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COVID-19 and Staffing Survey
*
1.
On a scale of 1 to 10 (with 1 being no impact and 10 being high impact), how much has COVID-19 impacted
you
in the last 14 days?
(Required.)
1 - No Impact
10 - High Impact
Clear
*
2.
On a scale of 1 to 10 (with 1 being no impact and 10 being high impact), how much has COVID-19 impacted your patient care in the last 14 days?
(Required.)
1 - No Impact
10 - High Impact
Clear
*
3.
How does COVID-19 impact
you
right now compared to what you were experiencing three months ago?
(Required.)
Higher impact
No change
Lower impact
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4.
How does COVID-19 impact on
your patients
right now compared to what
they
were experiencing three months ago?
(Required.)
Higher impact
No change
Lower impact
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5.
Has your facility implemented any of the following incentives in the last 12 months?
(Required.)
Sign-on bonus
COVID pay
Bonus for extra shifts
Referral bonus
All of the above
None of the above
Other (please specify)
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6.
Does your facility/practice currently have a shortage of RN staff?
(Required.)
Yes – severe shortage (work short-staffed daily)
Yes – moderate shortage (work short-staffed at least once a week)
No – but shortage pending
No
Not sure
N/A
*
7.
Did your facility/practice have a shortage of RN staff before the pandemic?
(Required.)
Yes – severe shortage (work short-staffed daily)
Yes – moderate shortage (work short-staffed at least once a week)
No – but shortage pending
No
Not sure
N/A
*
8.
If your facility/practice is experiencing a RN staff shortage, have you had to?
(Required.)
Work longer hours
Work extra shifts
Work different assignments (move to a different unit)
All the above
None of the above
Other (please specify)
9.
How has your facility responded to nurses' concerns about staffing?
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10.
How many years have you been a RN practicing direct patient care?
(Required.)
*
11.
Do you intend on leaving the nursing profession in the near future?
(Required.)
yes, within the year or less
yes, within the next 2-3 years
yes, within the next 5 years
not considering leaving yet
12.
If considering leaving the nursing profession in the near future, please share the major reasons why you have made this decision.
*
13.
How likely are you to leave the nursing profession before you are eligible for retirement?
(Required.)
0 - Unlikely
100 - Very likely
Clear
*
14.
Primary employment setting
(Required.)
Hospital (Community or Trauma Center)
Critical Access Hospital
Mental Health Facility
Long Term Acute Care Hospital
Health Care Provider Office
Clinic
FQHC
School
Corrections
Home Health
Hospice
Other
15.
Is there anything else, you would like to share with us?
Current Progress,
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