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El arte de esfumarse: crisis de la cultura consensual

All who renew their license should be required to complete the survey before their license is renewed. If they are not actively nursing there are still several survey items that they need to answer.

B. Specific recommendations for the items on the Indiana RN E-Survey instrument used in 2005:

1.Current Work Status. For those selecting responses options OTHER than “a. currently a paid position

related to nursing” (response option 1) or “d. working in nursing, but ONLY on a non-paid basis”, skip to question 10 and continue. Most web-based survey packages have the capability to automatically skip to future questions depending on their responses. Those selecting either response option a. or d. should continue with question 2. No changes recommended to the response options.

2.Principal Work Location. The instructions indicate that those not working in paid positions should

enter the Zip Code of their residence. However, their residence Zip Code is likely to be the one to which the license will be mailed, so it is recommended that this part of the instructions be removed – note that item 1 above instructs the respondent to skip to question 10 if they are not working in a paid nursing position.

3.More than One Paid Position. Most, (86%) work in only one paid position as a nurse. If the percentage

who work in more than one position increases significantly in the future, follow up questions should be added about their secondary work location, setting and position.

4.Principal Position. The response options for this question are a significant problem and need to be

addressed. Please see Dr. Przybylski’s analysis report on pages 4 to 8 of this appendix. The 34 option list used in 2005 included some settings as well as positions. It is recommended that the response options for this question match the 37 options listed in the 2004 National Sample Survey of Registered Nurses, item 24 (see page 16 below). Not only will this change clear up some confusion, but it will also allow comparisons with the National Survey results.

5. Principal Position time in Indiana. No changes recommended.

6. Setting. The response options for position in #4 above occasionally overlap with setting (i.e. operating

room nurse). This item is also included in Dr. Przybylski’s analysis report on pages 4 to 5 and 9 to 13 of this appendix. Again, it is recommended that the response options here match the 10 major categories (and perhaps some or all of the sub-categories) listed in the 2004 National Sample Survey of Registered Nurses, for item 23 and shown on pages 9-12 below.

7. Activities in Principal Position. Respondents are instructed to mark all that apply. No changes

recommended.

8. Age of patients. Many respondents marked multiple categories even though they were asked to indicate

the age of patients that they most frequently serve. The multiple responses were encouraged because

question also assumes that the respondent provides direct patient care. Some respondents were apparently

inconsistent in their response to this question in that they listed (an) age group(s) here while claiming elsewhere to not be involved in direct patient care. This question would be best placed as a follow-up to the “direct patient care” response to the “key activities” question.

9. Hours per week nursing. Few nurses worked less than 20 hours per week (less than 7%), even fewer

worked less than 10 hours per week (2.5%). Thus, the categories “9 hours or less” and “10-19” could be combined into a “less than 20 hours” category. A significant problem exists with the “30-39” hour category. While normally 40 hours per week would be considered full time, some facilities consider 36 hours (3 days X 12 hours) full time. Other creative arrangements have been made to attract and retain nurses that involve even fewer hours of work to be considered “full-time,” such as working 12 hour shifts on the weekend days every weekend. The current grouping does not allow for identification of the “full time” nurses versus “part-time.” Again, it is suggested that this item follow the format similar to the related items on the National Sample Survey of Registered Nurses as two separate questions:

30. When you work at this principal nursing position, do you work…?  Full-time  Part-time 33a. Number of hours worked in your last full workweek (including paid hours of on-call duty

and overtime) ___ ___

10. Worked as a CNA, Nursing assistant, Paramedic, EMT. It is suggested that the items from question

11 (LPN or LVN) be added to the list.

11. Worked as a LPN or LVN. It is recommended that this item be omitted if the response options are

added to #10.

12. to 16. No changes recommended

17. Foreign language spoken. Very few (less than 5%) of respondents indicated that were fluent in a

foreign language – including Spanish. With the growing Hispanic population in Indiana, it is important that to know what percentage of the RNs can speak Spanish. However, since so few (2.2%) could speak a language other than English or Spanish, is it necessary to ask about their ability to speak languages other than Spanish (and English)? It is recommended that this question only ask if the respondent can speak Spanish fluently. Also, fluency is quite a high standard in language proficiency. Perhaps asking about an “ability to communicate” would result in higher percentages and retain the intent to measure language proficiency.

18. to 20. If these are in the permanent RN licensure database – they don’t need to be asked on the survey.

It is recommended that these items be omitted.

Why left nursing: If you are not currently working for pay in nursing, what is the primary reason(s) for not

actively working as a nurse? PLEASE SELECT ALL THAT APPLY (NSSRN #59 -- modified)

 I have never worked in a paid position as a registered nurse.

 Burnout/stressful environment

 Career advancement/promotion

 Disability/illness

 Interested in another position/job

 Laid off/downsizing of staff

 Pay/benefits

 Relocated

 Retired

 Other: _______________________________

Advanced Training: Since graduating from your initial nursing program, have you completed a formal

education program preparing you for advanced practice nursing as a clinical nurse specialist, nurse anesthetist, nurse-midwife, or nurse practitioner? (NSSRN #12 -- modified)

 No

 Yes Æ Are you currently certified as a:

 Clinical Nurse Specialist

 Nurse Anesthetist

 Nurse-midwife

 Nurse Practitioner

Income: Please estimate your current, gross annual earnings (pre-tax) from your principal nursing position.

Include overtime and bonuses, but exclude sign-on bonuses. ___ ___ ___ , ___ ___ ___ . 00 (NSSRN #34)

D. Other data from the permanent licensure database to be added to the survey responses for the report: • Age = Month/year of survey – birth month/year

• Gender

• Race

• Hispanic

• Name of school where nursing training was completed

• Location of school where nursing training was completed

• Years registered as a nurse = Year of survey - year first registered as a nurse

Part 2: Principal Nursing Positions and Settings