What is a Staffing Complaint/ADO form?
Why should I fill one out?
How do I fill one out?

See the answers to these questions and more below:

What is a Staffing Complaint/Assignment Despite Objection (ADO) form?
A Staffing Complaint/ADO is a form that documents a good faith effort on the part of a nurse to call attention to problems that affect nurse and/or patient care, safety, or satisfaction. The goal is to fix these problems and ensure they don’t reoccur.

What is the purpose of filling out a Staffing Complaint/ADO form?
Staffing Complaint/ADO forms provide documented evidence that a problem exists on a unit and initiates a process for improving the situation. Once management has been presented with an issue, it is incumbent upon them to address it. Additionally, you are documenting the facts, which may be helpful to you if there is a negative outcome.

The submitted Staffing Concern/ADO also provides the Staffing Committee members with specific details, rather than with anecdotal examples about staffing complaints, and helps them determine if a complaint has been resolved or not. The Staffing Committee has the legal responsibility to determine if staffing complaints are resolved or unresolved. Complaints that show an unresolved trend for 60 days or more could result in an investigation by the Department of Health and possible fines.

When appropriate, some complaints may be taken to Conference Committee by our WSNA Local Unit officers to try to resolve the concern.

Steps to be taken before filling out a Staffing Complaint/ADO:

• Clarify what is being asked of you regarding your assignment
• Assess your capabilities, obstacles, acuity of patients, and availability of ancillary staff
• Identify all possible options for meeting patient’s needs
• Decide; communicate the decision to your Charge Nurse, or immediate supervisor, and document the decision-making process on the form

When to fill out a Staffing Complaint/ADO:

• When you find yourself in a situation that creates concerns about conditions for patients, or for you, complete the form as soon as possible.
• Think of it as an S.O.S. – Short on Safety, Short on Supplies, Short on Staff

Examples of when you should submit a Staffing Complaint/ADO form:

• Your unit is not staffed according to its staffing plan.
• Shift adjustments to staffing are inadequate.
• Charge nurse is unable to perform charge nurse duties, secondary to increased patient care assignment
• Inadequate nurse to patient ratios for patient acuity based on your clinical judgment; insufficient support staff
• You are not trained or experienced in the area assigned, or have not been oriented to this unit / case load
• Necessary equipment is not available (supplies, IVs, medication availability), or you are not trained or experienced to use equipment in assigned area
• An assignment poses a threat to the health and safety of a patient under your direct care
• Coerced/Mandatory overtime, or missed breaks

Questions? Contact WSNA Nurse Representative Sara Strite at sstrite@wsna.org or 206-575-7979, ext. 3065.