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I feel emotionally or physically exhausted after work.

1 = Never

3= Sometimes

5= Always

For each statement, select the option that best matches your experience:

1 = Never 2 = Rarely 3 = Sometimes 4 = Often 5 = Always

I often feel overwhelmed by the demands of my job.

1= Never

3= Sometimes

5= Always

For each statement, select the option that best matches your experience:

1 = Never 2 = Rarely 3 = Sometimes 4 = Often 5 = Always

At the end of my workday, I am too tired to enjoy personal activities or relationships.

1= Never

3= Sometimes

5= Always

For each statement, select the option that best matches your experience:

1 = Never 2 = Rarely 3 = Sometimes 4 = Often 5 = Always

I sometimes feel detached or indifferent toward my patients or colleagues.

1= Never

3= Sometimes

5= Always

For each statement, select the option that best matches your experience:

1 = Never 2 = Rarely 3 = Sometimes 4 = Often 5 = Always

I find it difficult to empathize with others at work when I’m stressed.

1= Never

3= Sometimes

5= Always

For each statement, select the option that best matches your experience:

1 = Never 2 = Rarely 3 = Sometimes 4 = Often 5 = Always

I feel disconnected from my team or the mission of my work.

1= Never

3= Sometimes

5= Always

For each statement, select the option that best matches your experience:

1 = Never 2 = Rarely 3 = Sometimes 4 = Often 5 = Always

I feel a sense of accomplishment in my role.

Never

Rarely

Sometimes

Always

Often

I believe the care or work I provide makes a meaningful difference.

Never

Rarely

Sometimes

Always

Often

I feel proud of the work I accomplish during my shifts.

Never

Rarely

Sometimes

Always

Often

I feel supported by my team or leadership.

Never

Rarely

Sometimes

Always

Often

I am able to set healthy boundaries with work and colleagues.

Never

Rarely

Sometimes

Always

Often

I am ready to make changes to improve my well-being at work.

1= Never

3= Sometimes

5= Always

For each statement, select the option that best matches your experience:

1 = Never 2 = Rarely 3 = Sometimes 4 = Often 5 = Always