We need your help advocating for the needs of our patients and ourselves! You can start by completing this survey, but don’t stop there. Management listens best when we speak with one LOUD voice, and right now we need more voices. The more we talk to one another the better we can speak with a single voice. Let us hear you! 

If you’re already talking to your colleagues about issues that affect your unit—as we all do— you're already doing the work. Consider making a formal commitment to your colleagues and patients by becoming a unit representative. As a unit rep, your primary job will be to simply communicate the information you’re already collecting to us, your local unit officers.

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* 1. Please provide your full name:

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* 2. In which unit do you primarily work?

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* 3. If you experience persistent or occasional staffing issues on your unit, please choose the top 3 in order of severity.

  Top severity 2nd highest severity 3rd highest severity
Census is higher than planned
Patient acuity/sickness is higher than planned
Patient intensity/workload is higher than planned
Unsafe assignments
Unit activities (e.g., discharges, admissions, transfers) are different than planned
Support staff different than the staffing plan
Inappropriate assignment for skill level
Charge nurse unable to perform charge nurse duties, due to assuming an assignment or increased patient care assignment
Forced / mandatory overtime
1:1 constant observation required without sufficient backup

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* 4. If you experience other issues on your unit, please choose the top 3 in order of severity.

  Top severity 2nd highest severity 3rd highest severity
Missed breaks
Lack of PPE
Lack of respect from management
Substandard equipment
Earned time denied
Other (specify below)

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* 5. Do you believe that if we take collective action on the issue(s) you mention above, that we can make the workplace better?

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* 6. If you answered yes above, can you commit to 1-2 hours/month to join us in building union power and making our workplace better?

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* 7. There are so many ways to get involved, all with varying time commitments. Please let us know if you are you interested in joining our team to serve in any of the following positions:

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* 8. Our team is meeting next on Monday, July 6 from 3 - 5 p.m. to plan next steps. Can you join us?

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* 9. Personal phone number or email to reach you:

In solidarity,

Carl Coyle, RN, WSNA Chair

Josef Mansour, RN, WSNA Co-Chair

Natasha Barrow, RN, WSNA Treasurer

Tiffany Guyette, RN, Grievance Officer

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