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20 » RNs in Motion Collective Advocacy PATIENT ADVOCACY— OUR GUIDING PRINCIPLE PATIENT-PROTECTION TOOLBOX As rapid changes are implemented in health care set- tings, RNs are often witnesses to unsafe or compromised patient care conditions. Advocating for safe, therapeutic, and effective care for your patients is one of the most important activities that you as a registered nurse can undertake to protect yourself and your patients. Our contracts provide important tools for protecting patients and your license in these situations. Assignment Despite Objection Form One of the first steps in the advocacy process is doc- umentation. Fill out an Assignment Despite Objection form every time you and coworkers are given an unsafe assignment. Remember, an unsafe assignment may simply be one where you were unable to provide all the care that each patient needed in a timely manner, while allowing you appropriate rest and meal breaks. A patient does not have to have a sentinel event for an assignment to be unsafe. ADOs are admissible in court, with regulatory agencies, and are protected under federal labor law. It's unlawful for the employer to discipline or retaliate against an RN for filing an ADO. Encourage your coworkers to fill out ADO forms when appropriate. Try to have everyone on the shift in question sign the form. There is strength in numbers. The Professional Practice Committee at Your Facility The Professional Practice Committee is a direct-care RN-controlled committee, negotiated into every contract, with the authority to document unsafe practices and the power to make real changes. Direct-care RNs elect representatives to serve on the committee, which meets in the hospital on paid time. The PPC tracks unsafe conditions utilizing ADOs. The PPC discusses practice and staffing problems on various units by analyzing the ADOs for trends and recurrent issues. Information requests are submitted as needed, to ensure that the committee has all the facts that might be useful in crafting a solution. The PPC may also elect to report the problem to the appropriate regulatory agencies. 20 » RNs in Motion