Common use of Surgical Services Clause in Contracts

Surgical Services. Operating Room, Roosevelt Operating Room. Cluster Four. Clinics: MICC, Ambulatory Float Team, Arlington Maternal Fetal Medicine, Bone and Joint Clinic, CHDD, Dermatology Center, Dermatology Surgery Center, Diabetes Care Center, Digestive Disease Center, Eastside Specialty Clinic, Employee Health, EEG, EMG, Eye Center, , General Internal Medicine Clinic, Medical Specialties Clinic, Men’s Health Center, Multiple Sclerosis Clinic, Neurology/Headache Clinic, Neurosurgery Clinic, Otolaryngology/Head and Neck Surgery Clinic, Center for Pain Relief, Outpatient Psychiatry Clinic, Pediatric Care Center, Pre-Anesthesia Clinic, Radiation Oncology, Regional Heart Center, Regional Heart Center – Xxxxxxx, Rehabilitation Medicine Clinic, Sports Medicine at Stadium Clinic, Transplant Services, Urology/Prostate Clinic, Weight Loss Management Center, Women’s Health Care Clinic, University Reproductive Clinic, Surgical Specialties Clinic, Xxxxxx Brain Tumor Center. The Employer shall negotiate with WSNA over the appropriate cluster designation of any Unit not listed above, including but not limited to newly created Units. APPENDIX IV – INNOVATIVE WORK SCHEDULE AGREEMENT FORM NAME (print) I wish to work the following schedule:  40 hours of work within a 7 day period  80 hours of work within a 14 day period (8 hour shifts)  160 hours of work within a 4 week (28 day) period I understand that I may change my work period prior to the request due date (listed below) of the affected schedule by submitting a request for change in writing to my Nurse Manager. I understand that changes to my work period may be submitted no more than two times a year, effective the first full schedule or when I transfer to a new work unit. 4 WEEK BLOCKS 2017-2018 Date change Form is Due 7/15/19-8/11/19 5/27/19 8/12/19-9/08/19 6/24/19 9/09/19-10/06/19 7/22/19 10/07/19-11/03/19 8/19/19 11/04/19-12/01/19 9/16/19 12/02/19-12/29/19 10/14/19 12/30/19-1/26/20 11/11/19 1/27/20-2/23/20 12/09/19 2/24/20-3/22/20 1/6/20 3/23/20-4/19/20 2/3/20 4-20/20-5/17/20 3/3/20 5/18/20-6/14/20 3/30/20 6/15/20-7/12/20 4/27/20 4 WEEK BLOCKS 2018-2019 Date change Form is Due 1/13/20-8/09/20 5/25/20 8/10/20-6/6/20 6/22/20 9/7/20-10/4/20 7/20/20 10/5/20-11/1/20 8/17/20 11/2/20-11/29/20 6/14/20 11/30/20-12/27/20 10/12/20 12/28/20-1/24/21 11/09/20 1/25/21-2/21/21 12/07/20 2/22/21-3/21/21 1/4/21 3/22/21-4/18/21 2/1/21 4/19/21-5/16/21 3/1/21 5/17/21-6/13/21 3/29/21 6/14/21-7/11/21 4/26/21 Registered Nurse Date Nurse Manager Date Notice Only A copy of this form shall be given to the RN and retained by the RN’s Nurse Manager.

