When Daina Nagaji lost her job as a loan officer a year ago, she decided to change careers.

Rather than helping people get loans, Nagaji, 30, wanted to help care for Hawai'i's elderly. She's on the verge of making that happen.

The Pearl City resident recently graduated from a two-month course to become a certified nurse aide, the front-line worker who provides the everyday care to the aged and disabled in Hawai'i's long-term care facilities.

Nagaji must pass a state test to be certified, then she enters a job market in which CNAs are in demand throughout the state.

A shortage exists largely because the work is demanding, the clients can be difficult and the pay and opportunity for advancement are limited. Burnout also is a big problem. None of that fazes Nagaji, who relishes what lies ahead.

"It's so rewarding being able to help the elderly," she said shortly after spending a four-day stint at a nursing home as part of her training.

Hawai'i has nearly 20 schools that train CNAs, but the quality can vary significantly, partly depending on how long the training lasts. Some stretch over two months, while others are over in as little as a few weeks. Tuition ranges from roughly $600 to $1,500.

Nagaji graduated from Regina L. Rivera's Pacific Nurses Aide Training Center in Pearl City. Rivera also does CNA training for Kapi'olani Community College.

Rivera said many of her graduates — she trains up to 200 each year — get jobs at hospitals, which typically pay better than other places. The starting pay for a CNA generally is around $10 an hour, though one of her graduates recently got a job at $19 an hour, Rivera said.

"They gotta have a passion for taking care of people," she said. "You can't go into this thinking about rewards."

Once certified, a CNA in Hawai'i must take an exam to be re-certified every two years. Cullen Hayashida, the long-term care coordinator at KCC, said that requirement has prompted some people to reconsider becoming CNAs, especially given that doctors and nurses aren't tested regularly for competency.

"There's a possibility people are going to walk away from this profession," Hayashida said.