Healthcare Employee Engagement Survey Questions: 40 Examples

A healthcare employee engagement survey asks clinical and non-clinical staff how sustainable their workload is, whether raising a concern changes anything, and whether they intend to stay. The questions that matter cover workload and staffing, manager support, speak-up safety, growth, recognition, communication, and intent to stay. Two rules separate a useful healthcare survey from a generic one: it has to be short and asynchronous because the workforce is shift-based, and its scores have to be benchmarked against healthcare, because engagement in hospitals runs lower than the cross-industry average and an absolute number misleads leadership in both directions. Below are forty questions grouped by driver, how to score results that concentrate by unit and shift, and the mistakes that make a hospital survey measure caution instead of reality.

Why healthcare engagement is measured differently

The stakes are unusually concrete here. NSI's 2026 National Health Care Retention Report put the average cost of losing a single bedside RN at $60,090, with the national RN turnover rate at 17.6 percent and the overall hospital turnover rate at 18.5 percent. For the typical hospital that is roughly $5.19 million walking out the door every year, most of it driven by conditions an engagement survey can see months before a resignation letter does. The problem is that a standard engagement survey, designed for a nine-to-five office, quietly fails in a hospital. A forty-minute annual survey with a Monday-morning email window returns day-shift administrative staff and almost nobody from nights, weekends, or the floor.

It also helps to be clear about which instrument answers which question, because healthcare leaders already run several and confuse them constantly.

The engagement survey earns its place on timing. Intent-to-stay scores move well before turnover rates do, and in a sector losing roughly one in six nurses a year, that lead time is the only window in which retention spending changes anything.

40 healthcare employee engagement survey questions by driver

Group questions by driver rather than shuffling them. A blended score tells you engagement is low. Grouped scores tell you it is low specifically on workload sustainability in the ICU night shift, which is an actionable finding. Unless noted, use a consistent five-point agreement scale, and keep the whole set under fifteen minutes so a nurse can finish it on a break.

Workload, staffing, and burnout (1 to 7)

1. My workload is sustainable across a typical stretch of shifts.
2. Staffing on my unit matches the acuity of the patients we care for.
3. I can take a real break during a shift without feeling I abandoned my patients.
4. I regularly leave a shift feeling physically or emotionally depleted. (reverse-scored)
5. My schedule is predictable enough to plan a life outside work.
6. When my unit is short-staffed, someone with authority acts on it.
7. Mandatory overtime or being held over is rare here. (reverse-scored)

Burnout runs higher in clinical settings than almost anywhere else, so if this section scores poorly, follow it with a focused employee burnout assessment rather than treating it as one theme among ten.

Manager and immediate leadership (8 to 13)

8. My manager understands the clinical reality of my role.
9. My manager removes obstacles rather than adding to them.
10. My manager gives me feedback that helps me improve.
11. I trust my manager to represent my unit honestly to senior leadership.
12. Decisions that affect my work are explained, not just announced.
13. I would stay in this organization under a different manager. (diagnostic: separates the employer from the boss)

Speak-up safety and voice (14 to 19)

14. I can raise a patient safety concern without it counting against me.
15. I can question a decision by someone more senior when a patient is at risk.
16. Concerns raised by staff here lead to visible change.
17. When something goes wrong, the response focuses on the system rather than blaming a person.
18. I have stayed silent about a problem because speaking up did not feel safe. (reverse-scored)
19. I know how to escalate a concern and trust that it goes somewhere.

Growth, development, and competence (20 to 25)

20. I have real opportunities to grow in this organization.
21. I get the training and orientation I need to do my job safely.
22. I understand what I would need to demonstrate to advance.
23. New staff on my unit are supported well enough to stay.
24. Continuing education and certification here are supported, not just permitted.
25. I would have to leave to advance my career. (reverse-scored)

Recognition and meaning (26 to 30)

26. The work I do here matters and I can see that it does.
27. I receive recognition when I do good work.
28. Recognition goes to the people who actually did the work.
29. The staff who quietly keep a unit running get credit for it.
30. I have been meaningfully thanked in the last three months.

Communication, resources, and technology (31 to 36)

31. I get the information I need to do my job without chasing it.
32. The technology and systems I use help me care for patients rather than slow me down.
33. I have the supplies and equipment I need on shift.
34. Communication between shifts and handoffs is reliable.
35. Charting and documentation demands are reasonable for the time I have.
36. Leadership communicates changes honestly, including bad news.

Intent to stay and advocacy (37 to 40)

37. I see myself working here in two years.
38. I rarely think about looking for a role at another organization.
39. I would recommend this organization as a place to work to a colleague I respect.
40. If a recruiter offered me a similar role elsewhere tomorrow, I would take the call. (reverse-scored)

Question 37 is the single most predictive item in the set. Satisfaction questions measure how a shift felt; forward commitment measures whether someone has already started picturing a different badge. Track it every quarter and segment it, because a hospital-wide average of 3.6 routinely hides a first-year nursing cohort sitting near 2.5, which is exactly the group whose departure costs the most to replace.

How to score healthcare survey results so they mean something

A list of questions is not an assessment. What makes hospital survey data usable is what happens after collection, and healthcare has two twists an office survey does not.

