NYONL Self-Care Practices Survey

Instructions

The first two sections of the survey ask questions about possible self-care practices.

The first section relates to personal self-care practices. Keep in mind there are no right or wrong answers. When filling out this part of the scale, please indicate how frequently you engage in each of the following by selecting the frequency for each item below that best fits you.

The second section relates to professional self-care practices. Remember, there are no right or wrong answers. When filling out this part of the scale, please indicate how frequently you engage in each of the following by selecting the frequency for each item below that best fits you.

The last section of the survey relates to demographic questions about yourself and your current position in healthcare. Please indicate the response that best fits you.

Question Title

* Personal

I engage in physical activities

Never

Rarely

Sometimes

Often

Very Often

Never

Rarely

Sometimes

Often

Very Often

Question Title

* I laugh

Never

Rarely

Sometimes

Often

Very Often

Never

Rarely

Sometimes

Often

Very Often

Question Title

* I engage in spiritual practices

Never

Rarely

Sometimes

Often

Very Often

Never

Rarely

Sometimes

Often

Very Often

Question Title

* I get adequate sleep for my body

Never

Rarely

Sometimes

Often

Very Often

Never

Rarely

Sometimes

Often

Very Often

Question Title

* I spend quality time with people I care about

Never

Rarely

Sometimes

Often

Very Often

Never

Rarely

Sometimes

Often

Very Often

Question Title

* I participate in activities that I enjoy

Never

Rarely

Sometimes

Often

Very Often

Never

Rarely

Sometimes

Often

Very Often

Question Title

* I accept help from others

Never

Rarely

Sometimes

Often

Very Often

Never

Rarely

Sometimes

Often

Very Often

Question Title

* I engage in physical intimacy

Never

Rarely

Sometimes

Often

Very Often

Never

Rarely

Sometimes

Often

Very Often

Question Title

* I take action to meet my emotional needs

Never

Rarely

Sometimes

Often

Very Often

Never

Rarely

Sometimes

Often

Very Often

Question Title

* Professional

I take small breaks throughout the workday

Never

Rarely

Sometimes

Often

Very Often

Never

Rarely

Sometimes

Often

Very Often

Question Title

* I seek out professional development opportunities

Never

Rarely

Sometimes

Often

Very Often

Never

Rarely

Sometimes

Often

Very Often

Question Title

* I take vacations

Never

Rarely

Sometimes

Often

Very Often

Never

Rarely

Sometimes

Often

Very Often

Question Title

* I acknowledge my successes at work

Never

Rarely

Sometimes

Often

Very Often

Never

Rarely

Sometimes

Often

Very Often

Question Title

* I problem solve when I have challenges at work

Never

Rarely

Sometimes

Often

Very Often

Never

Rarely

Sometimes

Often

Very Often

Question Title

* I reserve work tasks for designated work hours (e.g., paperwork, emails, work-related colleague contact)

Never

Rarely

Sometimes

Often

Very Often

Never

Rarely

Sometimes

Often

Very Often

Question Title

* I attend to feelings of being overwhelmed with my work

Never

Rarely

Sometimes

Often

Very Often

Never

Rarely

Sometimes

Often

Very Often

Question Title

* I seek out colleagues I find supportive

Never

Rarely

Sometimes

Often

Very Often

Never

Rarely

Sometimes

Often

Very Often

Question Title

* I am able to say "no" when appropriate

Never

Rarely

Sometimes

Often

Very Often

Never

Rarely

Sometimes

Often

Very Often

Question Title

* Demographics

Age

List age =

Prefer not to answer

Question Title

* Gender

Male

Female

Transgender

Non-binary

Prefer not to answer

Other (please specify)

Question Title

* Race

White/non-Hispanic

African American

Asian

Hispanic/Latino

American Indian

African

Native Hawaiian/Pacific Islander

Middle Eastern/Arabic

Other/Unknown

Prefer not to say

Question Title

* Primary Position

CNO/Vice President

Director

Nurse Manager

Dean/Chair (Academia)

