The Unsafe Staffing Form is Key to Protecting Your Practice & License

There is a very important tool that BWH/MNA RNs have to document any concerns they have about their practice of nursing or their role in that practice while at work. That tool is the “Report of Staffing Concerns Form" which is available to all RNs throughout the hospital when they want to put down in writing concerns he/she has about staffing or working conditions with which they may be dealing.

Why fill out this form?
There are two very important reasons: first, this form has been identified in our contract as a means of documenting for management problems we are having with staffing and second, it may be the single piece of evidence that could save your license to practice your profession if something happened to one of your patients on a shift where staffing was unsafe.

Documenting Problems to Be Solved
When your elected leaders sit down to discuss staffing issues with management, we need documented evidence to present as part of our case for improvements for staffing. Staffing Concerns Forms provide a detailed record of the types of problems that are occurring, and on what shifts these problems arise. There have been numerous occasions where these forms allowed us to identify a problem for Management. Also, under our contract, these forms must be reviewed on a monthly basis by the hospital’s “Care Improvement Council.”

Protecting Your License
How do these forms protect your license?
Consider the fact that the Board of Registration in Nursing and a Civil Court hold individual nurses accountable for the safety of their patients. In the event that a patient is harmed due to care on your shift and you are sued or brought before the Nursing Board in relation to your care, an unsafe staffing form provides documented evidence that you were working under duress, that you took the responsibility to notify your supervisor of your objection to these conditions, and also spells out what actions were taken or not taken to support you. This evidence might prove extremely valuable in defense of your license.

How to Use the Form
Please note the following steps when and if you choose to use this essential tool.

• Determine that the staffing or a situation is one that you believe compromises your nursing practice. If you feel the staffing level is unsafe, then it is unsafe. Fill out the form.
• Notify your supervisor that you are concerned and are going to use the tool to express those concerns.
• Obtain an unsafe staffing form. It is a hospital form and should be available on your unit. Ask your nurse manager where they are located or simply click on the "Download Unsafe Staffing Form Here" button above.
• Fill the form out as completely as possible, including who you notified (all other data is helpful, do not forget the date/time and reason for concern or objection).
• Make three copies: leave one with your manager, keep one for yourself, and give the third to a member of your union negotiating committee. Click the button above to download and print out a copy if you can’t find a form on your unit.

The use of this tool is a legally protected right as a union member at BWH. The tool cannot be the basis for discipline. As nurses, we know that documentation is a key function of our nursing practice. For unionized nurses, the unsafe staffing form is a key tool for documenting the safety of our practice environment. Use it!