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Illinois Nurse Staffing Survey 2022

1.What is your age?
2.What is your gender
3.Are you of Hispanic or Latino or Spanish origin?
4.Which best describes you? Select all that apply.
5.What is your level of nursing education?
6.What is your average annual salary?
7.What clinical setting do you work in? (If you do not work in a hospital please SKIP to Question #21)
8.Do you also have a Compact License to practice in other states besides Illinois?
9.What type of hospital do you work at?
10.Do you work at a Magnet accredited hospital? (If your hospital is in process then mark no as they are not complete yet.)
11.Are you aware that Illinois has had a law since 2008 (commonly called a Registered Safe Nurse Staffing Act) that requires hospitals to establish nurse staffing committees?
12.Does your hospital have a staffing committee?
13.Is your staffing committee composed of 50% or more RNs, who work direct patient care at least 50% of the time?
14.Does the staffing committee encourage feedback from nurses related to staffing issues?
15.Are you or have you been a member of your hospital’s staffing committee?
16.If you replied YES to question # 15, does a nurse relieve you when you need to attend a staffing committee meeting on days that you are providing direct patient care?
17.Does your staffing committee re-evaluate at least semi annually the effectiveness of the staffing plan?
18.Does your staffing committee re-evaluate the variations between the staffing plan and the staffing actually occurring?
19.Are the staffing recommendations determined by the staffing committees implemented in the daily staffing census?
20.What percentage of the time is the recommended staffing used?
21.Is your nurse staffing based on the needs of the patients in your unit?
22.Is nurse staffing re-assessed and adjusted based on changes in patient condition, patient needs and on different shifts?
23.If you replied YES to #21, is nurse staffing re-assessed and adjusted due to a change in patient condition?
24.If you replied YES to #21, is nurse staffing re-assessed and adjusted due to caring for the remainder of patients' needs if one patient’s condition becomes critical?
25.If you replied YES to #21 Is nurse staffing re-assessed and adjusted due to the staffing plan just because it’s a different shift?
26.Does your unit have a contingency plan for when the patient care needs unexpectedly exceed direct nurse resources?
27.Is retaliation feared for nurses who provide input about potential for unsafe staffing?
28.Is there an acuity tool that your hospital uses?
29.Do you feel that the nurse to patient ratio in your unit or facility is adequate/safe?
30.If you answered NO to Question # 29, what percentage of the time is your unit not safe.
31.How many patients on average do you normally have on a shift at one time?
32.Does your unit have a charge nurse?
33.Does the charge nurse have a patient assignment?
34.Does your unit use the following ancillary services? Mark all that apply.
35.What is the normal CNA/PCT to patient ratio?
36.Have you ever had to stay over your scheduled shift as "mandatory overtime" to cover scheduling gaps?
37.Does your unit use team nursing with LPN/LVN assist?
38.The next few questions are related to nurse staffing legislation and research. Are you aware there are two (2) federal legislative bills that if passed, would mandate Safe Patient Limits, or Nurse-Patient Ratios? HR 3165/S 1567 Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2021 and HR 1976 Medicare For All Act. HR 3165 would include staffing by acuity, staffing committees, ratios, enforcement and whistleblower protections. California is still the only state that has ratio staffing mandated by state legislation passed in 1999, enacted in 2004. Massachusetts has mandated by state law ICU ratios since 2015.
39.Are you aware that only 8 states have legislation mandating hospitals to have staffing committees responsible for staffing plans and policy – CT, IL, NV, NY, OH, OR, TX, WA?
40.Are you aware of nursing researcher Dr. Linda Aiken, who has conducted and published several papers (4) in Illinois and other states, which showed chronic staffing shortages Pre-Covid, published since 2019?
41.Are you aware that Illinois nurses across the state are seeking regulation to limit the number of patients any nurse in the hospital setting can care for? That bill is “Safe Patient Limits” House Bill 3871. https://www.ilga.gov/legislation/billstat
42.Are you aware that the Illinois Nurses' Association is working collaboratively with other nursing and non-nursing organizations, building a coalition to improve nurse staffing as it directly impacts public safety, improves retention and recruitment of nursing staff?
43.The American Association of Critical-Care Nurses (AACN) resource Moral Distress for Nurses: What You Need to Know defines moral distress as when someone knows the right thing to do, but constraints, conflicts, dilemmas or uncertainty makes it nearly impossible to pursue the right course of action. External factors can impede nurse actions contributing to moral distress such as bullying, incompetent colleagues, and an unhealthy work environment. Organizational factors can include inadequate staffing, lack of resources, pressures to decrease costs, hospital policies, violations in the standards of care, power hierarchy, ineffective communication and financial limitations. Moral distress manifests in both physical, emotional and psychological symptoms. Repeated unresolved episodes of moral distress may lead to moral residue – resulting in nurse burnout, leaving their jobs or the devastating decision to leave nursing altogether. Do you believe you are experiencing or have experienced moral distress in the work environment?
44.Does your work environment provide you with any resources to support staff in determining the level of moral distress and improve staff well-being?
45.If you answered YES to Question # 44, please select all responses that apply:
46.Do you have a routine at the end of the day to transition away from work?
47.Are you able to schedule personal time off from work?
48.Are you able to “detach” from work when you have personal time off?
49.Have you suffered any medical or mental health issues due to moral distress?
50.Have you had to seek medical or mental health support resources due to moral distress?
51.Have you left a nursing position to take another nursing position in the last year?
52.If you answered YES to Question # 51, please choose one or more of the following reasons for leaving that position:
53.If you answered YES to Question # 51, what position did you leave?
54.If you answered YES to Question # 51, did you leave your previous position to another but in the same facility?
55.If you answered YES to question # 51, did you leave to work in another facility?
56.If you answered YES to Question # 51, did you LEAVE to take a contract position, e.g. a travel nurse?
57.Are you considering leaving the nursing profession within the next twelve (12) months?
58.Please select one or more of the following reasons why you may be leaving the nursing profession:
59.If you no longer are choosing to work in a direct care nursing environment, what would draw you back returning to deliver direct care nursing? Check all that apply:
60.In today’s healthcare industry unlicensed assistive personnel (UAP e.g. Medical Assistant, Certified Nurse Assistant, Patient Care Technician) are now expected to perform similar tasks that RNs do. It is typically not a state-licensed/certified profession. This means that UAPs do not typically need specific credentials to practice or accomplish state agency approved standard education/licensure or are accountable to state agency oversight like RNs. All work of the UAP is delegated by a licensed person (i.e. MD, APRN, RN) if allowed in medical/nursing state acts.

