Print Page   |   Sign In
Staffing Request & Documentation Form (SRDF)

Oregon Nurses Association has provided a means by which staff nurses could report when nurse staffing on their unit/shift is insufficient and/or unsafe since 1997. The report is part of the ethical obligation of nurses to report when provision of "safe patient care” is, at the least, not supported or at the most, impossible. 

When a nurse on a shift is faced with staffing which is imminently or potentially unsafe according to the various causes of unsafe staffing, it is intended that the nurse a) notify someone in the chain of command, b) ask for additional staff, and c) ask for a response in a reasonable period of time, e.g., minutes, hours. The diagnostic reasoning based on professional practice is conducted as to the cause. Following this, the nurse assumes the patient care load as assigned, asking for help as he/she needs. At the end of the shift, or within 48 hours, the nurse completes the form, files it with the nurse manager, PNCC, and ONA. The data on the SRDF forms is converted to statistics, and reports are generated.

Definition and Description of a Staffing Problem

  • What is important to report
    • It is important to report the cause of the insufficient/unsafe staffing
    • The number of additional staffing requested
    • The turnover of the unit (admissions, discharges, transfers in/out) so that turnover can be evaluated
    • Untoward consequences

How to complete the SRDF

Fill out the General SRDF

COPIES of this form should go to ONA, your employer, your BU or PNCC chair, and keep a copy for yourself.

Online SRDF Submission. You can completed the form online (You must have Adobe Reader 8.0 or higher in order for all the information to be sent. Get Adobe Reader here Just hit the "submit by email" button at the top of the form and you will receive instructions for submission.

  • Note: The Submit by Email button in the form will send your form to ONA only, to get the additional copies you must print the form.

Printed SRDF Submission. If your browser does not support fillable pdf's, you can also choose to print the form and submit it by mail and/or fax. Mail completed SRDF to: ONA at 18765 SW Boones Ferry Road, Suite 200, Tualatin, OR 97062 or fax to ONA at 503-293-0013

To request paper copies of the SRDF or to request reports (monthly, quarterly, yearly) of SRDF submissions for your facility call 503-293-0011 ext 335 or e-mail Professional Services 

SRDF for American Red Cross Nurses

If you are an American Red Cross nurse, there is a different SRDF form to use.

  • American Red Cross SRDF - to print and mail and/or fax. Mail completed SRDF to ONA at 18765 SW Boones Ferry Road, Suite 200, Tualatin, OR 97062 or fax to ONA at 503-293-0013

SRDF Summary Reports

Staffing Request and Documentation Forms (SRDF) are filled out by staff nurses or charge nurses at 30 acute care facilities represented by the Oregon Nurses Association (ONA), to document the occurrence of an inappropriate staffing event on a specific shift and unit.

Privacy Policy

Oregon Nurses Association
18765 SW Boones Ferry Rd. Suite 200, Tualatin, OR 97062
(503) 293-0011 or 800-634-3552 (Oregon Only)