Nurse Readiness Survey

Name*

First NameLast Name
Email*
example@example.com
Mindset & Purpose
I often feel emotionally drained or disconnected from my work.*

1

2

3

4

5

1 is Disagree, 5 is Agree
I long for more purpose, joy, or meaning in my nursing career.*

1

2

3

4

5

1 is Disagree, 5 is Agree
I’m questioning if I want to stay in nursing—or how I can stay in a healthier way.*

1

2

3

4

5

1 is Disagree, 5 is Agree
Boundaries & Burnout
I struggle with setting or maintaining boundaries at work.*

1

2

3

4

5

1 is Disagree, 5 is Agree
I often feel overwhelmed or undervalued in my role.*

1

2

3

4

5

1 is Disagree, 5 is Agree
My work has started to negatively affect my personal life or health.*

1

2

3

4

5

1 is Disagree, 5 is Agree
Support & Community
I feel isolated and wish I had a supportive community of nurses who “get it.”*

1

2

3

4

5

1 is Disagree, 5 is Agree
I would benefit from guidance, mentorship, or career clarity.*

1

2

3

4

5

1 is Disagree, 5 is Agree
Career & Growth
I’m interested in continuing education that aligns with my goals and values.*

1

2

3

4

5

1 is Disagree, 5 is Agree
I want help navigating transitions—whether it's a new role, career shift, or professional reinvention.*

1

2

3

4

5

1 is Disagree, 5 is Agree
What inspired you to become a nurse?*
What are you currently craving in your personal or professional life?*
What’s one challenge you're facing right now that you’d love support with?*
Have you ever participated in a coaching program, retreat, or peer group? What was that experience like?*
Should be Empty:

Mindset & Purpose

Boundaries & Burnout

Support & Community

Career & Growth