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Burnout Self Assessment Tool

Burnout Self Assessment Tool

Instructions:
Take a moment to reflect on each of the following areas. Rate yourself on a scale of 1 to 10, where 1 represents the least and 10 represents the most in terms of how affected you feel. Use the notes section to identify contributing factors and areas that may need attention.

Click the button below to start.
Your results will be sent to you and to Helen Malinowski for review and support.

Start

Question 1 of 11

1. Emotional Exhaustion: How emotionally drained do you feel by your work or daily responsibilities? How difficult is it to maintain empathy or compassion?

Rating (1-5) 

A

1 - Very Low

B

2- Low

C

3 - Moderate

D

4 - High

E

5 - Very High

Question 2 of 11

 

 

2. Physical Well-Being: How much are you experiencing physical symptoms like headaches, muscle tension, or fatigue? How depleted do you feel physically at the end of the day?

Rating (1 - 5):

A

1 - Very Low

B

2 - Low

C

3 - Moderate

D

4 - High

E

5 - Very High

Question 3 of 11

 

3: Sleep Quality: How much difficulty are you having with falling asleep, staying asleep, or getting restorative rest? How unrefreshed do you feel when you wake up?

Rating (1 - 5) 

A

1 - Very Low

B

2. Low

C

3. Moderate

D

4. High

E

5. Very High

Question 4 of 11

4: Cognitive Function: How much difficulty are you experiencing with concentrating, making decisions, or remembering important information? How mentally foggy or overwhelmed do you feel by simple tasks?

Rating (1-5): 

A

1 - Very Low

B

2 - Low

C

3. Moderate

D

4 - High

E

5 - Very High

Question 5 of 11

 

5: Personal Fulfillment: How much joy or satisfaction do you feel in your work or personal activities? How monotonous do tasks feel? How lacking in purpose?

Rating (1-5): 

A

1 - Very Low

B

2 - Low

C

3 - Moderate

D

4 - High

E

5 - Very High

Question 6 of 11

6: Sense of Efficacy: How much do you doubt your abilities or feel like you're not making a difference? How ineffective do you feel in your work?

Rating (1-5): 

A

1 - Very Low

B

2 - Low

C

3 - Moderate

D

4 - High

E

5 - Very High

Question 7 of 11

7: Cynicism/Detachment: How cynical, detached, or negatively judgmental do you feel toward your work, clients, or colleagues? How much are you just going through the motions without genuine engagement?

Rating(1-5) 

A

1. Very Low

B

2. Low

C

3. Moderate

D

4. High

E

5. Very High

Question 8 of 11

8: Work-Life Balance: How difficult is it to maintain boundaries between work and personal life? How lacking in time do you feel for self-care and relaxation?

Rating (1-5)

 

A

1. Very Low

B

2. Low

C

3. Moderate

D

4. High

E

5. Very High

Question 9 of 11

9: Social Connection: How isolated or disconnected do you feel from colleagues, friends, or family? How lacking in support do you feel?

Rating (1-5)

A

1. Very Low

B

2. Low

C

3. Moderate

D

4. High

E

5. Very High

Question 10 of 11

10: Coping Mechanisms: How much have you noticed an increase in unhealthy coping behaviors (alcohol, substances, overeating, excessive screen time, avoidance)?

 

Rating (1-5)

A

1. Very Low

B

2. Low

C

3. Moderate

D

4. High

E

5. Very High

Question 11 of 11

11: Organizational Support: How lacking in adequate resources, support, and reasonable expectations is your workplace? How undervalued or unfairly treated do you feel?

Rating (1-5)

 

A

1. Very Low

B

2. Low

C

3. Moderate

D

4. High

E

5. Very High

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