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WCWI'S EMPLOYEE BURNOUT SURVEY - MASTER

Assessing Employee Experiences with Symptoms of 
Burnout & Wellbeing Support

For many of us, a third of our lives will be spent working. Burnout has become a concern for organizations as many employees are currently experiencing work-related and life-related stress. Your wellbeing is important to your employer. Providing this survey is part of your employer’s ongoing commitment to create a positive and wellbeing-supportive work experience. The questions will gather an understanding of how you’re feeling and your experiences with symptoms of burnout especially related to the workplace culture, the demands of your job, your relationships at work, the support you have, and the challenges you’re facing. 

This survey is to gather information only. Your personal information will not be collected and survey responses will be shared with your employer in de-identified summary only. Completing this survey will take about 15 minutes. Your participation will contribute to WCWI’s statewide effort to collect the experiences of employees across Wisconsin’s employers. WCWI believes that employee wellbeing is a foundational strategy and business priority for every employer of all sectors, industries, and sizes. The statewide survey data will inform Wisconsin employers for the purpose of developing meaningful strategies to impact the wellbeing of their employees.

 

Definitions of common terms used in the survey:

  • Burnout: Burnout is a condition resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions: (1) feelings of energy depletion or exhaustion; (2) increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and (3) reduced professional efficacy [Definition from World Health Organization]
     
  • Energy: the strength and vitality required for sustained physical or mental activity [Definition from Oxford Dictionary]
     
  • Wellbeing: includes the quality of your relationships, your positive emotions and resilience, the realization of your potential, the physical health of your body, the health of your mind, and your overall satisfaction with life. [Definition from Centers for Disease Control and Prevention]
     
  • Mental Health: includes your emotional, mental, and social wellbeing. Mental health affects how you think, feel, and act. It also is a part of how you handle stress, relate to others, and make choices. [Definition from US Department of Health and Human Services]
     
  • Coping: the use of cognitive, behavioral, or physical strategies to manage the demands of a situation that exceeds your resources or to reduce the negative emotions and conflict caused by stress [Definition from American Psychological Association]

Section 1:

The purpose of these questions is to collect demographic and background data that will best inform employee experiences with symptoms of burnout.

 
How long have you worked at this organization? 
 
What best describes your job function? 
 
What is your income? 
 
What is your age? 
 
What is your gender identity? 
 
How do you describe your ethnicity? (Select all that apply.) 
American Indian or Alaska Native
Asian
Black
Latino/Latinx or Hispanic
Mixed Race Bi-racial 
Native Hawaiian and other Pacific Islander
White
Prefer Not to disclose
 
Please select all groups that you identify with: 
LGBTQ+
BIPOC
Veteran or active military
Person with disability(ies) 
Other 
 
Are you a caregiver? (examples of caregivers include but are not limited to: biological parent, adoptive parent, foster parent, legal guardian, caregiver to elderly relative, caregiver to relative with physical or mental disability, chronic illness, caregiver to adult child unable to care for themselves or child with chronic illness or disability) 
 
What is your current employment status?  
 
Which of the following best describes your position? 
 
Please list your most valued wellbeing-supportive benefits that are currently offered at your organization 
 
 
Please list benefits that you would find valuable in support of your wellbeing that are not currently offered at your organization 
 

Section 2:

These questions will assess your experiences with symptoms of burnout. Please answer honestly; survey responses will be shared with your employer in de-identified summary only. Supportive resources will be shared with you at the end of this survey. 

