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  • Seiu Local 1107 Assignment Despite Objection Notification Form 2014

Get Seiu Local 1107 Assignment Despite Objection Notification Form 2014-2025

GN): (if more than one person is objecting, use the reverse side to write relevant information) Employer Job Title Shift/Date/Time Dept/Unit W/Phone H/Phone hereby advise the Supervisor/Charge, , on behalf of myself/ourselves and other employees in the hospital that I/we protest the assignment(s) described below which were made despite this objection. In my/our professional opinion, this assignment is unsafe because of (check appropriate item.

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Assignment refers to “a written delegation of duties to care for a group of patients by. trained personnel assigned to the unit.”

Assignment Despite Objection (ADO) Form Objective »» To inform nurses about how to properly complete an ADO form. To educate nurses about what to do when given an assignment they believe creates an unsafe patient care environment.

Registered nurses need to know their rights and responsibilities when considering a patient assignment. If you feel that you lack expertise on a unit and patient population, you don't just have the right to refuse an assignment there, you have an obligation to do so.

An example of a client assignment is when an RN assigns an LPN/VN to care for a client with stable heart failure. The LPN/VN collects assessment data, monitors intake/output throughout the shift, and administers routine oral medication.

ASSIGNMENT DESPITE OBJECTION. Page 1. PURPOSE: The purpose of this form is to notify hospital supervision that you have been given an assignment which you believe is potentially unsafe. for the patients and/or staff. This form will document the situation.

A nurse may refuse a work assignment. However, the refusal may be considered insubordination or abandonment.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232