Spiritual Care Team Survey

Questions that require an answer are marked with  *
   
This survey is confidential and voluntary. The answers will be used to assist us in providing appropriate support to our staff, never to penalize anyone.
   
   
1 Do you have a self-care plan? (If your answer is NO, please skip to question 4.)
   
   
2 Are you using your self-care plan?
   
   
3 How would you rate the effectiveness of your self-care plan?

(1 = Not Effective , 5 = Very Effective):
   
   
4 Does your self-care focus on: (Check all that apply)
   
   
5 How often do you do something for the sake of “self-care”?
   
   
6 How often do you find yourself feeling stressed, overwhelmed, or anxious at work?
   
   
7 How often do you find yourself feeling stressed, overwhelmed, or anxious about work while not at work?
   
   
8 How would you rate your overall job satisfaction?
   
   
9 How would you rate your overall life satisfaction?
   
   
10 How often do you experience the following?
   
 FrequentlySometimesInfrequentlyNever
Feeling irritable and impatient with coworkers
Feeling irritable and impatient with those you serve/care for
Feeling helpless
Feeling hopeless
Feeling disillusioned
Feeling indifferent, apathetic or cynical about your work
Low creativity
Lack of personal accomplishment
Difficulty finding meaning in your work
Difficulty finding meaning more generally in your life
Feeling appreciated, recognized, important at work
Feeling appreciated, recognized, important more generally in your life
Decreased productivity/difficulty making decisions at work
Decreased productivity/difficulty making decisions more generally in your life