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2021 September TRAVELER COVID-19 RN Screener
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1.
Are you a licensed Registered Nurse?
(Required.)
Yes
No
2.
Which title best describes your current position in nursing?
Shift manager
Staff nurse
Charge nurse
Nurse practitioner
Nurse educator
Director of Nursing
3.
Are you currently or have you taken a travel assignment since March 2020?
Yes
No
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4.
In what type of organization(s) are you currently employed at least part-time?
(Required.)
Hospital
Doctor’s office
Stand-alone clinic
None of the above
5.
How likely are you to consider working full- or part-time in a hospital setting in the future?
Very likely
Somewhat likely
Neither likely nor unlikely
Somewhat unlikely
Very unlikely
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6.
Thank you for your interest in the study about how you are feeling as an RN during the coronavirus (COVID-19) epidemic. Please let us know your contact information so we can send you a link to schedule your interview.
(Required.)
Name
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State/Province
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
Email Address
*
Phone Number
Current Progress,
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