ sponsible only for children’s educational activities. Other workers— sometimes called child-care workers—provide only basic care to children. However, even by providing basic care, workers teach the children; the children learn trust and gain a sense of security. Most preschool workers perform a combination of basic care and teaching duties. For example, a worker who shows a child how to tie a shoe teaches the child and also provides for that child’s basic care needs. Young children cannot be taught in the same manner as older stu­ dents because they are less physically, emotionally, and mentally de­ veloped. Children at this age learn mainly through play. What re­ sults is a less structured approach to teaching preschool children, including small group lessons, one-on-one instruction, and learning through creative activities, such as art, dance, and music. Preschool workers greet children as they arrive, help them re­ move outer garments, and teach them how to dress and undress. When caring for infants, they feed and change them. In order to en­ sure a well-balanced program, preschool workers prepare daily and long-term schedules of activities. Each day’s activities must balance individual and group play with quiet and active time. Recognizing the importance of play, preschool workers build their program around it. They capitalize on children’s play to further language de­ velopment (storytelling and acting games), improve social skills (working together to build a neighborhood in a sandbox), and intro­ duce scientific and mathematical concepts (balancing and counting blocks when building a bridge or mixing colors when painting). (A statement on teacher aides—who assist classroom teachers—ap­ pears elsewhere in the Handbook.) Helping to keep children healthy is an important part of the job. Preschool workers serve nutritious meals and snacks and teach good eating habits and personal hygiene. They see to it that children have proper rest periods. They spot children who may not feel well or show signs of emotional or developmental problems and discuss these matters with their supervisor and the child’s parents. Early identification of children with special needs, such as those with behavioral, emotional, physical, or learning disabilities, is im­ portant to improve their future learning ability. Special education teachers often work with these preschool children to provide the in­ dividual attention they need. (Special education teachers are cov­ ered in the statement on kindergarten, elementary, and secondary school teachers found elsewhere in the Handbook.) Working Conditions Preschool care facilities may be in private homes, schools, religious institutions, workplaces where employers provide care for employ­ ees’ children, or private buildings. Individuals who provide care in their own homes are generally called family daycare providers.  Preschool Workers (D.O.T. 092.227-018; 355.674-010; 359.677-010, -018, -026)  Nature of the Work Nurturing and teaching preschool children, those who are 5 years old or younger, is the job of preschool workers. Found in daycare centers, nursery schools, preschools, and family daycare homes, preschool workers play an important role in shaping the kind of ad­ olescent a child will become by caring for the child when the parents are at work or away for other reasons. Some parents enroll their child in a nursery school primarily to provide him or her with the opportunity to interact with other children. In addition to attending to children’s basic needs, these workers organize activities that stim­ ulate the children’s physical, emotional, intellectual, and social growth. They help children explore their interests, develop their tal­ ents and independence, build self-esteem, and learn how to behave with others. Preschool workers must work in two different worlds—the child’s and the parent’s. At the same time that they create a safe, comfortable environment in which children can grow and learn, Federal Reserve Bank of St. Louis  Preschool workers help children gain independence, explore their interests, and gain independence. 