Surgical Services. Operating Room, Roosevelt Operating Room. Cluster Four. Clinics: MICC, Ambulatory Float Team, Arlington Maternal Fetal Medicine, Bone and Joint Clinic, CHDD, Dermatology Center, Dermatology Surgery Center, Diabetes Care Center, Digestive Disease Center, Eastside Specialty Clinic, Employee Health, EEG, EMG, Eye Center, , General Internal Medicine Clinic, Medical Specialties Clinic, Men’s Health Center, Multiple Sclerosis Clinic, Neurology/Headache Clinic, Neurosurgery Clinic, Otolaryngology/Head and Neck Surgery Clinic, Center for Pain Relief, Outpatient Psychiatry Clinic, Pediatric Care Center, Pre-Anesthesia Clinic, Radiation Oncology, Regional Heart Center, Regional Heart Center – Xxxxxxx, Rehabilitation Medicine Clinic, Sports Medicine at Stadium Clinic, Transplant Services, Urology/Prostate Clinic, Weight Loss Management Center, Women’s Health Care Clinic, University Reproductive Clinic, Surgical Specialties Clinic, Xxxxxx Brain Tumor Center. The Employer shall negotiate with WSNA over the appropriate cluster designation of any Unit not listed above, including but not limited to newly created Units. APPENDIX IV – INNOVATIVE WORK SCHEDULE AGREEMENT FORM NAME (print) I wish to work the following schedule:  40 hours of work within a 7 day period  80 hours of work within a 14 day period (8 hour shifts)  160 hours of work within a 4 week (28 day) period I understand that I may change my work period prior to the request due date (listed below) of the affected schedule by submitting a request for change in writing to my Nurse Manager. I understand that changes to my work period may be submitted no more than two times a year, effective the first full schedule or when I transfer to a new work unit. 4 WEEK BLOCKS 2017-2018 Date change Form is Due 7/15/197/17/17-8/11/19 5/27/19 8/12/198/13/17 5/29/17 8/14/17-9/08/19 6/24/19 9/09/199/10/17 6/26/17 9/11/17-10/06/19 7/22/19 10/07/1910/08/17 7/24/17 10/09/17-11/03/19 8/19/19 11/04/1911/05/17 8/21/17 11/06/17-12/01/19 9/16/19 12/02/1912/03/17 9/18/17 12/04/17-12/29/19 10/14/19 12/30/1912/31/17 10/16/17 1/1/18-1/26/20 11/11/19 1/27/201/28/18 11/13/17 1/29/18-2/23/20 12/09/19 2/24/202/25/18 12/11/17 2/26/18-3/22/20 1/6/20 3/23/203/25/18 1/8/18 3/26/18-4/19/20 2/3/20 44/22/18 2/5/18 4/23/18-20/205/20/18 3/5/18 5/21/18-5/17/20 3/3/20 5/18/206/17/18 4/2/18 6/18/18-6/14/20 3/30/20 6/15/20-7/12/20 4/27/20 7/15/18 4/30/18 4 WEEK BLOCKS 2018-2019 Date change Form is Due 1/13/207/16/18-8/09/20 5/25/20 8/10/208/12/18 5/28/18 8/13/18-6/6/20 6/22/20 9/7/209/9/18 6/25/18 9/10/18-10/4/20 7/20/20 10/5/2010/7/18 7/23/18 10/8/18-11/1/20 8/17/20 11/2/2011/4/18 8/20/18 11/5/18-11/29/20 6/14/20 11/30/2012/2/18 9/17/18 12/3/18-12/27/20 10/12/20 12/28/2012/30/18 10/15/18 12/31/18-1/24/21 11/09/20 1/25/211/26/19 11/12/18 1/27/19- 2/23/19 12/10/18 2/24/19-2/21/21 12/07/20 2/22/213/23/19 1/7/19 3/24/19-3/21/21 1/4/21 3/22/214/20/19 2/4/19 4/21/19-4/18/21 2/1/21 4/19/215/25/19 3/4/19 5/26/19-5/16/21 3/1/21 5/17/216/22/19 4/1/19 6/23/19-6/13/21 3/29/21 6/14/21-7/11/21 4/26/21 7/20/19 4/29/19 Registered Nurse Date Nurse Manager Date Notice Only A copy of this form shall be given to the RN and retained by the RN’s Nurse Manager.

