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

Gender:

( )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:
5-Neither Satisfied or Dissatisfied

4- Very Satisfied

3- Satisfied

2- Dissatisfied

1- Very dissatisfied

A. SALARY 5 4 3 2 1
1.Amount of Monthly Pay

(Is the monthly pay enough to sustain needs and other demands?)
2.Receiving of Monthly Pay/Wage Schedule

(Is it always received on time?)

3. Deductions

(Are there deductions in the salary?)

B. DAILY ROUTINE/WORKLOAD 5 4 3 2 1
1.Amount of Workload

(Is the workload just enough for you to function efficiently?)

2.Physical Aspect of Daily Routine

(Are the daily routines too tiring/stressful?)

3.Staffing and Sufficiency of Time

(Are there adequate staff/time to finish all the daily routine

efficiently?)
C. WORK ENVIRONMENT 5 4 3 2 1
1.Facilities

(Are the institution’s facilities complete?)

2.Equipments

(Are there adequate equipments?)

3.Cleanliness and Convenience

(Is the environment clean and convenient to work at?)

D. COLLEAGIAL RELATIONSHIPS/ATTITUDES OF 5 4 3 2 1
CO-WORKERS
1.Friendliness of Co-workers

(Do you and your co-workers get along well with each other?)
2.Respect gained from Co-workers

(Are the colleagues doing their work with respect to fellow

nurses?)
3.Teamwork, Helpfulness and Punctuality of Co-workers

(Are the co-workers approachable when asked for help and do

they go to work on time?)
E. TREATMENT/LEADERSHIP OF SUPERIORS 5 4 3 2 1
1.Attitudes and Considerations

(Do superiors interact nicely, give kind considerations and show

no favoritism to the staff nurses?)

2.Decision-making and Good Communication

(Do the superiors listen and communicate to the nurses concerns

before making decisions?)
3.Response when being approached

(Are the superiors easy to approach when staff nurses have

concerns to talk about?)

F. BENEFITS/MOTIVATION SYSTEM 5 4 3 2 1
1.No. of Benefits

(Does the institution give lot of benefits?)

2.Availability of Benefits

(Are the benefits available for use when needed?)

3.Form of Benefits

(Are there monetary and non-monetary benefits provided?)

G. WORK SCHEDULE 5 4 3 2 1
1.Considerations in Organizing Schedule

(Is the easy adjustment/convenience of nurses considered in

making schedules?)
2.Rest Day Provided

(Does the institution give regular day off for adequate rest?)
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.Feeling of Job Security

(Does the institution provide assurance for steady employment?)

I. RECOGNITION 5 4 3 2 1
1.Recognition from superiors

(Do your superiors recognize/praise you for a job well done?)

2.Recognition from co-workers

(Do your co-workers appreciate you for doing tasks efficiently?)

3.Recognition from physicians

(Do the physicians recognize you for doing your job well?)
J. PERSONAL FULFILLMENT 5 4 3 2 1
1.Enjoyment and Contentment with the Job

(Do you get a feeling of accomplishment from your job?)

2.Autonomy and Confidence

(Does your job give you chances to use your own judgment and
build confidence?)

3.Personal Relationships and Experiences

(Do your personal relationships and experiences in your work

helps you to achieve your goals in life?)

K. PROMOTION/GROWTH OPPORTUNITIES 5 4 3 2 1
1.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. Vacant positions

(Are there vacant positions for promotion?)

3. Availability of Trainings, Seminars and other Activities
(Are there trainings and seminars to prepare you for higher
position and to improve your present job?)
L. WORKING RELATIONSHIP WITH PHYSICIANS 5 4 3 2 1
1.Approachableness and Accessibility of Physicians

(Are the physicians easy to approach?)

2.Interaction with Physicians

(Do the physicians interact with the nurses in a friendly manner?)

3.Collaboration

(Do the physicians have a good working relationship with the

nurses in providing patient care?)

III. Determining the Desire to Work Abroad

Direction: Answer each of the two questions below. Please put a check [✓] inside the
parenthesis that corresponds to your answer.

1. Do you have a desire or plan to go and work in other country?

( )yes ( )no

2. Do the factors mentioned above affect your motivation to go abroad?

( )yes ( )no ( )some factors only

3. 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.

a._____________________
b._____________________

c._____________________

_______________________

Signature of the Respondent