1. Benchmark against healthcare, not the whole economy. Engagement scores in hospitals run lower than cross-industry averages, so the same raw average can be a strong result in one sector and a red flag in another. Without a healthcare comparison the same number can talk leadership into complacency or into panic.
2. Segment by unit, shift, and role, with a floor. Engagement in a health system is almost never evenly distributed. Break results out by unit, by shift, and by clinical versus non-clinical role, and suppress any segment with fewer than five responses so nobody can be identified. The night shift on one unit is often a different organization than the day shift on the next.
3. Reverse-score the negative items. Questions 4, 7, 18, 25, 40 and any other reverse-worded item must be flipped before you average anything. This is the most common scoring error in homemade surveys, and it inverts the exact drivers you most want to see.
4. Score by driver, not one blended number. Report seven driver scores. "Engagement is 71 percent" cannot be acted on by any charge nurse or director.
5. Repeat the same questions. The value is in movement between measurements. Rewriting the instrument every year destroys the only trend line you had. If you want a shorter cadence between full surveys, our pulse survey questions keep the same drivers on a monthly rhythm.

This is the work our healthcare organizational assessment automates: the same driver questions each quarter, scored 0 to 100 against a benchmark, segmented with a minimum group size, and returned with the weakest driver named first. Engagement is one dimension of the broader picture our guide to organizational health lays out, and the speak-up items above belong to the same family as the fifty psychological safety survey questions we published separately.

Five mistakes that make a hospital engagement survey useless

• Using an office format for a shift workforce. A long survey with a single weekday email window measures day-shift administrative staff. Keep it short, asynchronous, and open across every shift for at least two weeks.
• Reporting a number with no healthcare benchmark. An absolute engagement score in a sector that runs below average is a number without a meaning. Benchmark it or do not report it.
• Letting managers chase completion. Response-rate pressure from the person being evaluated turns an anonymous survey into a compliance exercise with predictable answers.
• Surveying annually and acting slowly. In a sector losing one in six nurses a year, a twelve-month cycle means the most frustrated staff have already gone before the results are presented. The trade-offs of each cadence are laid out in our comparison of a pulse survey versus an annual engagement survey.
• Confusing it with the safety culture survey. Patient safety culture and workforce engagement are different questions. Running one and calling it the other leaves a real gap unmeasured.

The last point matters operationally too. When engagement dips because a unit is chronically short, the vacancy still has to be filled, and screening a high volume of applicants at the pace a 43-FTE gap demands is its own discipline that first-round screening interviews can carry so charge nurses are not interviewing between rounds. Retention and hiring are two sides of the same staffing math; our questions on the leaving side are in the retention survey guide.

Frequently asked questions

What is a healthcare employee engagement survey?

A healthcare employee engagement survey is an anonymous questionnaire sent to clinical and non-clinical staff to measure the conditions that drive them to stay or leave: workload and staffing, manager support, speak-up safety, growth, recognition, and intent to stay. It is built for a shift-based workforce, so it is short and open across every shift, and its results are benchmarked against healthcare specifically because engagement in the sector runs lower than the cross-industry average.

What questions should be on a nurse engagement survey?

Ask one forward-commitment question ("Do you see yourself working here in two years?"), then five to seven questions in each driver that matters most in nursing: workload and staffing sustainability, manager support, whether it is safe to raise a safety concern, growth and certification support, and recognition. Keep the full set under fifteen minutes so a nurse can complete it on a break, and use a consistent five-point scale so scores combine cleanly.

How often should hospitals survey staff?

Run a full engagement survey once or twice a year and pair it with short quarterly pulses using the same core questions. In a sector with a 17.6 percent RN turnover rate, cadence matters more than the depth of any single run, because retention work only becomes visible as movement between measurements. Increase frequency temporarily during a merger, a leadership change, or a major technology rollout, when the drivers move fastest.

What is a good employee engagement score in healthcare?

There is no universal number, and that is the point of benchmarking. Healthcare engagement scores run lower than cross-industry averages, so a result that looks weak against a general benchmark can be normal for the sector, and a result that looks fine can hide a serious gap in one unit or shift. Judge a score three ways: against a healthcare benchmark, against your own prior quarter, and by segment, because the hospital-wide average almost always conceals the unit that is actually in trouble.

Is this the same as the AHRQ patient safety culture survey?

No. AHRQ's Surveys on Patient Safety Culture, including the Hospital Survey on Patient Safety Culture, are the recognized national instruments for measuring patient safety culture, with a comparative database behind them. An engagement survey measures a broader picture: workload, manager support, growth, recognition, and intent to stay. The two overlap on speak-up safety but answer different questions, and many organizations run both because a strong safety climate and an engaged, staying workforce are not the same thing.

How do you improve nurse engagement?

Start with the driver that scores furthest below benchmark rather than launching a general engagement campaign. Most often it is workload and staffing, and the fix is operational: predictable scheduling, acted-on short-staffing escalation, and manager capability, since many nurse managers are excellent clinicians who were never trained to manage. Then re-measure the same questions next quarter and check the number moved. Recognition programs and perks rarely move a score that is really about sustainable workload.