This questionnaire is about your job as a nurse. Please feel free to answer the questions and respond. Thank you for your time!
1.) What type of nursing licensure do you have? Please check or type your title. ____LPN_____RN______Other
2.) How long have you been a nurse?
A. Less than one year B. 1-3 Years C. 4-6 Years D. 7-10 Years E. 10 Years or more
3.) What annual salary do you expect as a nurse with your amount of experience?
A. $35,000 - $45,000
B. $45,000 - $55,000
C. $55,000 - $65,000
D. $65,000 - $75,000
E. $75,000 or more
4.) What type of nursing education have you received?
A.) Diploma
B.) ADN
C.) BSN
D.) MSN
E.) Ph.D
F.) Other___________
5.) What type of facility do you work for?
A.) Hospital B.) Long-Term Care Facility C.) Home Care D.) Other _________________
6.) Have you ever worked on a medical/surgical floor? A. Yes B. No
7.) What shift do you work?
A.) 7:00 A.M.- 7:00 P.M. B.) 7:00 P.M. - 7:00 A.M. C.) 7:00 A.M. - 3:00 P.M.
D.) 3:00 P.M. - 11:00 P.M. E.) 11:00 P.M. - 7:00 A.M. F.) Other___________
8.) Do you like being a nurse?
Very Often_______Often_______Sometimes________Rarely________Not at all______
9.) What kind of nurse are you? (OB, Critical Care, ER, etc.)
_____________________________________________________