The 2019 National Guidelines for Nursing Delegation joint statement by National Council State Boards of Nursing (NCSBN) and the American Nurses Association (ANA) state clinical reasoning, nursing judgment and critical decision making cannot be delegated. Included in their 5 Rights of Delegation are: delegation of the right task, to the right person, in the right circumstance, with the right directions, and the right supervision. The facility is responsible for competency training. The delegatee must possess the appropriate skills and knowledge to perform the activity. The RN should be onsite and available to intervene if necessary (https://www.ncsbn.org/NGND-PosPaper_06.pdf).

A nursing intervention is defined as: “any treatment, based upon clinical judgment and knowledge, that a nurse performs to enhance patient/client outcomes” (Butcher, Bulechek, Docterman, & Wagner, 2018, p.xii).

Do you delegate nursing interventions to unlicensed assistive personnel (MA, CNA, PCT) in your workplace? Including medication administration or IV insertion. It does not include typical UAP patient care activities.
61.Please choose interventions that you have delegated to UAPs. You may choose more than one:
62.When delegating nursing interventions to UAPs (MA, CNA, PCT), are you on site and readily available to directly supervise the UAP?
63.Are you aware of current national research conducted by NursesTakeDC-a nonprofit nursing organization dedicated to educating nurses and supporting state and federal nurse-patio ratio staffing, aka Safe Patient Limits, published in 2022 by the Illinois Economic Policy Institute, which revealed union nurses had improved staffing conditions and combated labor shortages with increased salaries? 
64.At your place of employment are you a member of a union?
65.If you answered YES to Question #64, and therefore you are in a union, please name the Union (and then SKIP to question #67)
66.If you answered NO to Question # 63, are you interested in joining a union?
67.If you wish to add a comment about your experiences working through the Covid pandemic then please do so.