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How many years have you been a registered nurse?
 
(6months- 10yrs)
 
(11-20yrs)
 
(21-30yrs)
 
(>31yrs)
 
 
 
How old are you in years?
 
(18-30yrs)
 
(31-40yrs)
 
(41-50yrs)
 
(>51yrs)
 
 
 
How many years have you worked on a medical/surgical unit?
 
(6months-10yrs)
 
(11-20yrs)
 
(21-30yrs)
 
(>31yrs)
 
 
 
How confident are you in your ability to prepare a family for the death of a loved one?
 
(Very confident)
 
(Fairly confident)
 
(Not confident)
 
 
 
How confident are you in providing emotional support for family members before a loved one's death?
 
(Very confident)
 
(Fairly confident)
 
( Not confident)
 
 
 
How confident are you in your ability to discuss religious and spiritual beliefs with family members prior to a loved ones' death?
 
(Very confident)
 
(Fairly confident)
 
(Not confident)
 
 
 
How confident are you in your ability to assess the needs of family members who have just lost a:
 
Parent...
 
(Very confident)
 
(Fairly confident)
 
(Not confident)
 
Spouse....
 
(Very confident)
 
(Fairly confident)
 
(Not confident)
 
Child.....
 
(Very confident)
 
(Fairly confident)
 
(Not confident)
 
 
 
How confident are you in your ability to advise family members who have just lost a:
 
Parent....
 
(Very confident)
 
(Fairly confident)
 
(Not confident)
 
Spouse....
 
(Very confident)
 
(Fairly confident)
 
(Not confident)
 
Child.....
 
(Very confident)
 
(Fairly confident)
 
(Not confident)
 
 
 
How confident are you in speaking to family members regarding advance directives?
 
(Very confident)
 
(Fairly confident)
 
(Not confident)
 
 
 
How confident are you in providing physical and emotional care to a bereaved family member who just experienced a loss?
 
(Very confident)
 
(Fairly confident)
 
(Not confident)
 
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