Temple University Hospital Nurses Association

TUHNA Investigation Form

This form should be used by unit reps to inform Shanell Larsen, Grievance Chair, and PASNAP Staff Reps about any Weingarten/Investigation meetings where they represent a member.
Please include first and last name of the manager or HR representative that came to this meeting.
Please include first and last name of unit representative that came to this meeting.
Please include all employees involved in this investigation.
Please include all employees involved in this investigation.
Source/s of Allegation
Documentary Evidence Provided
Include Employee Response to Questions
Ex: Coaching concerns, contradictions, procedural issues, retaliation concerns

Past Practice/Progressive Discipline Check

To evaluate consistency and to protect from unfair discipline.
Previous discipline for this issue?
Please select all that apply
Is the alleged discipline consistent with past practice?

Next Steps/Closing

Requested Union follow up
Please select all that apply
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We use our collective strength to advocate for things like safe staffing, universal access to healthcare, and prevention of harassment and violence against healthcare workers. Our advocacy was instrumental in passing Act 102, Pennsylvania's ban on mandatory overtime for healthcare workers.

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