19  (Child-care workers who work in the child’s home are covered in the statement on private household workers found elsewhere in the Handbook.) Watching children grow, enjoy learning, and gain new skills can be very rewarding. The work, however, can be physically and emo­ tionally taxing, as workers constantly stand, walk, bend, stoop, and lift to attend to each child’s interests and problems. Preschool work­ ers must be enthusiastic and constantly alert, anticipate and prevent problems, deal with disruptive children, and provide fair but firm discipline. They must be able to communicate effectively with the children and parents. To ensure that children receive proper supervision, State regula­ tions require certain ratios of workers to children. The ratio varies with the age of the children. Child development experts generally recommend that a single caregiver be responsible for no more than 3 or 4 infants (less than 1 year old), 5 or 6 toddlers (1 to 2 years old), or 10 preschool-age children (between 2 and 5 years old). The working hours of preschool workers vary widely. Daycare centers are generally open year round with long hours so that par­ ents can drop off and pick up their children before and after work. Daycare centers employ full-time and part-time staff with staggered shifts in order to cover the entire day. Public and many private pre­ school programs operate during the typical 9- or 10-month school year, employing both full-time and part-time workers. Family day­ care providers have flexibile hours and daily routines, but may work long or unusual hours to fit parents’ work schedules. Employment Preschool workers held about 941,000 jobs in 1992. Many worked part time. About half of all preschool workers are self-employed, most of whom are family daycare providers. About half of all salaried preschool workers are found in child daycare centers and preschools, and nearly 1 in 4 works for a relig­ ious institution. The rest work in other service organizations and in government. Some employers run for-profit operations; many are affiliated with a local or national chain. Other employers, such as re­ ligious institutions, community agencies, school systems, and State and local governments, are nonprofit. A growing number of busi­ ness firms operate daycare centers for the children of their employ­ ees. Training, Other Qualifications, and Advancement The training and qualifications required of preschool workers vary widely. Many States have licensing requirements that regulate caregiver training, which generally range from a high school di­ ploma to college courses or a college degree in child development or early childhood education. Some States require continuing educa­ tion for workers in this field. For instance, Virginia requires that all workers in daycare centers receive 8 hours of courses related to child care each year. Formal education requirements in some pri­ vate preschools and daycare centers exceed State requirements. Many States require a Child Development Associate (CDA) cre­ dential, which is offered by the Council for Early Childhood Profes­ sional Recognition. The CDA credential is recognized as a qualifi­ cation for teachers and directors in 49 States and the District of Columbia. There are two ways to become a CDA—through direct assessment or by completing a 1-year training program. Direct as­ sessment is appropriate for people who already have some back­ ground and experience in early childhood education, while the training program is designed for people with little or no child devel­ opment education or experience. In order to receive the credential, the applicant must demonstrate the knowledge and skills that meet certain nationally recognized standards for working with young children, whether acquired through formal training or experience, to a team of child-care professionals from the Council for Early Childhood Professional Recognition. Some employers may not require a CDA credential, but may re­ quire secondary or postsecondary courses in child development and early childhood education, and possibly work experience in a child­ care setting. Other schools require their own specialized training. For example, Montessori preschool teachers must complete an ad­ ditional year of training after receiving their bachelor’s degree in 20 Federal Reserve Bank of St. Louis  early childhood education or a related field. Public schools typically require a bachelor’s degree and State teacher certification. Teacher training programs include a variety of liberal arts courses, student teaching, and prescribed professional courses, including instruction in teaching gifted, disadvantaged, and other children with special needs. Preschool workers should be mature, patient, understanding, and articulate, and have energy and physical stamina. Skills in music, art, drama, and storytelling are also important. Those who work for themselves must have business sense and management abilities. As preschool workers gain experience, they may advance to su­ pervisory or administrative positions in large child- care centers or preschools. Often, however, these positions require additional train­ ing, such as a bachelor’s degree. With a bachelor’s degree, preschool workers may become certified to teach in public schools at the kin­ dergarten, elementary, and secondary school levels. Some workers set up their own child-care businesses. Job Outlook Employment of preschool workers is projected to increase much faster than the average for all occupations through the year 2005. Job openings