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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
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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
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i We adjusted the number you entered based on the slider’s scale.

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3. How does COVID-19 impact you right now compared to what you were experiencing three months ago? (Required.)

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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.)

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5. Has your facility implemented any of the following incentives in the last 12 months? (Required.)

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6. Does your facility/practice currently have a shortage of RN staff? (Required.)

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7. Did your facility/practice have a shortage of RN staff before the pandemic? (Required.)

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8. If your facility/practice is experiencing a RN staff shortage, have you had to? (Required.)

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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.)

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11. Do you intend on leaving the nursing profession in the near future? (Required.)

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12. If considering leaving the nursing profession in the near future, please share the major reasons why you have made this decision.

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13. How likely are you to leave the nursing profession before you are eligible for retirement? (Required.)

0 - Unlikely 100 - Very likely
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14. Primary employment setting (Required.)

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15. Is there anything else, you would like to share with us?

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