Your Role During an Emergency/Disaster 1. Default Section The Washington State Nurses Association’s Disaster & Emergency Preparedness Committee would like your participation in a survey regarding your understanding of your role during an emergency/disaster. Question Title * 1. What is your current practice site? Acute care (hospital-based) Public Health School Nurse Ambulatory care (includes urgent care, free-standing ambulatory surgery, provider offices, etc) Long-term Care Educational Institution Other (please specify) Question Title * 2. County in which you Practice Washington Counties Adams County Asotin County Benton County Chelan County Clallam County Clark County Columbia County Cowlitz County Douglas County Ferry County Franklin County Garfield County (Palouse Economic Development Council) Grant County Grays Harbor County Island County Jefferson County King County Kitsap County Kittitas County Klickitat County Lewis County Lincoln County Mason County Okanogan County Pacific County Pend Oreille County Pierce County San Juan County Skagit County Skamania County Snohomish County Spokane County Stevens County Thurston County Wahkiakum County Walla Walla County Whatcom County Whitman County Yakima County Washington Counties menu Question Title * 3. Where would you go to get information and direction during a disaster if you were not at work? Radio TV Internet Reverse 911 Would use my organization’s communication system for employees Other (please specify) Question Title * 4. Do you have a personal and/or family disaster/emergency preparedness plan in place so that you could respond to your place of work or other designated site during an emergency? Yes No Question Title * 5. Does your organization have a written emergency preparedness/disaster plan? Yes No Don't Know Question Title * 6. Does your organization regularly have drills to review/evaluate this plan? Yes No Don't Know Question Title * 7. If yes to question #6, how often does your organization have drills? Every 3 months Every 6 months Annually Don’t Know Question Title * 8. Have you ever participated in a formal drill of this plan? Yes, actual live drill(s) Yes, but table-top exercise(s) only No Question Title * 9. Do you know your role expectations in this plan? Yes No Not sure/have questions Question Title * 10. Have you ever had to respond to an actual emergency/disaster in your organization using this plan? Yes No Question Title * 11. Was your role clear during that emergency/disaster? Yes, very clear My role was unclear/confusing No Question Title * 12. Are you registered as a volunteer responder, i.e. through the State of Washington’s Medical Research Corp (MRC), Washington State Health Volunteers in Emergency (WAHVE) program, American Red Cross(ARC), or other organization? Yes No If “other organization” besides MRC/WAHVE/ARC, please specify Question Title * 13. Does your employer allow you to volunteer to respond during an emergency without loss of seniority &/or benefits? Yes No Don't Know Question Title * 14. Do you have questions about your scope of practice in a declared statewide/public health/other emergency? Yes No Never thought about it What questions do you have? Question Title * 15. Do you feel you are prepared for an emergency/disaster in your workplace? Yes No Not sure Question Title * 16. In general, do you feel you would have enough supplies/correct supplies to manage a disaster in your workplace? Yes No Not sure Question Title * 17. What does your organization have in place in order to help you respond to an emergency/disaster? Family/Child Care Shelter Care (i.e. food, housing) Pet Care Phone/Call Tree Additional personal supplies so you can stay in facility (tooth brush, linen, etc.) Method for obtaining information about my family (link to schools, etc.) Don’t Know Question Title * 18. Do you feel you need more training in order to be prepared and to be able to respond during an emergency/disaster? Yes No Not Sure Question Title * 19. If yes to question #18, in what area? (check all that apply) More experience with my organization’s drills More information on my role expectations from my organization Radiological emergencies Infectious diseases and public health emergency declaration Natural disaster preparation, especially for earthquake Other (please specify) Question Title * 20. Do you know what “duty to respond” means? Yes No Question Title * 21. What do you feel is your “duty to respond” during an emergency/disaster? I would always respond immediately as instructed I would first need to know that my family/those significant to me are ok before I could stay/respond I would only respond if I felt safe and there was no potential harm to my family I would only respond if it was my scheduled shift I do not feel I am obligated to respond Comments Question Title * 22. Did you know that WSNA has a web page specifically devoted to emergency preparedness/disaster? Yes No Suggestions for information to be added to this web page: Thank you for participating in this survey!WSNA Disaster and Emergency Preparedness Committee Done