San Juan College Department of Nursing

ADN Employment Questionnaire

Are you currently employed in Nursing?

If YES, continue with this section.

1. Currently employed in nursing


3. In what type of facility are you employed?

5. Did you get the job you wanted?

If NO, complete this section.

7. Not currently employed in nursing (check all that apply)

How well do you feel the program prepared you to achieve the SJC Nursing Program pre-licensure outcomes: Very Well Well Poor Very Poor
1. Create supportive relationships to provide personal, individualized, compassionate care to meet patient needs and goals.
2. Participate cooperatively within nursing and multidisciplinary teams respecting the unique and diverse expertise that team members provide.
3. Integrate best current evidence with clinical practice to meet individualized patient needs and organizational goals.
4. Formulate care and process outcomes to support data driven decisions that improve the quality and safety of health care delivery.
5. Evaluate and mitigate risk of harm within the environment of care through organizational processes and individual performance.
6. Integrate technology to communicate, manage information, minimize error, and support decision making.
7. Exemplify integrity and commitment to a professional work ethic and lifelong learning.

Competency Questionnaire

As part of our ongoing process to ensure that one year following graduation our graduates meet the competencies expected of entry level nursing care, we ask you to complete the following for your practice. Scale of 1-5: One (1) indicates least frequent/effectively and five (5) the highest frequency/effectiveness.

Scale of 1-5: One (1) indicates least frequent/effectively and five (5) the highest frequency/effectiveness. Highest Least
5 4 3 2 1
1. Safely performs the priority technical procedures required by the patient assignment.
2. Establishes and/or revises priorities for job/patient care activities based on acuity of the need.
3. In response to data indicating potential or actual risk to the individual's health, initiates action to correct, reduce, or prevent the risk.
4. Is able to provide rationale for actions or decisions based on evidence and/or standards of practice.
5. Seeks supervision, consultation, assistance when unable to perform effectively or safely independently.
6. Uses interpersonal-communication strategies with individuals that achieve acceptable outcomes/responses and a perception of satisfaction by those involved.
7. Initiates or maintains interventions to assure continuity of safe/effective care for patients
8. Complies with established facility personnel and other workplace policies
9. Uses internal and/or external resources to resolve and/or prevent problems that cannot be managed independently.
10. Develops or revises a plan of care for assigned patients that is based on patient data analysis.
11. Modifies plan of care on the basis of evaluation of effectiveness, efficiency and/or patient satisfaction.
12. Documents interventions/actions, data collection, and outcomes of interventions consistent with established guidelines, using the appropriate health record protocols.
13. Delegates to other team members, indirect/direct patient care tasks based on appropriate team member role and qualifications and patient acuity.

*Modified from Del Bueno,D. Performance Based Development System

For more information, please call Department of Nursing at (505) 566-3224. Or send an email to