Surgical Services. Operating Room, Roosevelt Operating Room. Cluster Four. Clinics: MICC, Ambulatory Float Team, Arlington Maternal Fetal Medicine, Bone and Joint Clinic, CHDD, Dermatology Center, Dermatology Surgery Center, Diabetes Care Center, Digestive Disease Center, Eastside Specialty Clinic, Employee Health, EEG, EMG, Eye Center, , General Internal Medicine Clinic, Medical Specialties Clinic, Men’s Health Center, Multiple Sclerosis Clinic, Neurology/Headache Clinic, Neurosurgery Clinic, Otolaryngology/Head and Neck Surgery Clinic, Center for Pain Relief, Outpatient Psychiatry Clinic, Pediatric Care Center, Pre-Anesthesia Clinic, Radiation Oncology, Regional Heart Center, Regional Heart Center – XxxxxxxEdmonds, Rehabilitation Medicine Clinic, Sports Medicine at Stadium Clinic, Transplant Services, Urology/Prostate Clinic, Weight Loss Management Center, Women’s Health Care Clinic, University Reproductive Clinic, Surgical Specialties Clinic, Xxxxxx Brain Tumor Center. The Employer shall negotiate with WSNA over the appropriate cluster designation of any Unit not listed above, including but not limited to newly created Units. APPENDIX IV – INNOVATIVE WORK SCHEDULE AGREEMENT FORM NAME (print) I wish to work the following schedule:  🞎 40 hours of work within a 7 day period  🞎 80 hours of work within a 14 day period (8 hour shifts)  🞎 160 hours of work within a 4 week (28 day) period I understand that I may change my work period prior to the request due date (listed below) of the affected schedule by submitting a request for change in writing to my Nurse Manager. I understand that changes to my work period may be submitted no more than two times a year, effective the first full schedule or when I transfer to a new work unit. 4 WEEK BLOCKS 2017-2018 Date change Form is Due 7/15/197/17/17-8/11/19 5/27/19 8/12/198/13/17 5/29/17 8/14/17-9/08/19 6/24/19 9/09/199/10/17 6/26/17 9/11/17-10/06/19 7/22/19 10/07/1910/08/17 7/24/17 10/09/17-11/03/19 8/19/19 11/04/1911/05/17 8/21/17 11/06/17-12/01/19 9/16/19 12/02/1912/03/17 9/18/17 12/04/17-12/29/19 10/14/19 12/30/1912/31/17 10/16/17 1/1/18-1/26/20 11/11/19 1/27/201/28/18 11/13/17 1/29/18-2/23/20 12/09/19 2/24/202/25/18 12/11/17 2/26/18-3/22/20 1/6/20 3/23/203/25/18 1/8/18 3/26/18-4/19/20 2/3/20 44/22/18 2/5/18 4/23/18-20/205/20/18 3/5/18 5/21/18-5/17/20 3/3/20 5/18/206/17/18 4/2/18 6/18/18-6/14/20 3/30/20 6/15/20-7/12/20 4/27/20 7/15/18 4/30/18 4 WEEK BLOCKS 2018-2019 Date change Form is Due 1/13/207/16/18-8/09/20 5/25/20 8/10/208/12/18 5/28/18 8/13/18-6/6/20 6/22/20 9/7/209/9/18 6/25/18 9/10/18-10/4/20 7/20/20 10/5/2010/7/18 7/23/18 10/8/18-11/1/20 8/17/20 11/2/2011/4/18 8/20/18 11/5/18-11/29/20 6/14/20 11/30/2012/2/18 9/17/18 12/3/18-12/27/20 10/12/20 12/28/2012/30/18 10/15/18 12/31/18-1/24/21 11/09/20 1/25/211/26/19 11/12/18 1/27/19- 2/23/19 12/10/18 2/24/19-2/21/21 12/07/20 2/22/213/23/19 1/7/19 3/24/19-3/21/21 1/4/21 3/22/214/20/19 2/4/19 4/21/19-4/18/21 2/1/21 4/19/215/25/19 3/4/19 5/26/19-5/16/21 3/1/21 5/17/216/22/19 4/1/19 6/23/19-6/13/21 3/29/21 6/14/21-7/11/21 4/26/21 7/20/19 4/29/19 Registered Nurse Date Nurse Manager Date Notice Only A copy of this form shall be given to the RN and retained by the RN’s Nurse Manager.

