Staffing Objection Forms: Protect Your License, Your Career, and Your Patients

November 2014

Recognize the symptoms of an unhealthy assignment:

  • Charge RN is unable to perform charge duties, secondary to increased patient care assignment
  • Inadequate nurse to patient ratios for patient acuity based on your clinical judgment
  • Insufficient support staff requires you to assume additional duties
  • You are not trained or experienced in the area assigned
  • You have not been oriented to this unit / case load
  • Patient care equipment missing or unusable
  • Necessary equipment is not available (e.g.: supplies, IVs, medication availability)
  • You are not trained or experienced to use equipment in assigned area
  • System failure (e.g.: computer, phone, pyxis, call system)
  • An assignment poses a serious threat to your health and safety
  • An assignment poses a serious threat to the health and safety of a patient under your direct care
  • Forced / Mandatory Overtime
  • Missed breaks

If you find yourself in a situation that you believe creates unsafe conditions for patients or you, take a minute to complete the Staffing Objection Form as soon as possible. A copy goes to your supervisor, a copy for you and a copy should be faxed to the Union.

By completing the form, you are bringing the problem to management’s attention to create an opportunity for the problem to be addressed. Additionally, you are documenting the facts, which may be helpful to you later if your professional performance comes into question.

Contact Staff Representative Linda Meyer
619-610-9505 or 909-344-0920
Fax: 619-280-7406

Click here for a PDF version of the information above.