Find information and resources about workload issues and professional responsibility workload report forms.
Unit Specific check lists available here
ONA Central Professional Practice overview and FAQ available here
Last updated: March 2020.
Do you worry about the quality of care you can provide?
Then here a reminder why we need to complete the Professional Responsibility Workload Report Form (PRWRF)
Remember, completion of the ONA PRWRF is not a “nice-to-do” activity; rather it is a “need-to- do.” ONA members need to provide this written proof of compliance with CNO Standards.
Unless members inform the employer of care concerns by filling out the ONA PRWRF, the employer will assume patient care is satisfactory and/or that members are willing to tolerate the high-risk work environment. Past history has proven that completed PRWRFs can result in an increase in registered and support staff, changes in policy and procedures, additional equipment and many other workplace improvements. ONA’s Professional Practice Specialists use the completed PRWRF to track trends and nursing concerns, assist in lobbying CNO regarding the need for change or development of new standards, and help ONA’s bargaining teams in identifying professional issues.
At times there may be some reluctance on the part of members to use an ONA PRWRF. In many cases, the member may not be aware of the form. However, even if the member is aware of the form, there appears to be a fear of reprisal from management and that by raising the issue/complaining, it will appear that s/he is not a good employee. There is also the view that the form will not change anything or there is no time to fill it in and provide the necessary documentation.
With respect to the fear of reprisals, the member needs to be reminded the PRWRF is a negotiated provision of most collective agreements. The employer has agreed to incorporate this document and the professional responsibility clause in the collective agreement.
In 2014, the parties added a new Note to the Hospital Central Collective Agreement at the end of Article 8 confirming that the provisions of Article 3 (Relationship) apply to conduct pursuant to this provision (no discrimination or harassment). This language was negotiated following ONA’s experience using Article 8 where some ONA members were harassed by hospital management and effectively silenced. This new language provides ONA members with protection against this type of management behaviour.
Therefore, any reprisals against the member for exercising her/his rights under the collective agreement should be reported immediately to the union, both at the Bargaining Unit level and to the LRO so the appropriate action against the employer can be taken.
What are the reasons for completing the ONA PRWRF? The forms provide a:
- Mechanism to identify situations that impact a member’s ability to provide safe quality client/patient/resident care.
- Mechanism to make recommendations to improve the quality of client/patient/resident care.
- Mechanism to motivate the employer to make the necessary changes.
- Protection for the individual nurse (it is the nurse’s professional responsibility to report incidents of unsafe client/patient/resident care to her/his supervisor) and shifts the accountability for resolution back to the management nurses and Chief Nurse Executive (CNE) related to their obligations set out by the College of Nurses of Ontario as administrative nurses.
The ONA PRWRF protects the individual member by providing:
Written proof that registered staff (RNs, RNECs, RPNs and other regulated health professionals) has met their CNO Professional Standards (Revised, 2002) and Ethics, 2009.
- Written proof the registered staff informed the employer of unsafe patient/client/resident care concerns. This ensures that in the event of an incident, accountability and legal liability shifts to the employer, administrative nurses and the Chief Nursing Executive and away from the member if s/he can prove the employer was informed of the unsafe situation and elected to do nothing about it.
- A mechanism to hold the Registered Nurse administrator accountable to their standards, (i.e. CNO’s Professional Standards as defined for nurses in an administrative role).
Find your Work load report here
Please discuss this tool with your Bargaining Unit President and/or your Professional Responsibility / HAC Rep.
Printable version of Review Tool available here
When filling out a Workload Report Form ensure the following process is followed:
- At the time of the Workload occurrence, discuss the issue within your unit to develop strategies to meet patient care needs using current resources.
- If no resolution, seek assistance from your Clinical Leader, Manager, Manager on call.
Note: Flow Coaches or Shift Coordinators may be ONA members, not MANAGERS
You do not require a Charge Nurse approval to report a Professional Practice Concern
- If no resolution, document all avenues taken on the Workload Report Form.
- Complete the Workload Report Form and submit it by (e) mail to your manager, copy to yourself and your Bargaining Unit President.
- Meet your manager the next day or within 7 calendar days whichever comes sooner. This meeting can occur over the phone.
- Your manager will provide a written response on the Workload Report Form within 7 calendar days of receipt of the Form and will copy to the Bargaining Unit President.
- When meeting with your manager you may request an ONA Rep to attend the meeting.
- Every effort will be made to resolve Workload issues at the unit level.
- Failing resolution at the unit level, the Workload Report Form will be forwarded to HAC (Hospital Association Committee) within 20 calendar days from the date of the Manager’s response or when she/he ought to have responded.
- Workload issues will be raised at the next HAC (Hospital Association) Committee meeting.
Complete the ONA-Professional Responsibility Workload Report Forms / Improper Work Assignment Forms. It is your professional responsibility to report unsafe patient care / practice to your employer. Failure to comply with your professional obligation of reporting may be considered professional misconduct.
Remember, the workload report form in itself is not a grievance, but the start of a paper trail to identify and demonstrate ongoing problems that will require a response by your employer. It also acts as proof of your identification of patient safety issues to your manager, and provides you with documentation, should you find yourself in the unfortunate position of responding to the Complaints and Disciplines Committee at the College of Nurse’s .
CNO requires a nurse to identify, report and work with the employer to resolve issues, in order to provide safe, quality resident care.
There are five aspects of practice for which long-term care (LTC) nurses are most frequently reported to CNO:
1. Failure to assess the client.
2. Failure to intervene/take appropriate action.
3. Medication administration/documentation errors.
4. Failure to ensure client safety.
5. Poor interpersonal/communication skills.
LTC or Hospital Employers are also utilizing these practice examples to discipline nurses.
The PRC form is the documentation forms used to identify situations when you feel that patient care is compromised and you are unable to provide care to meet your nursing professional standards due to practise, patient acuity, fluctuating workloads and fluctuating staffing. This form will help to protect you in the current working conditions and it serves as your documentation that the Employer has been notified of working conditions that are not conductive to standard in patient care. It provides a tool for documentation to facilitate discussion and to promote a problem-solving approach.
The Local collects the information and copies are given to the Labour Relations Officer. Summary reports are presented and discussed at the HAC (Hospital Association Committee). Over the years our local was successful in increasing nursing patient ratio on many units across the corporation. This in term keeps the patient safe and offers them the best optimal care. It does work, if there is a unity within the department and all our nursing colleges support each other in difficult times.