Report Unsafe Staffing
Reporting Concern for Safe Staffing
Staffing can affect the safety and well-being of patients and of nurses. Whenever you feel staffing provided was not adequate to safely address patient needs or the well-being of the nurse, you should document it using MNA’s Concern for Safe Staffing Form. Documenting the facts of potentially unsafe staffing situations is the first step in protecting your patients and yourself.
Report for Concern for Practice
This Concern for Practice Form may be used for submission to the MNA Commission on Nursing Practice. To download in Word Format click here.
Concern for Safe Staffing Forms
Nurses are obligated to speak up for our patients and our practice. For example, the 3rd provision of the Code of Ethics for Nurses states: "The nurse promotes, advocates for and strives to protect the health, safety and rights of the patient. (American Nurses Association, 2001)
When and how should I fill out this form?
Whenever you feel staffing provided was not adequate to safely address patient needs or the well being of the nurse. Staffing can affect the safety and well-being of patients and of nurses. Documenting the facts of potentially unsafe staffing situations is the first step in protecting your patients and yourself. Please check all the boxes applicable to your situation. Please complete the form after your shift ends if you do not have time to complete it during your shift. In any case, however, you must notify your charge nurse and/or supervisor at the time you identify the concern or need.
What is the purpose of the form?
- The primary purpose is to document the facts and your professional judgment regarding your staffing concern, and provide written notification of your concern to the appropriate person responsible for staffing.
- A record of staffing concerns is also important to identify trends and issues to support nurses in working with administration to solve the concerns.
- Although no document can protect you from liability, a written notice of your concerns may be helpful in case an untoward event occurs.
Who fills out the form?
Any individual registered nurse or group of nurses on a unit who feel potential for harm exists due to staffing.
Is there anything I should NOT put on the form?
Do not put any patient information (names or other identifying data) on the forms. Be aware of your employer's policies on data and confidentiality. If you attach an assignment sheet, remove patient identifying information.
What if I am injured, or concerned about my safety?
Some safety issues related to lifting, workload, stress and violence may also be related to staffing. Those concerns should also be reported on the Concern for Safe Staffing Form. Please note:
- If you believe your safety to be compromised, you should immediately report this to your supervisor.
- If you are injured on the job, you should immediately follow your institution's procedure for reporting an injury.
What if I have a concern for nursing practice that is not related to staffing?
Please contact the MNA office (651-646-4807/1-800-536-4662) or click here to download a Concern for Practice Report Form*.
NOTE: If you experience pressure from your supervisor or are "counseled" for completing the form, contact Minnesota Nurses Association immediately. (Source: MNA, A Member's Guide)
