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Demographic Profile


Direction: Please put a check [✓] inside the parenthesis that corresponds to your answer.

Name(Optional): _______________________

Age Group:

( )20-24 ( )30-34 ( )40-above

( )25-29 ( )35-39


( )Male ( )Female

Civil Status:

( )Single ( )Married

( )Single Parent ( )Widow

Length of Service/Tenure:

( )less than 1 year ( )6-10 years ( )more than 20 years

( )1-5 years ( )11-20 years

Educational Attainment:

( )BSN ( )MSN

( )MAN ( )Other(specify):_______________

Working Area:

( )Wards ( )ICU ( )Dialysis Unit

( )O.R./D.R./NICU ( )E.R./O.P.D.

II. Assessment of Level of Satisfaction

Direction: Below are the factors that affect/influence nurses’ job satisfaction. Please rate
the following factors by putting a check [✓] on the column that corresponds to your
answer. Use the legend that follows:

Physical Aspect of Daily Routine (Are the daily routines too tiring/stressful?) 3.Amount of Monthly Pay (Is the monthly pay enough to sustain needs and other demands?) 2.Equipments (Are there adequate equipments?) 3. Deductions (Are there deductions in the salary?) B.Amount of Workload (Is the workload just enough for you to function efficiently?) 2.Dissatisfied 1. DAILY ROUTINE/WORKLOAD 5 4 3 2 1 1.Satisfied 2. COLLEAGIAL RELATIONSHIPS/ATTITUDES OF 5 4 3 2 1 CO-WORKERS .Receiving of Monthly Pay/Wage Schedule (Is it always received on time?) 3. SALARY 5 4 3 2 1 1.Very dissatisfied A.Cleanliness and Convenience (Is the environment clean and convenient to work at?) D.Very Satisfied 3.Facilities (Are the institution’s facilities complete?) 2. WORK ENVIRONMENT 5 4 3 2 1 1.5-Neither Satisfied or Dissatisfied 4.Staffing and Sufficiency of Time (Are there adequate staff/time to finish all the daily routine efficiently?) C.

Response when being approached (Are the superiors easy to approach when staff nurses have concerns to talk about?) F.Teamwork. TREATMENT/LEADERSHIP OF SUPERIORS 5 4 3 2 1 1.Respect gained from Co-workers (Are the colleagues doing their work with respect to fellow nurses?) 3.Decision-making and Good Communication (Do the superiors listen and communicate to the nurses concerns before making decisions?) 3.Considerations in Organizing Schedule (Is the easy adjustment/convenience of nurses considered in . BENEFITS/MOTIVATION SYSTEM 5 4 3 2 1 1.No.Availability of Benefits (Are the benefits available for use when needed?) 3.1.Form of Benefits (Are there monetary and non-monetary benefits provided?) G. of Benefits (Does the institution give lot of benefits?) 2. WORK SCHEDULE 5 4 3 2 1 1. give kind considerations and show no favoritism to the staff nurses?) 2. Helpfulness and Punctuality of Co-workers (Are the co-workers approachable when asked for help and do they go to work on time?) E.Attitudes and Considerations (Do superiors interact nicely.Friendliness of Co-workers (Do you and your co-workers get along well with each other?) 2.

Recognition from co-workers (Do your co-workers appreciate you for doing tasks efficiently?) 3.Grants of Day Off Requests (Does the institution grant it whenever you request for a day off?) H. JOB SAFETY/SECURITY 5 4 3 2 1 1.Safety in the workplace (Does the institution strictly implement safety measures and precautions?) 2.Physical Security (Can the institution provide adequate security personnel?) 3.Rest Day Provided (Does the institution give regular day off for adequate rest?) 3.Autonomy and Confidence (Does your job give you chances to use your own judgment and build confidence?) 3.Feeling of Job Security (Does the institution provide assurance for steady employment?) I. RECOGNITION 5 4 3 2 1 1.Recognition from physicians (Do the physicians recognize you for doing your job well?) J.Enjoyment and Contentment with the Job (Do you get a feeling of accomplishment from your job?) 2.Personal Relationships and Experiences (Do your personal relationships and experiences in your work .Recognition from superiors (Do your superiors recognize/praise you for a job well done?) 2. PERSONAL FULFILLMENT 5 4 3 2 1 1.making schedules?) 2.

_____________________ . Do the factors mentioned above affect your motivation to go abroad? ( )yes ( )no ( )some factors only 3. a. Availability of Trainings.Approachableness and Accessibility of Physicians (Are the physicians easy to approach?) 2.Collaboration (Do the physicians have a good working relationship with the nurses in providing patient care?) III. Seminars and other Activities (Are there trainings and seminars to prepare you for higher position and to improve your present job?) L. Please put a check [✓] inside the parenthesis that corresponds to your answer. Vacant positions (Are there vacant positions for promotion?) 3.helps you to achieve your goals in life?) K. PROMOTION/GROWTH OPPORTUNITIES 5 4 3 2 1 1. Determining the Desire to Work Abroad Direction: Answer each of the two questions below.Chances of Improvement (Are there opportunities to do something that makes use of my abilities and chances to try my own method to do the job?) 2. Do you have a desire or plan to go and work in other country? ( )yes ( )no 2. Which of the factors mentioned above has the greatest influence to your decision to go or not to go abroad? Enumerate at least three factors. WORKING RELATIONSHIP WITH PHYSICIANS 5 4 3 2 1 1.Interaction with Physicians (Do the physicians interact with the nurses in a friendly manner?) 3. 1.

_____________________ _______________________ Signature of the Respondent .b._____________________ c.