Surgical Services. Operating Room, Roosevelt Operating Room. Cluster Four. Clinics: MICC, Ambulatory Float Team, Arlington Maternal Fetal Medicine, Bone and Joint Clinic, CHDD, Dermatology Center, Dermatology Surgery Center, Diabetes Care Center, Digestive Disease Center, Eastside Specialty Clinic, Employee Health, EEG, EMG, Eye Center, , General Internal Medicine Clinic, Medical Specialties Clinic, Men’s Health Center, Multiple Sclerosis Clinic, Neurology/Headache Clinic, Neurosurgery Clinic, Otolaryngology/Head and Neck Surgery Clinic, Center for Pain Relief, Outpatient Psychiatry Clinic, Pediatric Care Center, Pre-Anesthesia Clinic, Radiation Oncology, Regional Heart Center, Regional Heart Center – XxxxxxxEdmonds, Rehabilitation Medicine Clinic, Sports Medicine at Stadium Clinic, Transplant Services, Urology/Prostate Clinic, Weight Loss Management Center, Women’s Health Care Clinic, University Reproductive Clinic, Surgical Specialties Clinic, Xxxxxx Brain Tumor Center. The Employer shall negotiate with WSNA over the appropriate cluster designation of any Unit not listed above, including but not limited to newly created Units. APPENDIX IV – INNOVATIVE WORK SCHEDULE AGREEMENT FORM NAME (print) I wish to work the following schedule:  🞎 40 hours of work within a 7 day period  🞎 80 hours of work within a 14 day period (8 hour shifts)  🞎 160 hours of work within a 4 week (28 day) period I understand that I may change my work period prior to the request due date (listed below) of the affected schedule by submitting a request for change in writing to my Nurse Manager. I understand that changes to my work period may be submitted no more than two times a year, effective the first full schedule or when I transfer to a new work unit. 4 WEEK BLOCKS 2017-2018 Date change Form is Due 7/15/19-8/11/19 5/27/19 8/12/19-9/08/19 6/24/19 9/09/19-10/06/19 7/22/19 10/07/19-11/03/19 8/19/19 11/04/19-12/01/19 9/16/19 12/02/19-12/29/19 10/14/19 12/30/19-1/26/20 11/11/19 1/27/20-2/23/20 12/09/19 2/24/20-3/22/20 1/6/20 3/23/20-4/19/20 2/3/20 4-20/20-5/17/20 3/3/20 5/18/20-6/14/20 3/30/20 6/15/20-7/12/20 4/27/20 4 WEEK BLOCKS 2018-2019 Date change Form is Due 1/13/20-8/09/20 5/25/20 8/10/20-6/6/20 6/22/20 9/7/20-10/4/20 7/20/20 10/5/20-11/1/20 8/17/20 11/2/20-11/29/20 6/14/20 11/30/20-12/27/20 10/12/20 12/28/20-1/24/21 11/09/20 1/25/21-2/21/21 12/07/20 2/22/21-3/21/21 1/4/21 3/22/21-4/18/21 2/1/21 4/19/21-5/16/21 3/1/21 5/17/21-6/13/21 3/29/21 6/14/21-7/11/21 4/26/21 Registered Nurse Date Nurse Manager Date Notice Only A copy of this form shall be given to the RN and retained by the RN’s Nurse Manager.

