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Virginia Mason Breaks Mini-Survey
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1.
First and Last Name:
(Required.)
2.
Home unit/department
Bronchoscopy
CCU
CP 16 Pulm/Thoracic/Specialty
CP10 Medical
CP12 Short Stay
CP14 Medical
CP15
General Surgery
CP17 Neuro, Neph, Transplant
CP7 Med Surg
CP8 Telemetry
CP9 Progressive Care
Float pool
Hyperbaric
IV Therapy
Jones 11 Ortho
Jones 18
Jones 7 ED
Jones IPC Cath Lab
Jones IPC EP lab
Jones IPC GI
Jones IPC IR
Jones IPC Prep/ Recovery OIC
OR PAAC PACU
Resource
Float Pool
IV team
CP7 med surg/ITA holds
Wound Ostomy
3.
Shift:
Days
Nights
Evenings
4.
Contact email address and/or phone number for follow-up questions (do not use your work email):
5.
On average, how many 15-minute rest breaks do you miss during each shift? (Note: You are entitled to 2 rest breaks during each 8-hour or 10-hour shift and 3 rest breaks during each 12-hour shift.)
0 – I get all of my rest breaks.
I miss 1 rest break during an average shift.
I miss 2 rest breaks during an average shift.
I miss 3 rest breaks during an average shift.
6.
On average, how often do you miss your 30-minute meal period?
I rarely or never miss my meal break
I occasionally miss my meal break (25% of the time)
I regularly miss my meal break (About 50% of the time)
I often miss my meal break (More than 50% of the time)
I almost always miss my meal break
7.
When you do take a rest or meal breaks, who usually covers your patient care assignment?
A break buddy/another staff nurse on my floor
The charge nurse
A dedicated break relief nurse
Other (please specify)
8.
Which break coverage role do you think would work best in your unit?
A break nurse assignment that is equitably rotated among the nurses in our unit
A dedicated break nurse position whose main job is to provide break relief every shift
Other (please specify)
