Alacare Nursing Student Survey Question Title * 1. What is your first name? Question Title * 2. What is your last name? Question Title * 3. What school are you currently attending? Auburn University Calhoun Community College The University of Alabama, Capstone College of Nursing Gadsden State Community College Jacksonville State University South University Montgomery Tuskegee University School of Nursing UAB School of Nursing University of North Alabama Other Other Question Title * 4. In which semester are you currently enrolled? 1-2 3-4 5-6 7-8 Question Title * 5. Did you sign an Alacare HIPAA form? yes no Question Title * 6. What Alacare branch are you in today? Albertville Alex City Anniston Opelika/Auburn Clanton Cullman Decator Dothan Gadsden Greenville Hamilton Hoover Homecare Hoover Hospice Huntsville Jasper Mobile Montgomery Muscle Shoals Oneonta Pell City Rainsville Scottsboro Troy Tuscaloosa Question Title * 7. What was the name of the nurse you shadowed today? Question Title * 8. How many patients did you visit today? 3-5 4-6 5-7 Question Title * 9. How many hours did you spend at the clinical site? 1-3 3-5 5-8 Other Other (please specify) Question Title * 10. Did you see home health patients or hospice patients or both? Home Health Hospice Both Question Title * 11. What skills did you observe today? (Check as many as apply) Auscultation of breath sounds Auscultation of heart sounds Blood pressure measurement Comfort Care Decubiti dressing change Enema administration Enteral feeding management Foley catheter insertion/change IM/SQ/ID injection Implanted port access IV insertion Medication reconciliation Medication teaching Mini Mental status testing Nebulizer Treatment Ostomy care Other Pain assessment Patient or family teaching Phone call to physician PICC line care Pulse oxygen saturation Staple removal Suprapubic catheter change Suture removal Temperature measurement Tracheostomy care/suctioning Venipuncture Wound vacuum dressing change Other (please specify) Question Title * 12. Rate your experiences in the following areas: Not receptive Neutral Somewhat receptive Receptive Very receptive How receptive was the nurse to having you (as a student) ride with him/her today? How receptive was the nurse to having you (as a student) ride with him/her today? Not receptive How receptive was the nurse to having you (as a student) ride with him/her today? Neutral How receptive was the nurse to having you (as a student) ride with him/her today? Somewhat receptive How receptive was the nurse to having you (as a student) ride with him/her today? Receptive How receptive was the nurse to having you (as a student) ride with him/her today? Very receptive Was the nurse receptive to explaining the skills performed on the visit? Was the nurse receptive to explaining the skills performed on the visit? Not receptive Was the nurse receptive to explaining the skills performed on the visit? Neutral Was the nurse receptive to explaining the skills performed on the visit? Somewhat receptive Was the nurse receptive to explaining the skills performed on the visit? Receptive Was the nurse receptive to explaining the skills performed on the visit? Very receptive How did the patient react to your presence on the nursing visit? How did the patient react to your presence on the nursing visit? Not receptive How did the patient react to your presence on the nursing visit? Neutral How did the patient react to your presence on the nursing visit? Somewhat receptive How did the patient react to your presence on the nursing visit? Receptive How did the patient react to your presence on the nursing visit? Very receptive How receptive was the patient care giver/family to your presence on the nursing visit? How receptive was the patient care giver/family to your presence on the nursing visit? Not receptive How receptive was the patient care giver/family to your presence on the nursing visit? Neutral How receptive was the patient care giver/family to your presence on the nursing visit? Somewhat receptive How receptive was the patient care giver/family to your presence on the nursing visit? Receptive How receptive was the patient care giver/family to your presence on the nursing visit? Very receptive Question Title * 13. Did the nurse explain what it means to be "home-bound" and eligible for home health care? Yes No Question Title * 14. Did the nurse explain the difference between home health and hospice care? Yes No Question Title * 15. Where you encouraged to ask questions? Yes No Question Title * 16. Do you feel this clinical experience enhanced your nursing education? Yes No Please explain Question Title * 17. Would you consider home health nursing as a career possibility for you in the future? Yes No Please explain Question Title * 18. Would you consider home hospice nursing as a career possibility for you in the future? Yes No Please explain Question Title * 19. Please enter your contact information using your school address and school e-mail. Name Address Address 2 City/Town State/Province ZIP/Postal Code Country Email Address Phone Number Question Title * 20. Please enter your home address and personal e-mail. Name Address Address 2 City/Town State/Province ZIP/Postal Code Country Email Address Phone Number Question Title * 21. Please provide your anticipated graduation date. Alacare appreciates your time in completing this survey. Alacare strives to make every student nursing encounter to be a positive and enjoyable learning experience. Julie Aldridge, MSN, CRNP, ACHPN, DNP Director of Education Alacare Home Health and Hospice julie.aldridge@alacare.com (205) 981-8759 Next
