MNA LGBTQIA in Healthcare: A Survey for all Nurses

Thank you for completing this survey, which will take approximately 5 minutes of your day.

We realize that a survey such as this is limited in what it can encompass, and that all descriptors or choices may not be fully listed. We welcome your comments and feedback to improve this process and these questions in the future.

All of your answers will be confidential and cannot be traced back to you unless you choose to input your personal information to have further discussion with a staff and/or committee member from MNA.

By answering these survey questions you agree to let us collect this information that may be used for research and education purposes.

Thank you! ~ The MNA Committee for Diversity Inclusion, and Cultural Competency

Question Title

* 1. Number of years working as a nurse

0-5

6-10

11-15

16-20

Greater than 20 years

Prefer not to answer

Question Title

* 2. The gender that I identify with is:

Woman

Man

Gender non-conforming / non-binary / NB

Other

Prefer not to answer

Comments

Question Title

* 3. Do you identify as transgender?

Yes

Prefer not to say

Comment

Question Title

* 4. Please select one that best describes the sexuality you most identify with

Asexual / graysexual

Straight / heterosexual

Gay

Bisexual

Pansexual

Polysexual or multisexual

Queer

Transgender

Lesbian

Questioning

Other (please specify) or comments

Question Title

* 5. In my current or most recent nursing work setting, my sexual orientation or gender identity is:

Well represented among other nurses

Under represented among other nurses

I am one of the only nurses of my sexual orientation

Prefer not to answer

I don't know / not able to identify sexual orientation of coworkers

Comments

Question Title

* 6. In my current or most recent nursing work setting, nurses from my identified sexual orientation and/or gender identity are:

Well represented in leadership, on committees, and in other decision-making capacities

Under represented in leadership, on committees, and in other decision-making capacities

Not at all represented in leadership, on committees, and in other decision-making capacities

Prefer not to answer

Comments

Question Title

* 7. In my current or most recent nursing work setting, I feel comfortable addressing healthcare issues related to sexual orientation and/or gender identity:

Yes

Prefer not to answer

If no, please explain:

Question Title

* 8. In my current or most recent nursing work setting, I am aware of nurses that have been unfairly disciplined and/or terminated related to issues surrounding sexual orientation and/or gender identity.

Yes

Prefer not to answer

If yes, please explain:

Question Title

* 9. In my current or most recent nursing work setting, I have had patients express discomfort/dissatisfaction with the perceived sexual orientation and/or gender identity of their healthcare provider.

Yes

Prefer not to answer

If yes, please explain:

Question Title

* 10. In my current or most recent nursing work setting, I have felt as if I needed more information to adequately or correctly care for patients of varying sexual orientations and/or gender identities.

Yes

Prefer not to answer

If yes, please explain:

Question Title

* 11. In my current or most recent nursing work setting, I have received or observed verbal and/or physical aggressions from patients or staff towards myself or another healthcare professional related to sexual orientation and/or gender identity.

Yes

Prefer not to answer

If yes, please explain:

Question Title

* 12. In my current or most recent nursing work setting, I have witnessed inequitable, substandard or unfair treatment of patients based on sexual orientation and/or gender identity.

Yes

Prefer not to answer

If yes, please explain:

Question Title

* 13. Please check the boxes next to the terms that you feel comfortable defining:

biological sex

gender identity

gender expression

gender presentation

sexual orientation

None of the above / I don't feel I can adequately define any of these terms

Comments

Question Title

* 14. Please select how much knowledge you currently have to provide accurate care for transgender individuals:

No knowledge

Don't have enough knowledge

Neutral

I have some knowledge

I have enough knowledge

No knowledge

Don't have enough knowledge

Neutral

I have some knowledge

I have enough knowledge

Comments:

Question Title

* 15. Please select how well you can use or ask about accurate pronouns when talking with or about individuals:

No knowledge

Don't feel I have enough knowledge

Neutral

I have some knowledge

I have enough knowledge

No knowledge

Don't feel I have enough knowledge

Neutral

I have some knowledge

I have enough knowledge

Comments:

Question Title

* 16. Please share any personal story that reflects your experiences in healthcare as related to sexual orientation and/or gender identity.

Question Title

* 17. Please provide any other comments, issues, or concerns that you have related to your nursing practice, and how to incorporate knowledge of varying sexual orientations into your care, especially how MNA can assist in addressing those topics:

Question Title

* 18. Optional Information if you would like follow up communication from MNA

Name:

Email:

Phone:

Preferred method of communication