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POA Intake for Delegate Follow-Up — document a specific shift for delegate follow-up.

Privacy & ReviewAnonymous submission is available when you do not provide your name or contact information. Some technical metadata may be processed by the website platform. Submissions are reviewed before publication or follow-up. Do not submit PHI, confidential documents, screenshots, or patient-identifying information.
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POA Intake for Delegate Follow-Up

POA Intake for Delegate Follow-Up — document a specific shift for delegate follow-up.

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What this is for: document a specific shift or assignment concern (staffing, ratios, breaks, mandatory OT, floating, unfilled call-outs) so a delegate can follow up.

This electronic POA intake helps nurses document assignment concerns and connect with a delegate. It does not replace any official union or hospital-required process unless approved by the union. A delegate may follow up with you before formal submission.

Privacy: Do not submit patient names, MRNs, room numbers, screenshots, dates of care, rare clinical details, confidential documents, or patient-identifying information. Anonymous submission is available when you do not include your name or contact information. Submissions are reviewed before follow-up.

★ Pending union review

POA resources pending union review

POA resources and printable materials will be linked here once union leadership confirms what should be shared publicly. In the meantime, use the intake below to document a shift so a delegate can follow up with you.

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Optional attachments may be uploaded only if they contain no PHI, no patient identifiers, no screenshots from hospital systems, no confidential documents, and no patient care details. When in doubt, do not upload. Up to 5 files, 10MB each.