Concerns have been brought to WSNA’s attention regarding the working conditions and work environment in the Emergency Department at St Clare Hospital. We want to fully understand the perspective of every nurse that works in the ED. Therefore, we are asking every WSNA nurse that works in, or floats to the ED to take the following survey,

 All responses are confidential. WSNA staff will not share the individual responses with anyone. We ask for your current contact information so that we may contact you if we have questions about your responses and so that we can share important information with you.

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* 1. Please provide your contact information:

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* 2. I work in the (clinical area or patient care area where you typically spend your time):

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* 3. This is in the department:

Please complete this survey with respect to your experiences in the above-listed clinical area.

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* 44. Have you completed this survey before?

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* 45. Position (mark one)

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* 46. Gender

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* 47. I work primarily:

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* 48. Years in specialty:

If you have questions, please contact WSNA Nurse Representative Barbara Friesen at brfiesen@wsna.org or 206-575-7979, ext. 3056.



This survey copyright 2004 by The University of Texas at Austin - based off a Mark Reflex form by Pearson NCS MW 263511.1 321 HC99

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