1.What is your gender?

Female

Male

Other (specify)

2.Which ethnicity best describes you? (Please choose only one.)

American Indian or Alaskan Native

Asian / Pacific Islander

Black or African American

Hispanic or Latino

Non-Hispanic / Caucasian

Other

Multiple ethnicity / Other (please specify)

3.What is your age?

Under 25

25-35

36-45

46 - 59

60+

4.What is the highest level of education you have completed?

Associate's DegreeLicensed Practical NurseBachelor of Science in NursingMaster of Science in NursingDoctoral DegreeOther (please specify)

5.Years as a NICU nurse

Less than 2 years

2-5 years

6-10 years

11-20 years

21-30 years

Greater than 30 years

6.What shift do you currently work in the NICU?

8 hour day-shift

12 hour day-shift

8 hour night-shift

12 hour night-shift

7.In what state or U.S. territory do you currently work?

AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of Columbia (DC)FloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaVirgin IslandsWashingtonWest VirginiaWisconsinWyomingOther (please specify)

8.Are you currently working as a bedside, Level III or IV NICU nurse?

Yes

No

9.Have you been working as a bedside NICU nurse for at least 2 years or more?

Yes

No

10.Do you currently hold a formal leadership position within the NICU in which you are employed?

Yes

No

11.If you answered Yes, Yes, and No to the previous three questions and would like to participate in this research study, please enter your email below.

Email Address