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* 1. Burnout is defined as: exhaustion of physical or emotional strength or motivation usually as a result of prolonged stress or frustration. Burnout is manifested by different signs and symptoms. Check all symptoms that you have experienced in the last month.

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* 2. During the past 30 days, thinking of shifts worked,  what percent of the time did you take uninterrupted, scheduled breaks and lunch?

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* 3. What do you feel contributes most to nurse burnout?

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* 4. What is one thing that your manager and/or administration can do to prevent nurse burnout?

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* 5. Which of the following do you feel would be the most useful to you in preventing burnout?

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* 6. To what extent are you experiencing burnout?

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* 7. How likely are you to seek new employment in the next 12 months?

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* 8. Which of the following most closely represents your current position?

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