Surgical Services. Operating Room, Roosevelt Operating Room. Cluster Four. Clinics: MICC, Ambulatory Float Team, Arlington Maternal Fetal Medicine, Bone and Joint Clinic, CHDD, Dermatology Center, Dermatology Surgery Center, Diabetes Care Center, Digestive Disease Center, Eastside Specialty Clinic, Employee Health, EEG, EMG, Eye Center, , General Internal Medicine Clinic, Medical Specialties Clinic, Men’s Health Center, Multiple Sclerosis Clinic, Neurology/Headache Clinic, Neurosurgery Clinic, Otolaryngology/Head and Neck Surgery Clinic, Center for Pain Relief, Outpatient Psychiatry Clinic, Pediatric Care Center, Pre-Anesthesia Clinic, Radiation Oncology, Regional Heart Center, Regional Heart Center – Xxxxxxx, Rehabilitation Medicine Clinic, Sports Medicine at Stadium Clinic, Transplant Services, Urology/Prostate Clinic, Weight Loss Management Center, Women’s Health Care Clinic, University Reproductive Clinic, Surgical Specialties Clinic, Xxxxxx Brain Tumor Center. The Employer shall negotiate with WSNA over the appropriate cluster designation of any Unit not listed above, including but not limited to newly created Units. APPENDIX IV – INNOVATIVE WORK SCHEDULE AGREEMENT FORM NAME (print) I wish to work the following schedule:  🞎 40 hours of work within a 7 day period  🞎 80 hours of work within a 14 day period (8 hour shifts)  🞎 160 hours of work within a 4 week (28 day) period I understand that I may change my work period prior to the request due date (listed below) of the affected schedule by submitting a request for change in writing to my Nurse Manager. I understand that changes to my work period may be submitted no more than two times a year, effective the first full schedule or when I transfer to a new work unit. 4 WEEK BLOCKS 2017-2018 Date change Form is Due 7/15/197/17/17-8/11/19 5/27/19 8/12/198/13/17 5/29/17 8/14/17-9/08/19 6/24/19 9/09/199/10/17 6/26/17 9/11/17-10/06/19 7/22/19 10/07/1910/08/17 7/24/17 10/09/17-11/03/19 8/19/19 11/04/1911/05/17 8/21/17 11/06/17-12/01/19 9/16/19 12/02/1912/03/17 9/18/17 12/04/17-12/29/19 10/14/19 12/30/1912/31/17 10/16/17 1/1/18-1/26/20 11/11/19 1/27/201/28/18 11/13/17 1/29/18-2/23/20 12/09/19 2/24/202/25/18 12/11/17 2/26/18-3/22/20 1/6/20 3/23/203/25/18 1/8/18 3/26/18-4/19/20 2/3/20 44/22/18 2/5/18 4/23/18-20/205/20/18 3/5/18 5/21/18-5/17/20 3/3/20 5/18/206/17/18 4/2/18 6/18/18-6/14/20 3/30/20 6/15/20-7/12/20 4/27/20 7/15/18 4/30/18 4 WEEK BLOCKS 2018-2019 Date change Form is Due 1/13/207/16/18-8/09/20 5/25/20 8/10/208/12/18 5/28/18 8/13/18-6/6/20 6/22/20 9/7/209/9/18 6/25/18 9/10/18-10/4/20 7/20/20 10/5/2010/7/18 7/23/18 10/8/18-11/1/20 8/17/20 11/2/2011/4/18 8/20/18 11/5/18-11/29/20 6/14/20 11/30/2012/2/18 9/17/18 12/3/18-12/27/20 10/12/20 12/28/2012/30/18 10/15/18 12/31/18-1/24/21 11/09/20 1/25/211/26/19 11/12/18 1/27/19- 2/23/19 12/10/18 2/24/19-2/21/21 12/07/20 2/22/213/23/19 1/7/19 3/24/19-3/21/21 1/4/21 3/22/214/20/19 2/4/19 4/21/19-4/18/21 2/1/21 4/19/215/25/19 3/4/19 5/26/19-5/16/21 3/1/21 5/17/216/22/19 4/1/19 6/23/19-6/13/21 3/29/21 6/14/21-7/11/21 4/26/21 7/20/19 4/29/19 Registered Nurse Date Nurse Manager Date Notice Only A copy of this form shall be given to the RN and retained by the RN’s Nurse Manager.

