Nursing Concerns during COVID-19

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1. Are you a nurse (at any level of practice) working in Arkansas?

Yes

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2. Type of nursing license

CNA (certified Nurse's Aid)

MA-C (Medication Assistant-Certified)

LPN/LVN (Licensed Practical Nurse)

LPTN (Licensed Psychiatric Technician Nurse)

RN (Registered Nurse

RNP (Registered Nurse Practitioner) (BSN level- renewal license only)

CNP (Certified Nurse Practitioner) (all specialties- Master's level & above)

CRNA (Certified Registered Nurse Anesthetist)

CNS (Clinical Nurse Specialist)

CNM (Certified Nurse Midwive)

APRN (Advanced Practice Registered Nurse) - Other (please specify)

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3. Are you having trouble getting the proper PPE you need?

Yes

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4. Does your concern for adequate PPE impact where you are willing to work?

Yes

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5. If yes, what kind of practice do you work?

NP owned Primary care clinic

MD owned Primary care clinic

Hospital owned Primary care clinic

NP owned Specialty clinic- please answer type of specialty below

MD owned Specialty clinic- please answer type of specialty below

Hospital owned Specialty clinic- please answer type of specialty below

Hospital/Inpatient

Emergency Department

N/A- I am getting the PPE I need

Other/Type of specialty

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6. Are you currently working?

Yes

No, I'm furloughed from my job

No, I was unemployed prior to the COVID-19 pandemic

No, I am unemployed due to the COVID-19 pandemic

If furloughed or unemployed d/t COVID-19, have you sought other opportunities to work or volunteer in healthcare? What have you found?

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7. Are you willing to work or volunteer to help during this COVID-19 crisis?

Yes

I am willing to travel within Arkansas if needed.

How far are you willing to travel to help within Arkansas? Please note whether this includes work, volunteer, or both.

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8. Are you willing to work outside your typical practice setting to address current needs?

Yes

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9. Do barriers to your scope of practice within Arkansas impact where you plan to work?

Yes

I have considered working in another state.

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10. Tell your story about how COVID 19 has affected you, your practice, your family.

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11. Please give your City/Town.
Include your preferred email/contact, if you would like.

Name

City/Town

ZIP/Postal Code

Email Address

Phone Number

Nursing Concerns during COVID-19

Question Title

* 1. Are you a nurse (at any level of practice) working in Arkansas?

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* 2. Type of nursing license

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* 3. Are you having trouble getting the proper PPE you need?

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* 4. Does your concern for adequate PPE impact where you are willing to work?

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* 5. If yes, what kind of practice do you work?

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* 6. Are you currently working?

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* 7. Are you willing to work or volunteer to help during this COVID-19 crisis?

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* 8. Are you willing to work outside your typical practice setting to address current needs?

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* 9. Do barriers to your scope of practice within Arkansas impact where you plan to work?

Question Title

* 10. Tell your story about how COVID 19 has affected you, your practice, your family.

Question Title

* 11. Please give your City/Town. Include your preferred email/contact, if you would like.

1. Are you a nurse (at any level of practice) working in Arkansas?

2. Type of nursing license

3. Are you having trouble getting the proper PPE you need?

4. Does your concern for adequate PPE impact where you are willing to work?

5. If yes, what kind of practice do you work?

6. Are you currently working?

7. Are you willing to work or volunteer to help during this COVID-19 crisis?

8. Are you willing to work outside your typical practice setting to address current needs?

9. Do barriers to your scope of practice within Arkansas impact where you plan to work?

10. Tell your story about how COVID 19 has affected you, your practice, your family.

11. Please give your City/Town.
Include your preferred email/contact, if you would like.