Midwife

Staff Nurse

Clinical Nurse Specialist

Nurse Practitioner

CRNA

Nurse Educator (Academic Faculty)

Nurse Educator (Staff Development)

Prefer not to answer

Other (please specify)

Question Title

* Highest Level of Education

Diploma

Associate

Bachelor

Masters

Doctorate PhD

Doctorate DNP

Doctorate EdD

Prefer not to answer

Other (please specify)

Question Title

* Number of Years in Nursing

List number of years

Prefer not to answer

Question Title

* Number of Years in present position

List number of years

Prefer not to answer

Question Title

* Work Status at Primary Position

Employment Full-Time

Employment Part-Time

Self-Employed

Seeking Opportunities

Retired

Student

Prefer not to say

Other (please specify)

Question Title

* Do you work for a Magnet Designated Facility?

Yes

Question Title

* What type of facility do you work for?

Community Based

Academic Medical Center

Private

Public

Prison

School of Nursing

Other (please specify)

Question Title

* What NYONL region do you work in?

CNYONEL

FLONEL

GNYNSONEL

NORMET

NENYONEL

WNYONEL

Question Title

* How many hour do you work a week?

None

Less than 10 hours a week

Between 10-20 hours a week

Between 20-30 hours a week

Between 30-40 hours a week

40 hours a week

Between 40-60 hours a week

More than 60 hours a week

Prefer not to answer

Other (please specify)

Question Title

* What area (s) do you work in? (Check all that apply)

Medical Surgical - Adult

Medical Surgical - Pediatric

Critical Care - Adult

Critical Care - Pediatric

Critical Care - Neonatal

Obstetrics/GYN

Operative Services

Oncology

Emergency Department

Procedural

Psychiatric

Outpatient

Hospice

Home care

Administration

Other (please specify)

Question Title

* Marriage status

Single

Married

In a domestic partnership

Divorced

Widowed

Separated

Prefer not to say

Question Title

* Household income

Less than $10,000

$10,000-$50,000

$50,000-$100,000

$100,000-$150,000

Over $150,000

Prefer not to answer

Question Title

* How many dependents do you have?

No dependents

2-3

More than 4

Prefer not to answer

NYONL Self-Care Practices Survey

Instructions

Question Title

* PersonalI engage in physical activities

Question Title

* I laugh

Question Title

* I engage in spiritual practices

Question Title

* I get adequate sleep for my body

Question Title

* I spend quality time with people I care about

Question Title

* I participate in activities that I enjoy

Question Title

* I accept help from others

Question Title

* I engage in physical intimacy

Question Title

* I take action to meet my emotional needs

Question Title

* ProfessionalI take small breaks throughout the workday

Question Title

* I seek out professional development opportunities

Question Title

* I take vacations

Question Title

* I acknowledge my successes at work

Question Title

* I problem solve when I have challenges at work

Question Title

* I reserve work tasks for designated work hours (e.g., paperwork, emails, work-related colleague contact)

Question Title

* I attend to feelings of being overwhelmed with my work

Question Title

* I seek out colleagues I find supportive

Question Title

* I am able to say "no" when appropriate

Question Title

* DemographicsAge

Question Title

* Gender

Question Title

* Race

Question Title

* Primary Position

Question Title

* Highest Level of Education

Question Title

* Number of Years in Nursing

Question Title

* Number of Years in present position

Question Title

* Work Status at Primary Position

Question Title

* Do you work for a Magnet Designated Facility?

Question Title

* What type of facility do you work for?

Question Title

* What NYONL region do you work in?

Question Title

* How many hour do you work a week?

Question Title

* What area (s) do you work in? (Check all that apply)

Question Title

* Marriage status

Question Title

* Household income

Question Title

* How many dependents do you have?

* Personal

I engage in physical activities

* Professional

I take small breaks throughout the workday

* Demographics

Age