If you have been employed at CNH for <1 year did you receive adequate orientation and mentorship before you were allowed to practice on your own?
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What shift do you work?
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Days (7a-7p)
Eves (3p-11p)
Nights (7p-7a)
Rotating
How many hours do you normally work per day?
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8 hours
10 hours
12 hours
What unit/department are you assigned to?
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Emergency Department
OR
PACU
CPRU
Hem/Onc
Cath Lab/Interventional Radiology
Central Staffing Office
Acute Care Float Pool
Critical Care Float Pool
Pediatric ICU
Cardiac ICU
Neonatal ICU
HKU
Transport
4 Main
NSU
SCU
GI/IRU
7 East
Radiology
MRI
APU
CPU
Outpatient Clinics
Dialysis
ECMO core
Other
If "other" please specify.
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My average workload is (i.e… RN/Patient ratio per shift; # of cases per day/week; # of consults per day/week; # of medication orders processed per shift; etc.):
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Staffing has been a problem on my unit _____ times per month for the past 12 months
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Have you experienced changes to staffing patterns or other conditions of work that have impacted your ability to deliver safe care or that you feel has placed your license at risk?
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Do you want to share specific instances from the question above?
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Have you ever submitted an "Assignment Despite Objection" Form to report staffing issues?
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If you have never filled out an ADO form what is the most likely reason?
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My unit is adequately staffed
My supervisor makes changes based on complaints about staffing
I don't know how to access the form
I feel intimidated by my supervisor(s)
I don't think it would make a difference
I worry about retalliation
Other
N/A, I have filled one out before
Would you like to add more info from your answer above?
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Have you been forced to work without appropriate supportive staff (i.e… CPS, ET, PCT, RT, RTA, UCA, USA)?
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If yes to the above, about how many times per month does that happen?
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In the past 12 months I have been floated ___ times
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Please use this space to express any additional concerns/comments you have that you would like us to hear:
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