 
1. I am often physically exhausted 
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
2. I am often mentally exhausted 
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
3. I have experienced a significant life event and/or trauma within the last year 
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
4. I have felt depressed or anxious within the last year
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
5. I participate and/or have participated in healthy coping strategies when I feel exhausted and worn out within the last year (example include, but not limited to: exercise, rest, meditation, journaling, talking with loved ones)
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
6. I participate and/or have participated in unhealthy coping strategies when I feel exhausted and worn out within the last year (example include, but not limited to: drinking alcohol, using substances, withdrawing from loved ones or avoiding social connections) 
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
7. I tend to bounce back quickly after challenges
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree  
 
8. I am afraid of failure
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
9. I often find joy in my life
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
10. It is difficult for me to set boundaries in my life
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
11. I engage in behaviors that place a strong priority on my physical health
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
12. I engage in behaviors that place a strong priority on my mental health
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
13. I feel financially secure
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
14. Financial challenges are one of my greatest sources of stress
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
15. Thinking of your energy as a gas tank that is full, empty, or somewhere in between - what percent of energy are you operating from on a daily basis? (example: 100% = highest quantity + quality of energy, 0% = lowest quantity + quality of energy)
0-25%26-50%51-74%75-99%100%
 

Section 3:

These questions will assess work-related factors that may contribute to or influence your experiences with burnout. The factors assessed in this section will include the workplace culture, environment, manager and co-worker relationships, and your experience with your job and workload. Please answer honestly; survey responses will be shared with your employer in de-identified summary only. 

 
16. My company demonstrates a commitment to the wellbeing of employees
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree  
 
17. I feel supported in my wellbeing when I’m working
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
18. I have autonomy over my work
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
19. I am treated fairly in my workplace
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
20. I feel emotionally drained by the work I am doing
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree 
 
21. I feel frustrated by the work I am doing
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
22. I feel exhausted in the morning at the thought of another day of work
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
23. After work, I have little energy for family and friends
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree 
 
24. I am unable to maintain a healthy separation between my work and home life
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
25. After work, I feel worn out and weary
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree 
 
26. I have to move from task to task during the work day with no breaks or time to recharge
 Strongly Disagree  Disagree  Neutral  Agree Strongly Agree
 
27. I’m mentally exhausted at the end of the work day but I still don’t feel like I’ve had enough time to attend to what’s most important
 Strongly Disagree  DisagreeNeutral  Agree  Strongly Agree 
 
28. When my energy feels depleted, I have the support available to help me at work
 Strongly Disagree  Disagree Neutral  Agree  Strongly Agree
 
29. On average, how many total hours per week do you work?  
 
30. My relationships with my co-workers deplete my energy
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree 
 
31. I feel supported by my manager
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree  
 
32. My manager genuinely cares about my wellbeing
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree  
 
33. My manager asks me how I’m doing regularly
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree  
 
34. I really don’t care what happens to my colleagues or clients at my job
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
35. If I choose to make use of flexible working arrangements, I feel supported by my manager
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree 
 
36. If I choose to make use of flexible working arrangements, I feel supported by my co-workers
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree  
 
37. When my energy is depleted, I feel safe to share this with my manager
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
38. When I am struggling with my wellbeing and/or mental health, I feel safe to share this with my manager
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree 
 
39. When I am struggling with my physical health, I feel safe to share this with my manager
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree  
 
40. Our company leaders actively communicate wellbeing-supportive messages and information
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
41. My manager actively communicates wellbeing-supportive messages and information
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree 
 
42. Our company leaders express the importance of balancing work life and personal life
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree  
 
43. My manager expresses the importance of balancing work life and personal life
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree  
 
44. There are company norms that make it difficult for me to feel like a balance between work and life is supported or valued (example include, but not limited to: it’s common and expected to work additional hours above and beyond 40, it’s expected to respond to emails all the time/at any time, there is a culture of competition among co-workers, etc.)
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
45. Our company leaders visibly model behaviors that show that they value their own wellbeing
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree  
 
46. My manager visibly models behaviors that show that they value their own wellbeing
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
47. I feel supported in my career goals and growth
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
 
48. I feel supported by formal policies that are in place to impact my wellbeing while I’m working
Strongly DisagreeDisagreeNeutralAgreeStrongly Agree

© Copyright 2022 WCWI


By Mail: P.O. Box 524 Brookfield, WI 53008-0524

By Email: wcwi@wellnesscouncilwi.org.

By Phone: 262.254.7888

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