Objection to Assignment forms: A key tool for keeping patients and nurses safe
What is an OTA?
An Objection to Assignment (OTA) is a tool to record your objection to an assignment, which is unsafe for you, your coworkers, and/or your patients. On the OTA you document the specific reasons why your assignment poses a risk to staff and/or patients and that you have notified management of these problems.
Why should I fill out an OTA?
There are many reasons to fill out an OTA:
- To document that you have notified your employer that your assignment poses a risk to staff and/or patients.
- In the event that patient care is compromised as a result of unsafe working conditions, an OTA form documents your objection to these conditions and your employer’s failure to address them.This puts responsibility for lapses in patient care squarely on the employer.
- OTAs document issues that can be taken to regulatory agencies like Cal/OSHA or the California Department of Public Health. Filing regulatory complaints helps us advocate for our patients and safe working conditions.
- To build power in our workplace: when multiple nurses object to assignments, we are collectively showing management that unsafe working conditions will not be ignored and must be addressed. OTAs are one way we can hold our employer accountable for understaffing and decisions that put patients and staff at risk.
When should I fill out an OTA?
All NUHW members (not just stewards) should fill out an OTA anytime your assignment is unsafe for patients or staff and management fails to immediately correct the issue. Here are the steps you need to take:
- When you get your assignment, you must first notify your supervisor that it is unsafe. (You can verbally tell your supervisor or, if they aren’t readily accessible in-person, you can text, call, or email them.)
- If your supervisor does not immediately address your concerns and correct the issues, you must then inform them that you are accepting the assignment only because you are being instructed to do so, despite your objections.
- After communicating your objection to your supervisor either verbally or in writing, fill out an OTA to document the date, time and location as well as the reasons for your objection. Do NOT include any protected health information (patient information/identifiers) in your OTA.
- OTAs can be completed either online at https://nuhw.org/ota or in hardcopy form. On the online form be sure to include your supervisor’s email so a copy is sent to them. If you complete a hardcopy OTA, please provide a copy to your supervisor and your NUHW representative.
What are some examples of things to document on an OTA?
- Understaffing including violations to California’s nurse-to-patient ratio regulations in hospitals. Be sure to provide examples of how the understaffing compromises patient care and safety like late medication passes, worsening pressure ulcers due to inadequate repositioning, preventable falls or other injuries etc.
- Broken or missing equipment or other workplace hazards.
- Not enough or incorrect PPE.
- Failure to appropriately isolate and/or cohort patients with infectious diseases.
- Unsafe patient handling (not enough staff to safely reposition, lift, transfer, ambulate a patient etc.).
- Inadequate training or orientation for an assignment.
- Any other issue which puts you, your coworkers, or your patients at risk.
Can I be disciplined for filling out an OTA?
You have a legal right to voice an objection to an assignment that is unsafe for staff or patients and to document that you are only accepting the assignment because you have been instructed to do so, despite your objection. Most supervisors are aware of this right and are familiar with the OTA process. However, if a supervisor tries to stop you from filling out an OTA or retaliates against you, please notify your steward(s) and NUHW representative immediately.