should be plentiful as many preschool workers leave the occupation each year for other—often better paying—jobs, fam­ ily responsibilities, or other reasons. The relatively high turnover, combined with an increased demand for preschool workers, is ex­ pected to create many openings. Qualified persons who are inter­ ested in this work should have little trouble finding and keeping a job. Despite a slight decline in the number of children age 5 and under, the proportion of youngsters in daycare and preschool is ex­ pected to increase, reflecting a shift in the type of child-care arrange­ ments parents choose. Many parents turn to formal child-care ar­ rangements for a variety of reasons—they may need two incomes; they may find it too difficult to set up a satisfactory arrangement with a relative, babysitter, or live-in worker; or they may prefer the formal arrangements for personal reasons, such as a more struc­ tured learning and social environment. Rising labor force participation among women age 20-44, though increasing more slowly than during the 1980’s, will also contribute to the growth of employment among preschool workers. Currently, mothers of very young children are almost as likely to work as other women, and this pattern is not expected to change. Moreover, wo­ men are returning to work sooner after childbirth. Earnings Pay depends on the employer and educational attainment of the worker. Although the pay is generally low, more education means higher earnings in some cases. In 1992, median weekly earnings of full-time, salaried child-care workers were $260; for early childhood teacher assistants, $220. The middle 50 percent of child-care workers earned between $210 and $320; assistants, between $190 and $300. The top 10 percent of child-care workers earned at least $460; assistants, at least $420. The bottom 10 percent of child-care workers earned less than $140; teacher assistants, less than $150. The small number of preschool workers in public schools who have State teacher certification generally have salaries and benefits comparable to kindergarten and elementary school teachers. Ac­ cording to the National Education Association, kindergarten and elementary school teachers earned an average salary of $34,800 in 1992. (A statement on kindergarten, elementary, and secondary school teachers is found elsewhere in the Handbook.) Earnings of self-employed child-care workers vary depending on the hours worked, number and ages of the children, and the loca­ tion. Benefits for preschool workers also vary. Many employers offer free or discounted child care to employees. Some offer a full benefits package, including health insurance and paid vacations, but others offer no benefits at all. Some employers offer seminars and work­ shops to help workers improve upon or learn new skills. A few are willing to cover the cost of courses taken at community colleges or technical schools.  Related Occupations Child-care work requires patience; creativity; an ability to nurture, motivate, teach, and influence children; and leadership, organiza­ tional, and administrative abilities. Others who work with children and need these aptitudes include teacher aides, children’s tutors, kindergarten and elementary school teachers, early childhood pro­ gram directors, and child psychologists. Sources of Additional Information For information on careers in educating children and issues affect­ ing preschool workers, contact: ty National Association for the Education of Young Children, 1509 16th St. NW„ Washington, DC 20036. ^Association for Childhood Education International, 11141 Georgia Ave., Suite 200, Wheaton, MD 20902.  For information on the Federally sponsored Head Start program, contact:  Head Start Bureau, Chief, Education Service Branch, P.O. Box 1182, Washington, DC 20013.  For eligibility requirements and a description of the Child Devel­ opment Associate credential, write to: W Council for Early Childhood Professional Recognition, 1341 G St. NW., Suite 400, Washington, DC 20005.  For information on salaries and efforts to improve compensation in child care, contact:  " Child Care Employee Project, 6536 Telegraph Ave., A201, Oakland, CA 94618. 13  State Departments of Human Services or Social Services can sup­ ply State regulations and training requirements for child-care work­ ers.  