Professional Practice

Overview and FAQs

The College of Nurses of Ontario (CNO) and other regulatory bodies have Standards of Practice that registrants are expected to meet in order to provide safe, ethical and quality patient/client/resident care within their scope of practice.

By engaging in the Professional Responsibility and Workload (PRW) process, you are playing a pivotal role in meeting your Accountability Standard for your regulatory college and you are advocating for patient safety and quality patient care.

According to your Collective Agreement, any time the employer assigns a number of patients or workload to an individual nurse or a group of nurses/regulated health-care professionals, such that they have cause to believe that they are being asked to perform more work than is consistent with proper patient care, that would constitute a workload concern. For a comprehensive list of workload concerns, review the Professional Responsibility Workload Indicators for Hospitals, Long-Term Care, HCCSS and other sectors. Regardless of the Collective Agreement language, all regulated health-care professionals are accountable to report concerns that prevent them from complying with their college’s standards.

Completing a Professional Responsibility Workload Report Form (PRWRF) assists you to meet your professional and regulatory standards. It allows you to document and report concerns and make recommendations to improve the quality of patient/client/resident care.

Complete a form whenever your workload or working conditions compromise your college standards, including your ability to provide safe, ethical, quality care.  Submit the form to your Employer, your Bargaining Unit President, your Professional Responsibility and Workload (PRW) Representative and keep a copy for yourself.

No. Completing the Professional Responsibility Workload Report Form (PRWRF) is your way of documenting the concerns and provides evidence that you have reported your concern to your leadership. It is a way to document if an incident or near miss occurs due to an increased workload.

The completed form is the start of  a paper trail identifying professional practice issues, establishing trends and recording whether there was an appropriate response or resolution from management at the time of the incident. Although the issue may be resolved at the time (e.g. critical incident was prevented), the underlying cause of the workload concern can be an ongoing concern and is best reflected in the detailed and consistent filing of PRWRFs.

These forms will prove to be essential in demonstrating that you have taken all the right steps to advocate for optimal patient care.

The Professional Responsibility Workload Report Forms may be found in your workplace in each unit. If you are unable to locate the form on your unit, please ask your Bargaining Unit President or Professional Responsibility and Workload (PRW) Representative for the form.

You can also find a copy of the form on the ONA website. You can download the form, fill it in, and then distribute it. Be sure to keep a copy for yourself! Remember to choose the form specific to your sector as there are indicators that are particular to the different sectors.

Some workplaces have an electronic process for submitting a Professional Responsibility Workload Report Form. If your workplace has this process, please contact your Unit Rep, Professional Responsibility and Workload Representative or your Bargaining Unit President who will be happy to assist you.

Yes. On the website, review the guidelines to completing the forms. There are sample completed forms that serve as a reference for each sector. You can also access the eLearning site, which has tips for each sector on completing the form.

In addition to sharing your concerns with your manager, please contact your Unit Rep, Professional Responsibility and Workload Representative and/or your Bargaining Unit President, so they are informed of the issue and can further assist you. Remember to complete the form as soon as possible after the workload or practice concern occurs and most importantly to omit any patient/family names or identifiers when providing details of the situation to avoid breaching confidentiality.

No. ONA recommends that you complete the workload form as soon as possible after your shift. Completing the form as soon as possible ensures that you can best recall the details of the workload issues that occurred and will help prepare you for your meeting with the manager. You do not have to fill out the form before you leave at the end of your shift however, if you wait, it may be difficult to recall multiple days of workload concerns/issues if they occur consecutively and are similar in nature.

Your Unit Rep or Professional Responsibility and Workload (PRW) Representative will be happy to help you complete the form. If you don’t know who your Unit Rep or Professional Responsibility and Workload (PRW) Representative is, please ask your Bargaining Unit President for assistance.

Hard copies of the Professional Responsibility Workload Report Forms include five copies of the form. A copy needs to go to your manager, the Bargaining Unit President or Professional Responsibility and Workload Representative, and yourself. Please consult with your Bargaining Unit President to ensure a copy gets to the Labour Relations Officer and Chief Nursing Executive. Please make sure you print firmly when you are completing the form. All copies of the form need to be legible and readable.

You should submit the form as soon as you can after the incident. The form does not have to be completed before the end of the shift in question. Most collective agreements contain a timeline in which the form must be submitted. Please refer to your collective agreement for timelines, or contact your Bargaining Unit President for clarity.

The Professional Responsibility Workload (PRW) process is a collaborative process and needs to include management at every step. Your manager has additional accountabilities under the administrative accountabilities of their professional standards and must act to resolve issues and concerns raised. By being transparent with management, you are allowing them the opportunity to implement resolutions in a timely manner and provide appropriate supports to enable regulated health professionals to practice in a setting that is consistent with proper patient/client/resident care.

The employer and ONA agree that patient care is enhanced if concerns relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective manner (see the relevant Professional Responsibility Article in your collective agreement). By submitting a Professional Responsibility Workload Report Form, ONA members are using an agreed-to process to meet their professional practice standards from the regulatory college.

If your manager has taken actions or steps to interfere or offset the PRW process, including the filing of workload forms, you should contact your Bargaining Unit President at the earliest opportunity. They will support you and advise you of the next steps.

Your manager is required to respond to you and your union representatives in writing within the specified time frame outlined in your Collective Agreement. Please refer to your collective agreement for timelines, and follow up with your Bargaining Unit President or Professional Responsibility and Workload (PRW) Representative. As a best practice, we recommend meeting with your manager after you submit your form to discuss the issues. You can request an ONA representative to accompany you to this meeting.

The Professional Responsibility and Workload Process can be ongoing and lengthy. Once you have submitted a Professional Responsibility Workload Report Form (PRWRF), and have spoken with your Manager and Bargaining Unit President and/or Professional Responsibility and Workload (PRW) Representative regarding the workload concern, an attempt to resolve the workload should occur.  If the issue is not resolved at that time, then the PRWRF will be forwarded and discussed at a meeting with key stakeholders of your place of employment to resolve your concerns. If your concerns are unable to be resolved at this level, your Labour Relations Officer will become involved and may consult and involve a Professional Practice Specialist if they cannot obtain resolution of the issue.

In collaboration with membership, the Bargaining Unit President and key stakeholders of your place of employment, and the Professional Practice team, we will strive to ensure a timely and positive outcome of your workload concerns.

If the concerns remain unresolved, the Professional Practice Specialist will meet with the Bargaining Unit President and/or Professional Responsibility and Workload Representative, Labour Relations Officer and membership to discuss further.  The team will determine whether progress is being made, or if consideration should be given to proceed to Grievance, Mediation or Independent Assessment Committee (IAC), as per your specific Collective Agreement.

Members are encouraged to attend and participate in the meetings between the Union and the Employer, to provide specific and relevant input to the discussion to ensure appropriate outcomes.

At any point throughout this process, you can contact your Bargaining Unit President or your Professional Responsibility and Workload Representative for an update.

Please consult your Collective Agreement for the full process.