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Garfield Medical Center – ER and ER Overflow Survey
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Step
1
of
2
50%
Name
(Required)
First
Last
Email
(Required)
Phone
Text message opt-in
Opt in to receive text messages from SEIU 121RN
* By providing my mobile phone number and checking the box above, I understand that SEIU and its locals and affiliates may use automated calling technologies and/or text message me on my mobile phone on a periodic basis. SEIU will never charge for text message alerts. Carrier message and data rates may apply to such alerts. Text STOP to 787753 to stop receiving messages. Text HELP to 787753 for more information.* By providing my mobile phone number, I understand that SEIU and its locals and affiliates may use automated calling technologies and/or text message me on my mobile phone on a periodic basis. SEIU will never charge for text message alerts. Carrier message and data rates may apply to such alerts. Text STOP to 787753 to stop receiving messages. Text HELP to 787753 for more information.
Department Name
ICU
Tele
Emergency Department
Med Surg
OR/PACU
Acute Rehab
Mother Baby (L&D, NICU, Postpartum, Nursery)
Cath Lab
Critical Care Units (ICU, CCU, CSU)
GI Lab
Surgery
FTE Status
(Required)
Full-Time
Part-Time
Per-Diem
Shift Status
(Required)
Day
Night
Evening
Other
How long have you worked as an RN? (Your years of experience in the field)
YOE in years in the field
YOE months in the field
How long have you worked at your facility? (Your years of service at your hospital)
Years of service at the facility
Years of service in months at the facility
Do you work at other hospitals in addition to this facility?
(Required)
No
Yes
Please list the other hospital(s) where you work
Meal/Break Coverage
Instructions: Please select one or more (if applicable)
Have you been unable to take meals or breaks due to your charge nurse being unavailable to cover?
Yes
No
How often does this happen?
More than 75%
50% to 70%
25% to 50%
Less than 25%
How often does the house supervisor have to cover your meals or breaks because the charge nurses are busy?
Always
Usually
Rarely
Never
Has the house superisor refused to cover your meal or breaks because the charge nurse is unavailable?
Yes
No
Has your charge nurse refused to sign your misses meal or break form?
Yes
No
Does management make you feel like you will be disciplined for turning in a missed meal or break form?
Yes
No
Are there any comments you would like to add or priorities you don’t see listed above that you want the bargaining team to consider?
Published On: February 26, 2026
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Categories:
Garfield Medical Center
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