Nurse Support Survey

Thank You for taking a moment to share your preferences about Nurse Stress Support. Your answers are important to us!

Once you submit your survey, you will receive a Thank You form containing your link to a special relaxation audio gift that I prepared for you!

Your survey answers are strictly confidential. Below the survey is a way for you to enter your name and e-mail address, if you would like additional information on Nurse Support and the results of the survey. Your e-mail address is not connected with your survey answers.

Warmest :)))
Aila

WV Nurse Support Survey

How much stress do you experience as a nurse?
None
Mild
Moderate
Continuous
Intolerable
How do you deal with your stress?
(Check all that apply)
Smoke
Drink caffeine
Drink alcohol
Take over the counter medication
Meditate
Excercise
Talk to a friend
Eat
Take prescription medications
Other
If Other, What do you do?
Have you ever sought help for stress?
Yes
No
If yes, what kind of resource did you consult?
Are the following resources available to you?
(Check all that appy)
Employee Wellness Program
Pastoral Care
Employee Assistance Program (EAP)
Nurse Support Group
Therapist/Counselor
Do you know a nurse who is stressed?
Yes
No
If there was an accessible, confidential nurse support group,
would you use the service?
Yes
No
Possibly
Have you ever talked with another nurse about stress related issues?
Yes
No
Wanted to but didn't
Would you participate in a wellness program just for nurses?
Yes
No
Possibly
If you knew a nurse needed help with stress or addiction
what would you do?
Ignore or deny the signs
Share your concerns with the nurse
Report the nurse to supervisor
Discuss the nurse with others
Other
If Other, What would you do?
Please share any additional comments.

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If you would like more information about the Nurse Care Network and the results of this Nurse Support Survey, Please enter your first name and e-mail address below. Your name and e-mail are recorded separately from your survey answers. The survey is strictly confidential. We will not share your e-mail with anyone.

Name
Email


Please feel free to contact Aila on the form below if you have questions or would like more information.

Contact Aila

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E-mail Address*
Street Address*
City*
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Business Phone
Comments & Questions

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