Graduate Follow-up Study

Employment Data

A.

Are you currently employeed in nursing?
Yes - Full time
Yes - Part time
No - but actively seeking employment in nursing
No - not actively seeking employment in nursing
No - but working in another field (please specify)

B.

If not currently employeed, what is/are the reason(s)?
Family responsibilities
Attending school
Lack of positions available in geographic area
Lack of positions available in speciality
Other (please explain)

C.

Which type of facility are you currently employeed in?
Hospital
Nursing Home/Extended Care Facility
Home Health Agency
Public Health Department
Nursing School
Physician's Office
School
Business/Industry
Private Duty
Other (please specify)

D.

Name & Address of agency where currently employeed.

E.

What is your current area of clinical nursing practice?
Maternal-child health
Medical-surgical (adult)
Psychiatric/mental health
Operating/recovery room
Critical care/emergency
Occupational health
Physician's office
Industry
Education/staff development
Home health/community health
Ambulatory care/clinics
Extended care/nursing home
School nurse
Other (please specify)

F.

What is your present position?
Staff Nurse
Educator
Supervisor
Asst. Supervisor
Head Nurse
Asst. Head Nurse
Administrator

G.

How long have your worked in your present position?
less than 6 months 3 years
1 year 4 years
2 years 5 years

H.

How many positions have you held since graduation?

Education

Have you taken college courses since graduation?
Yes No

If yes:
Degree Sought:
Number of credits earned:
Degree Earned:

B.

Have you attended continuing education programs since graduation?
Yes No

C.

Have you received any specialty certifications since graduation?
Yes No

Areas of Certification:

D.

Have you participated in some type of clinical/career ladder advancement program since graduation?
Yes No

If so, what is your current level of experience?

LPN II
LPN III
Other
Other:

Professional Life

A.

Please list the professional organizations to which you have belonged since graduation. Please include length of membership.

B.

List the professional journals you read on a fairly regular basis.

C.

List committe/boards on which you have served since graduation.
Please include both those at work and in professional organizations.

D.

List community activities in which you participate.

E.

Please rate how well you feel Lynchburg General Hospital School of Nursing prepared you to meet your professional expectations after graduation.
1 - Below Average
2
3 - Average
4
5 - Above Average

Comments:

Name:
Current Address:
Year of Graduation: