| QUESTIONS |
Yes |
Sometimes |
No |
| Do you know what it's like to have worries, frustrations and concerns about your work? |
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| Do people seek you out to talk about their concerns? |
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| Is the amount of time you spend listening at least four times what you spend talking? |
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| Has anyone in your life helped you uncover an aspect, ability or talent of yours that, until then, had lain dormant and unrecognized? |
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| Has anyone provided you with a quote that had great meaning for you, that influenced your thinking or behavior, and that you sometimes pass on to others? |
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| Has anyone provided you with an "aha!" experience that enabled you to pierce the core of meaning of some event, in someone, in something, or in yourself? |
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| Has a colleague helped you gain knowledge about how things work? About how to get things done? |
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| Has anyone encouraged you to find a way to deal with challenges in your life or work? |
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| Has there ever been anyone in your life who had a profound positive effect on you, but you didn't realize it until much later in your life? |
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| Has someone in your life provided just the right help to you at just the right time? |
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| Has another WOC nurse in your life helped you to grow and deepen your character, moral or ethical integrity or gain a stronger commitment to your values? |
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| Has anyone inspired you to shift the direction of your life in a constructive way? |
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| Have you ever reached out to a colleague who was deeply in need and what you provided appeared to make a beneficial difference to them? |
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| Do other people reach out to you to assist them? |
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| Have you ever had an experience where something that you observed, read, or experienced had a profound effect on your strengths and abilities? |
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| SCORING KEY |
| If your total score is between 60-75 you not only have potential to be a great mentor, but you are probably already acting as a mentor to several people. |
| If your score is between 45-59 you are clearly valued and have experienced what it takes to be a mentor. Go for it! |
| If your score is between 30-44 you have some strengths that can blossom into great mentoring opportunities. |
| If your score is below 29 the fact that you completed this survey shows that you are interested enough to connect with mentoring. Training and further exploration may help you achieve your mentoring goal. |
| Please note that this Mentor Survey is not a scientifically validated test; it is only for self-exploration purposes and to highlight some of the qualities of mentoring. |
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| Area of specialty:________________________________________________ |
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| Contact information:______________________________________________ |
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| Comments:_____________________________________________________ |
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Print out and send your results via FAX to: (916) 852-5889
or email them to: joycemoss_@hotmail.com |