Private Household Workers (D.O.T. 301 except 687-018; 302; 305; 309 except .354-010, .367-010, .677-010 and-014)  Nature of the Work Private household workers clean homes, care for children, plan and cook meals, do laundry, administer the household, and perform nu­ merous other duties. Private household workers are employed by many types of households of various income levels. Although wealthy families may employ a large staff, it is much more common for one worker to be employed in a household where both parents work. Many workers are employed in households having one par­ ent. A number of household workers work for two or more employ­ ers. Most household workers are general house-workers and usually the only worker employed in the home. They dust and polish furni­ ture; sweep, mop, and wax floors; vacuum; and clean ovens, refrig­ erators, and bathrooms. They also wash dishes, polish silver, and change and make beds. Some wash, fold, and iron clothes. A few wash windows. Other duties may include looking after a child or an elderly person, cooking, feeding pets, answering the telephone and doorbell, and calling and waiting for repair workers. General houseworkers may also take clothes and laundry to the cleaners, buy groceries, and do other errands. Household workers whose primary responsibility is taking care of children are called child-care workers. Those employed on an hourly basis are usually called baby-sitters. Child-care workers bathe, dress, and feed children; supervise their play, wash their clothes, and clean their rooms. They may also waken them and put them to sleep, read to them, involve them in educational games, take them for doctors’ visits, and discipline them. Those who are in charge of infants, sometimes called infant nurses, also prepare bottles and change diapers. Nannies generally take care of children from birth to age 10 or 12, tending to the child’s early education, nutrition, health, and other needs. Governesses look after children in addition to other house­ hold duties. They may help them with schoolwork, teach them a for­ eign language, and guide them in their general upbringing. (Child­ Federal Reserve Bank of St. Louis  care workers who work outside the child’s home are covered in the statement on child-care workers elsewhere in the Handbook.) Those who assist elderly, handicapped, or convalescent people are called companions or personal attendants. Depending on the em­ ployers’ needs, a companion or attendant might help with bathing and dressing, preparing and serving meals, and keeping the house tidy. They also may read to their employers, write letters for them, play cards or games, and go with them on walks and outings. Com­ panions may also accompany their employers to medical appoint­ ments and handle their social and business affairs. Households with a large staff may include a housekeeper or a but­ ler, a cook, a caretaker, and a launderer. Housekeepers and butlers hire, supervise, and coordinate the household staff to keep the household running smoothly. Butlers also receive and announce guests, answer telephones, deliver messages, serve food and drinks, chauffeur, or act as a personal attendant. Cooks plan and prepare meals, clean the kitchen, order groceries and supplies, and may also serve meals. Caretakers do heavy housework and general home maintenance. They wash windows, wax floors, and hang draperies. They maintain heating and other equipment and do light carpentry, painting, and odd jobs. They may also mow the lawn and do some gardening if the household does not have a gardener. Working Conditions Private household workers usually work in pleasant and comforta­ ble homes or apartments. Most are dayworkers who live in their own homes and travel to work. Some live in the home of their em­ ployer, generally with their own room and bath. Live-ins usually work longer hours. However, if they work evenings or weekends, they may get other time off. Living in may isolate them from family and friends. On the other hand, they often become part of their em­ ployer’s family and may derive satisfaction from caring for them. Being a general houseworker can also be isolating, since work is usu­ ally done alone. Housekeeping is hard work. Both dayworkers and live- ins are on their feet most of the day and do much walking, lifting, bending, stooping, and reaching. In addition, some employers may be very demanding. Employment Private household workers held about 869,000 jobs in 1992. More than half were general houseworkers, mostly dayworkers. About 40 percent were child-care workers, including baby-sitters. About 4 percent were housekeepers, butlers, cooks, and launderers. Most jobs are in big cities and their affluent suburbs. Some are on large es­ tates or in resorts away from cities.  Private household child-care workers are often employed only while children are young. 