About you Question Title * 1. What's your gender identity? Female Male Decline to state Question Title * 2. What’s your age? <20 20-25 26-30 31-35 36-40 41-45 46-50 51-55 56-60 >60 Question Title * 3. Where do you live? New England: CT, ME, MA, NH, RI, VT Middle Atlantic: NJ, NY, PA East North Central: IL, IN, MI, OH, WI West North Central: IA, KS, MN, MO, NE, ND, SD South Atlantic: DE, DC, FL, GA, MD, NC, SC, VA, WV East South Central: AL, KY, MS, TN West South Central: AR, LA, OK, TX Mountain: AZ, CO, ID, MT, NV, NM, UT, WY Pacific: AK, CA, HI, OR, WA Canada Other (please specify) Question Title * 4. What’s your current title? CEO/COO Adminstrator Vice President Director Nurse Manager Asst. Nurse Manager Case Manager Supervisor Educator Consultant Other (please specify) Question Title * 5. How long have you been in nursing? 1-2 years 3-5 years 6-10 years 11-15 years 16-20 years 21-25 years 26-30 years >30 years Question Title * 6. How long have you held your current position? 1-2 years 3-5 years 6-10 years 11-15 years 16-20 years 21-25 years 26-30 years >30 years Question Title * 7. What’s your level of education? Doctoral degree MSN Master's degree - other BSN Bachelor's degree - other ADN Diploma in nursing Other (please specify) Question Title * 8. Are you nationally certified in nursing administration or your clinical specialty? Yes No If yes, what’s your certification? Next
