Education Corner

Putting Advocacy into Action

March 14, 2023

Everyday our members face complex practice situations where they are challenged, or simply unable, to meet the minimum standards of nursing practice.

We know it’s distressing to work without the resources you need to meet your professional nursing standards. A lack of control over your work environment, encountering issues that are beyond your ability as an individual to resolve, and facing abuse in the workplace is significantly impacting the health and well-being of RNs and NPs.

During these times, it is critical that you document all incidents and concerns. Not only is it your professional and legal obligation to do so, but documenting is the only way to ensure concerns, near misses, violence and occurrences are recorded and escalated to the appropriate person(s).

RNs and NPs know best that what is not documented is not done. Put simply, if you don’t report unsafe staffing, violence and other occurrences, you are letting the employer off the hook. Failing to document can misrepresent your workplace by passing it off, on paper, as unproblematic.

Without documentation, it’s easy for unacceptable practices such as ongoing workplace harassment, constant understaffing leading to medication errors, or abuse from patients and family members to continue.

Documenting new, ongoing and recurring concerns is the number one way to effect change and improve working conditions at an individual RN or unit level.

We know it’s a frustrating and time-consuming process, but proper, province-wide reporting would illustrate the severity of issues in our health care system, provide evidence to strengthen RNU’s fight for change at the bargaining table and beyond, and create a sense of urgency among employers to act.

Benefits of persistently reporting workplace incidents and concerns include:

  • Provides proof that you fulfilled your duty to identify and address unsafe or unethical concerns by escalating a concern appropriately.
  • Creates a paper trail of a concern that needs to be addressed.
  • When relevant, provides RNU volunteers and labour relations officers with important information needed to advocate on your behalf.
  • Helps to raise a red flag and ensure the employer cannot absolve themselves of dealing with the problem or underestimate its frequency and the resources required to resolve it.

Which reporting mechanism is right for my situation?

You must use your own discretion to decide which is the most appropriate tool or process to document the specific concern or situation you face.

Sometimes, a situation will need to be reported in more than one way.

For example, if a patient under your care has a fall, you must document the incident using your employers’ internal occurrence reporting system. However, perhaps your unit was short staffed at the time and as a result you were unable to monitor your patients appropriately. In this scenario you were unable to meet certain standards of practice and, ideally, would already have outlined your concern using the professional practice process.

Let’s say you also hurt your back running to catch the patient as they fell; this would require reporting through PIERS. And, going even further, say the fall happened in your 24th hour of work after being mandated for a double shift. You would also want to file a grievance. Many situations will only require one reporting path, but it’s important to look at every incident in a holistic way. Some reporting mechanisms you should be aware of:

Provincial Employee Incident Reporting System (PIERS):

  • The goal of the PIERS is to reduce injuries. This includes both physical and psychological/mental injuries. It provides employees and managers with tools to report and investigate incidents in the workplace.
  • Employees must personally notify their manager, or designate, of all work-related incidents immediately following the incident (subject to extenuating circumstances) and complete the incident report sections of PIERS.
  • You should always complete a PIERS report if you become injured or experience harassment or violence of any sort in the workplace.
  • You can find the PIERS policy on your employers’ intranet.

Clinical Safety Reporting System (CSRS) *Note: name may vary by employer

  • The CSRS (commonly known as ‘occurrence reporting’) is the tool utilized to manage occurrences.
  • A CSRS report must be completed for all occurrences, including near misses/ close calls.
  • Medication errors and patient falls are examples of when to complete a report via the CSRS.
  • The intent of the system is to support and promote individual and organizational accountability to foster a culture of safety.
  • You can find the policy on your employers’ intranet.

Professional Practice Process

  • The Professional Practice Process is your tool to achieve change in the workplace.
  • Professional practice concerns are those that are usually outside the realm of a grievance, but there may be instances where a situation is both a PPC concern and a violation of the CA. PPC concerns impact nursing workload, nursing practice and patient/member safety.
  • The professional practice form is an advocacy tool that formally communicates a concern to the employer. It creates a paper trail of a concern that needs to be addressed and is key to improving workplace conditions.
  • For more information on this process check out our Professional Practice Tool Kit. Please note that RNU does not have access to professional practice forms. Currently there are many different forms in circulation as they vary by region and worksite. Work is underway to establish one consistent form across the province.

Dispute Resolution Process (Grievance)

  • A grievance is the process for resolving disputes between an employee and their employer and usually arises out of perceived violation of the collective agreement.
  • The dispute resolution process is outlined here.
  • For more information on this process get in touch with your Shop Steward.

We know the continued deterioration of working conditions is clearly correlated to the loss of RNs and NPs from our healthcare system. RNU is pushing hard for Government and Employers to truly understand this impact on retention – but an uptick in reporting by our members would help call attention to the enormous, systemic problems within your workplaces. We know you are hanging on by a thread. Call on your colleagues to use the proper reporting mechanisms to document the unacceptable situations you face every day. Don’t let it slide. You deserve better.

If you are unsure where to document a particular incident or concern, contact a RNU volunteer or reach out to RNU directly at or 709 753 9961.