Surgical Services. Operating Room, Roosevelt Operating Room. Cluster Four. Clinics: MICC, Ambulatory Float Team, Arlington Maternal Fetal Medicine, Bone and Joint Clinic, CHDD, Dermatology Center, Dermatology Surgery Center, Diabetes Care Center, Digestive Disease Center, Eastside Specialty Clinic, Employee Health, EEG, EMG, Eye Center, , General Internal Medicine Clinic, Medical Specialties Clinic, Men’s Health Center, Multiple Sclerosis Clinic, Neurology/Headache Clinic, Neurosurgery Clinic, Otolaryngology/Head and Neck Surgery Clinic, Center for Pain Relief, Outpatient Psychiatry Clinic, Pediatric Care Center, Pre-Anesthesia Clinic, Radiation Oncology, Regional Heart Center, Regional Heart Center – Xxxxxxx, Rehabilitation Medicine Clinic, Sports Medicine at Stadium Clinic, Transplant Services, Urology/Prostate Clinic, Weight Loss Management Center, Women’s Health Care Clinic, University Reproductive Clinic, Surgical Specialties Clinic, Xxxxxx Brain Tumor Center. The Employer shall negotiate with WSNA over the appropriate cluster designation of any Unit not listed above, including but not limited to newly created Units. APPENDIX IV – INNOVATIVE WORK SCHEDULE AGREEMENT FORM NAME (print) I wish to work the following schedule:  ¨ 40 hours of work within a 7 day period  ¨ 80 hours of work within a 14 day period (8 hour shifts)  ¨ 160 hours of work within a 4 week (28 day) period I understand that I may change my work period prior to the request due date (listed below) of the affected schedule by submitting a request for change in writing to my Nurse Manager. I understand that changes to my work period may be submitted no more than two times a year, effective the first full schedule or when I transfer to a new work unit. 4 WEEK BLOCKS 2017-2018 Date change Form is Due 7/15/197/17/17-8/11/19 5/27/19 8/12/198/13/17 5/29/17 8/14/17-9/08/19 6/24/19 9/09/199/10/17 6/26/17 9/11/17-10/06/19 7/22/19 10/07/1910/08/17 7/24/17 10/09/17-11/03/19 8/19/19 11/04/1911/05/17 8/21/17 11/06/17-12/01/19 9/16/19 12/02/1912/03/17 9/18/17 12/04/17-12/29/19 10/14/19 12/30/1912/31/17 10/16/17 1/1/18-1/26/20 11/11/19 1/27/201/28/18 11/13/17 1/29/18-2/23/20 12/09/19 2/24/202/25/18 12/11/17 2/26/18-3/22/20 1/6/20 3/23/203/25/18 1/8/18 3/26/18-4/19/20 2/3/20 44/22/18 2/5/18 4/23/18-20/205/20/18 3/5/18 5/21/18-5/17/20 3/3/20 5/18/206/17/18 4/2/18 6/18/18-6/14/20 3/30/20 6/15/20-7/12/20 4/27/20 7/15/18 4/30/18 4 WEEK BLOCKS 2018-2019 Date change Form is Due 1/13/207/16/18-8/09/20 5/25/20 8/10/208/12/18 5/28/18 8/13/18-6/6/20 6/22/20 9/7/209/9/18 6/25/18 9/10/18-10/4/20 7/20/20 10/5/2010/7/18 7/23/18 10/8/18-11/1/20 8/17/20 11/2/2011/4/18 8/20/18 11/5/18-11/29/20 6/14/20 11/30/2012/2/18 9/17/18 12/3/18-12/27/20 10/12/20 12/28/2012/30/18 10/15/18 12/31/18-1/24/21 11/09/20 1/25/211/26/19 11/12/18 1/27/19- 2/23/19 12/10/18 2/24/19-2/21/21 12/07/20 2/22/213/23/19 1/7/19 3/24/19-3/21/21 1/4/21 3/22/214/20/19 2/4/19 4/21/19-4/18/21 2/1/21 4/19/215/25/19 3/4/19 5/26/19-5/16/21 3/1/21 5/17/216/22/19 4/1/19 6/23/19-6/13/21 3/29/21 6/14/21-7/11/21 4/26/21 7/20/19 4/29/19 Registered Nurse Date Nurse Manager Date Notice Only A copy of this form shall be given to the RN and retained by the RN’s Nurse Manager.