Staffing Plan noncompliance? How to file an effective staffing complaint
This story appears in the December 2025 edition of The Washington Nurse.
Washington state’s 2023 hospital staffing law (SB 5236) is the result of a compromise between the Washington State Hospital Association (WSHA) and the healthcare unions. The law requires hospital staffing committees, composed equally of frontline nursing staff and management, to create unit-specific, shift-by shift staffing plans. A majority vote of the committee and the chief executive officer approve these plans.
Holding the hospital accountable for failing to staff according to the plan requires filing complaints with more details than you may have provided in the past. This article explains the complaint process and essential complaint details in accordance with the staffing law.
This law does not set fixed staffing ratios or a specific number of patients per nurse. According to the Washington State Department of Health, hospitals must follow approved staffing plans, with noncompliance documented at any time during the shift when there are fewer direct-care nursing staff providing care on the unit/department than required by the staffing plan.
WSNA members have filed staffing complaints, referred to as assignment despite objection (ADO) forms, for years. If a registered nurse believes there is a situation that creates an unsafe condition for the patient or the nurse, an ADO is completed as soon as possible. The facts of the situation are documented, and management is notified of the problem and provided an opportunity for resolution. Many of these complaints describe an unsafe number of patients cared for by the nurse.
With implementation of the new staffing law, it is important to provide additional data when filing a staffing complaint. This includes:
- The patient census.
- The number of nurses required to provide direct patient care on the unit/department for the shift according to the staffing plan.
- The actual number of nurses (e.g., RNs, LPNs, CNAs, UAPs) providing direct patient care on the unit/department for the shift.
A staffing complaint is filed with the hospital staffing committee in any written format. Once submitted, the committee follows its established process to review and respond to complaint data.
Per law:
- A process for attendance of the hospital staffing committee by any employee, (and a labor representative if requested) who has filed a complaint.
- Each complainant receives a letter stating the outcome of the complaint from the hospital staffing committee.
Example of a complete staffing complaint
On November 21, 2025, 0700-1900 shift, the medical/surgical unit floor 2 census was 20 patients.
Noncompliance with the staffing plan
There were fewer RNs and CNAs delivering direct patient care on the floor than required by the staffing plan:
| Staffing Required by hospital staffing plan | 20 Census | 5 RNs | 2 CNAs | 1 Charge Nurse |
| Actual staffing | 20 Census | 4 RNS | 1 CNA | 1 Charge Nurse |
I was assigned to care for five high acuity patients—unstable, high-fall risk, isolation, confused. RNs were required to cover the meal and rest breaks of co-workers, doubling the number of patients cared for while co-workers were on break. The unit had one less CNA assigned. This created an unsafe situation — with one patient fall during the shift.
If you have questions about filing a staffing complaint, your WSNA nurse representative can help. Reach out to them.