PHRMH Nomination Form - Oregon Nurses Association

PHRMH Hospital Housewide Staffing Committee (HWSC) Intent to Serve Form

Staffing Committee Positions

Med/Surg & ICU
FBC
ED
Infusion
OR
Surgical Services - PACU

Intent to Serve Form

Please fill in the name of the person (or people) you are nominating in the space for the appropriate position(s).

Staffing Committee Position Nominations
Choose the position for which you are nominating. Please see list above for which departments are included in each position.
Position *
Role *	I want to run for primary and alternate position I am ONLY interested in an alternate position
Name *
Email Address *
Unit
Phone Number
PHRMH Hire Date
Intent to Serve	I confirm my intent to serve on the staffing committee.
Staffing Committee Nomination Questions
Please complete the questions below. Your answers to the questions will be published as part of the ballot.
Pledge (select all) *	I will vote along with my direct care RN peers as a block when HWSC votes are held I will make best efforts to meet as a group with other HWSC reps to arrive at consensus on decisions I commit to engage w/nurses on each unit covered by my seat & support UBC members to develop plans
What qualities or experience do you feel you will bring to the committee?
What staffing issues would you like to see addressed in your cluster and hospital?

ONA Calendar more

11/12/2025
OCCNS General Meeting

11/14/2025
Labor Cabinet Meeting

11/14/2025
CA 5 Fall Dinner

12/4/2025
ONA Board of Directors Meeting, Day 1

12/5/2025
ONA Board of Directors Meeting, Day 2

12/5/2025
Labor Cabinet Meeting

5/4/2026 » 5/6/2026
ONA Convention and House of Delegates

Get in Touch

Oregon Nurses Association
18765 SW Boones Ferry Rd., Suite 200
Tualatin, OR 97062
503-293-0011
ONA@OregonRN.org

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