In my mind, the three things that should be required for a CNA are loyalty, compassion, and a good constitution. If anyone can figure out a reliable way to test for these, let me know. Our work environments would improve greatly if everyone had these qualities.
I put loyalty first just because it's the most important to me. I don't mean loyal to your employer, I mean loyal to the residents. These folks live here year in and year out and just watch the help come and go and sometimes come back again. It must be hard for them to adjust to new people and personalities all the time. I have one resident who won't deal with new co-workers at all. They have dementia and seeing new faces puts them on the defensive. Now that I've been there for more than a year, while they don't know me, I think they recognize me. Most days they'll allow me to care for them and give them their medication. They'll smile and talk to me as best they can. If a new person tries to care for them, they get suspicious and refuse help, medication and anything else they can say "no" to.
Compassion is a no-brainer. No one wants to live in a Nursing Center. Sure, some of them become resigned to it, but none of them are really happy to be there. Being compassionate means comforting them and empathizing with them. This includes being kind even when they are angry, but being firm if you can't honor their requests. (I run into this a lot when a resident wants a pill that they don't have an order for. Sure, we have that pill in-house somewhere, but if they don't have an order for it, we can't give it.) It means offering alternatives when they can't have what they want. It means saying "What can I do for you?" instead of "What do you want?" when you enter their room. It means taking a moment after you've completed their care to see if there's anything else they need before rushing out the door. It means resisting the urge to put words in their mouths when they hesitate mid-sentence. The previously mentioned resident speaks in a word salad and gets angry when you try to correct them or fill in the blanks for them. I've learned to let them hunt for the word they want and try to figure out what they mean at the end of the sentence. Patience is a large part of compassion in this environment.
A good constitution is necessary because a lot of times we find ourselves working sick or injured. And we need to be willing to work, if possible, when we're ill or hurt. (Personally, my rule is that unless I'm vomiting, have diarrhea that can't be controlled with Immodium, or have a fever that can't be controlled with Tylenol, I'm working. And don't talk to me about spreading germs, we have gloves and masks and frankly, most of the time, we're contagious 24 hours before we even know we're sick, so we've already "shared the love" before we had to start taking Nyquil to sleep.) We need strong backs and strong hands because our residents need us to be their strength. We need to be able to smile and be kind even when our heads are pounding or our throats are sore. If I could infuse every cup of coffee or iced tea we drank with a +5 Constitution, I would.
Which brings me back to my initial question: How do we test for these qualities? Even if we had a test for them, would the people who had them even apply for the job? If a person doesn't have these qualities, can they be taught?