21  Training, Other Qualifications, and Advancement Private household workers generally do not need any special train­ ing. Individuals who cannot find other work because of limited lan­ guage or other skills often turn to this work. Most jobs require the ability to clean well, cook, or take care of children. These skills are generally learned by young people while helping with housework at home. Some training takes place on the job. Employers show the household workers what they want done and how. For child-care workers and companions, general education, background, and abil­ ity to get along with the person they will care for are most impor­ tant. Home economics courses in high schools and vocational and adult education schools offer training in cooking and child care. Courses in child development, first aid, and nursing in postsecon­ dary schools are also useful. Special schools for butlers, nannies, and governesses teach house­ hold administration, early childhood education, nutrition, child care, and bookkeeping. Private household workers must be honest, discreet, dependable, courteous, and neat. They need physical stamina. Opportunities for advancement within this occupation are very limited. There are very few large households with big staffs where general houseworkers can advance to cook, executive housekeeper, or butler, and these jobs may require specialized training. Advance­ ment usually consists of better pay and working conditions. Work­ ers may move to similar jobs in hotels, hospitals, and restaurants, where the pay and fringe benefits are usually better. Others transfer into better paying unrelated jobs. Job Outlook Job opportunities for people wishing to become private household workers are expected to be excellent through 2005, as the demand for these services continues to far outpace the supply of workers willing to provide them. For many years, demand for household help has outstripped the supply of workers willing to take domestic jobs. The imbalance is expected to persist—and possibly worsen—through the year 2005. Demand is expected to grow as more women join the labor force and need help running their households. Demand for companions and personal attendants is also expected to rise due to projected rapid growth in the elderly population. The supply situation is not likely to improve. Unattractiveness of the work, low status, low pay, lack of fringe benefits, and limited ad­ vancement potential deter many prospective household workers. In addition, demographic factors will continue to aggravate the supply situation. Teenagers and young adults, the age group from which many child-care workers and baby-sitters come, will rebound in ab­ solute terms, but continue to slip further as a share of the workforce. Due to the limited supply of household workers, many employers have turned to domestic cleaning firms, child-care centers, and tem­ porary help firms to meet their needs for household help. This trend  22 Federal Reserve Bank of St. Louis  is expected to continue. (See the statements on janitors and cleaners, child-care workers, and homemaker-home health aides elsewhere in the Handbook.) Although employment of private household workers is expected to decline through 2005, many jobs will be available because of the need to replace the large number of workers who leave these occupa­ tions every year. Persons who are interested in this work and suited for it should have no trouble finding and keeping jobs. Earnings Earnings of private household workers depend on the type of work, the number of hours, household and staff size, geographic location, training, and experience. Nearly 2 out of 3 private household workers work part time, or less than 35 hours a week. Some work only 2 or 3 days a week, while others may work half a day 4 or 5 days a week. Earnings vary from about $ 10 an hour or more in a big city to less than the Federal mini­ mum wage in some rural areas (some domestic workers are not cov­ ered by minimum wage laws). Those covered by the Federal mini­ mum wage receive $4.25 an hour. In addition, dayworkers often get carfare and a free meal. Live-in domestics usually earn more than dayworkers and also get free room and board. However, they often work longer hours. Baby-sitters usually have the lowest earnings. In 1992, median earnings for full-time private household workers were about $179 a week. The median for cleaners was about $191 and for child-care workers, about $ 154 a week. Some full-time live-in housekeepers or butlers, nannies, and gov­ ernesses earn much higher wages than these. In New York City, for example, an experienced cook may earn up to $900 a week. Trained nannies start at $300-$375 per week, and with experience may earn up to $800 per week. A major domo, or senior butler, who runs a large household and supervises a staff of six people or more can ex­ pect to start at $20,000 and with experience earn over $35,000 per year. Private household workers who live with their employers may be given room and board, medical benefits, a car, vacation days, and other benefits. However, most private household workers receive very limited or no benefits. Related Occupations Other workers with similar duties are building custodians, hotel and restaurant cleaners, child-care workers in day care centers, home health aides, cooks, kitchen workers, waiters and waitresses, and bartenders. Sources of Additional Information Information about job opportunities for private household workers is available from local private employment agencies and State em­ ployment service offices.  •fir U.S. GOVERNMENT PRINTING OFFICE: 1994 363-539 2450-15  Selected items from The Bureau of Labor Statistics library of  Career and Job Outlook Publications Do you have the latest editions?  Occupational OutiookHandbook-1994-95Edition The original, and still leading source of authoritative, nontechnical career information for about 250 occupations. Each description includes information on nature of the work, training required, earnings, job prospects, and sources of additional information. 473 pp„ $26, hard cover; $23, soft cover. OccupationalOutlookHanilbookReprints Groups of related jobs covered in the 1994-95 Occupational OutlookHandbookmm\\ab\e as individual reprints. These reprintsare especially useful for jobseekers whowantto know about a single field and for counselors who need to stretch the contents of a single Handbook among many students. No.  2450 2450-1 2450-2 2450-3 2450-4 2450-5 2450-6 2450-7 2450-8 2450-9 2450-10 2450-11 2450-12 2450-13 2450-14 2450-15 2450-16 2450-17 2450-18 2450-19 2450-20  Price  $24.00 Tomorrow's Jobs: Overview 1,25 Businessand Managerial Occupations 2.75 Engineering, Scientific, and Related Occupations 1.75 Computerand Mathematics-Related Occupations 2.00 Social Science and Legal Occupations 1.50 Education and Social Service Occupations and Clergy 2.00 Health Diagnosing Occupations and Assistants 1.50 Dietetics, Nursing, Pharmacy, and Therapy Occupations 1.50 Health Technologists and Technicians 1.50 Communications, Design, Performing Arts, and Related Occupations 1.50 Technologists and Technicians, Except Health 1.25 Sales Occupations 1.50 Clerical and Other Administrative Support Occupations 1.50 Protective Service Occupations and Compliance Inspectors 2.00 Service Occupations: Cleaning, Food, Health, and Personal 1.00 Mechanics, Equipment Installers and Repairers 1.50 Construction Trade and Extractive Occupations 1.25 Metalworking, Plastic-working, and Woodworking Occupations 2.00 Production Occupations 1.50 Transportation and Forestry, Fishing, and Related Occupations 2.00 Collated setofall 20 reprints  OccupationalOutlookQuarterly Keeps you informed about new studies by the Bureau of LaborStatistics. Articles cover a wide range of subjects useful to job counselors, labor force analysts, and people choosing careers. New and emergi ng jobs, unusual jobs, employment projections and trends, and changing technology area few of the areas covered by this award-winning magazine. Four issues, 40 pages each, in color, $8.00; single copy $2.75.  )  der  SSSSSgrS? &«2S>*** Federal Reserve Bank of St. Louis  Outlook  Ubo' ‘sL^or  '  Quart*,,..  Related Publications 1994  Occupational Projections and Training Data  The American Work Force: 1992-2005  Edition  U-S. Department of Labor Bureau of Labor Statistics  A Statistical and Research Supplement to the 1994-95 Occupational Outlook Handbook  Bulletin 2452 April 1994  U.S. Department of Labor Bureau of Labor Statistics May 1994  l to :0 T..I ,'T t. of bt1'- I to f-j'nr  endi r,repeat 1 .'j' f cf  t%*?3in tL true  fftr ejt v.:Lh x ] toit hil.dht of btd *  true Lhcn  ; L visible cf fU .4 tc tr-e  WM  BLS Bulletin 2451  BLS Bulletin 2452  Occupational Projections and Training Data, 1994 Edition  The American Work Force: 1992-2005  This supplement to the Occupational Outlook Handbook provides the statistical and technical data supporting the information presented in the Handbook. Education and training planners, career counselors, and jobseekers can find valuable information that ranks occupations by employment growth, earnings, susceptibility to unemployment, separation rates, and part-time work. Not*: At press time, prices for these publications were not available. For prices and ordering information, contact any of the Bureau of Labor Statistics Regional Offices. Federal Reserve Bank of St. Louis  Every 2 years, the Bureau of Labor Statistics producers de­ tailed projections of the U.S. economy and labor force. This bulletin presents the Bureau’s latest analyses of economic and industrial growth, the labor force, and trends in occupa­ tional employment into the 21 st century. An overview article fo­ cuses on important issues raised by these projections.  Bureau of Labor Statistics Regional Offices Boston  1 Congress St., 10th Floor Boston, MA 02114-2023  Phone (617) 565-2327  New York  Room 808, 201 Varick St. New York, NY 10014-4811  Phone (212) 337-2400  Philadelphia  P.O. Box 13309 Philadelphia, PA 19101-3309  Phone (215) 596-1154  Atlanta  1371 Peachtree St. NE. 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