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Workload Staffing Reports

Download the Nursing Workload/Staffing Report: Guidelines for Use (ZIP/PPTX)

Below are some examples when Workload Staffing Reports are to be filled out:
  • Safe care is not able to be provided
  • Nursing standards cannot be met
  • Breaks will be missed (coffee/meal)
  • Too many clients
  • Incomplete referrals
  • Unsafe situation or the potential for an unsafe situation related to workload and/or staffing
NOTE: Nurses should be encouraged to complete a Workload Staffing Report. THIS FORM IS THE RESULT OF COLLABORATION BETWEEN UNION AND MANAGEMENT AND IS JOINTLY ENDORSED BY BOTH. The form is used to facilitate discussion and promote a problem solving approach.

Step (1)
  • Review work day plan and re-prioritize the workload. This can be done in collaboration with other health care colleagues who can offer advice and may have the capacity to assist with priority development or redistribution of workload.
Step (2)
  • Contact and wherever possible, discuss with immediate supervisor (or designate) or after hours supervisor.
Step (3)
  • The nurse(s) involved complete the form. One form per situation is needed.
  • Remember – DO NOT identify patients, clients, family or doctors involved.
  • Avoid abbreviations.
  • Ensure the community area or centralized program name and site address are identified (examples Downtown – 755 Portage Ave; Transcona – 845 Regent Ave W.)
  • Patient information is NOT to be attached
  • If space is inadequate, attach a narrative report. The Workload Staffing Report number must be noted on all additional papers.
  • Ensure all areas are completed including recommendations which are your professional opinion of how the matter can be resolved for the future
Step (4)
Once report is completed, the vouchers are detached and distributed as follows:
  • Voucher 1 – is kept by the nurse
  • Voucher 2 – is sent to the Worksite President or designate by the nurse.
  • Voucher 3 – stays on the original form and is given to the nurse’s own Team Manager or designate.
Step (5)
  • When the Team Manager receives a completed Workload Staffing Report, he/she will review the workload issues and the response with the nurse(s).
  • The Team Manager completes and signs the response portion of the form Section 9 within 14 days.
  • The Team Manager retains the green copy for their records. A photocopy will be given to the nurse(s).
  • The Team Manager sends the original report to their Community Area Director or Community Program Director for review.
Step (6)
  • The Community Are Director/Community Program Director reviews and then forwards the original report to the following Administrative Assistant, to have the information inputted into a Database:

    Home Care: Denise Okun, Admin Assistant
    975 Henderson Hwy. - (inter-office mail marked “Confidential”)

Step (7)
  • After information is inputted in the Database, the Administrative Assistant will mail original report to the appropriate Union President as follows:

    Julie Lackner - MNU President (Worksite 97)
    975 Henderson (inter-office mail marked “Confidential”)

Step (8)
  • A Workload Staffing Summery Report is generated from the Database. This database report is reviewed quarterly at the HC NAC meetings.


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