PeaceHealth Southwest Medical Center

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If you find yourself in a situation that you believe creates unsafe conditions for patients or for you, you should complete a Staffing Complaint / ADO Form as soon as possible.

By completing the form, you will help make the problem known to management, creating an opportunity for the problem to be addressed. Additionally, you will be documenting the facts, which may be helpful to you later if there is a negative outcome.

WSNA also uses your ADO forms to track the problems occurring in your facility. When you and your coworkers take the important step of filling out an ADO form, you are helping to identify whether there is a pattern of unsafe conditions for you or your patients at your facilities. This information is used by your conference committee, staffing committee, and WSNA labor staff to improve your working conditions.

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If called into a meeting with management, read the following to management when the meeting begins:

If this discussion could in any way lead to my being disciplined or terminated, I respectfully request that my union representative be present at this meeting. Without representation present, I choose not to participate in this discussion.

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