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How often are you able to eat during an shift in the ED?
 
I always make it a priority to eat during a shift
 
I sometimes eat during a shit (50% of the time)
 
I rarely eat during a shift (25% or less)
 
Food, what's that? I never eat during a shift because I am famine resistant.
 
 
 
How much water do you drink while you are on shift in the ED?
 
I don't need liquids. I am drought resistant.
 
I don't really think about it, maybe a drink if I happen to get lunch
 
1-2 glasses of water
 
I drink at least 1-2 Liters/day
 
 
 
How often do you exercise?
 
I don't have time to exercise
 
Couple times a month
 
1-2 times a week
 
More than 5 days/week
 
 
 
After a shift, my ____ hurts:
 
shoulder
 
back
 
neck
 
all of the above
 
none of the above
 
Other
 
 
 
 
When it comes to my own health I . . .
 
Schedule regular appointments with my primary care doctor and my dentist
 
I only see a doctor/dentist if something is seriously wrong
 
I do not have time to see a doctor or dentist
 
 
 
How many servings of fruits and vegetables do you have each day?
 
None (Are coffee and splenda fruits and veggies?)
 
1-2 (I get veggies in my breakfast burrito)
 
2-4
 
5 +
 
 
 
In the past 6 months I have felt ____
 
Alone
 
Depressed
 
Burned Out
 
Exhausted
 
Other
 
 
 
 
I spend quality time with my family, friends and loved ones
 
Every day
 
Several times a week
 
Once a week
 
Once a month if I'm lucky
 
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