Contract negotiations between the nurses and administrators at Stanford Hospital & Clinics (SH&C) and Lucile Packard Children’s Hospital (LPCH) took a turn for the worse last month when the nurses voted to authorize a strike. A federal mediator has since requested that both parties return to the bargaining table this Thursday.
The vote to authorize a strike marks an escalation in tensions after more than a year of negotiations between the Committee for Recognition of Nursing Achievement (CRONA) and the Stanford hospitals. CRONA represents 2,700 nurses at both hospitals.
In December, the two parties reached a tentative agreement, which was later voted down by the nurses. This past February, the hospitals decided to impose the new employment contract on the nurses, a move that the CRONA leadership described as “a declaration of war.”
At the heart of the conflict is the hospitals’ proposed Professional Nurse Development Program, which introduces a four-level ranking system and conditions for professional advancement. The hospitals argue that the program is necessary to maintain high standards of care and is comparable with programs at other hospitals.
“[The program] is based solidly on examples of what other academic medical campuses are doing across the country,” Lucile Packard spokesperson Sarah Staley said. “The truth of the matter is no one is demoted, no one loses any salary. All of our nurses are getting the tools provided to them to achieve professional excellence.”
However, the nurses claim that the new program sets unattainable standards for nurses who want to be promoted.
“It is something that a majority of the hospitals across the country are indeed implementing,” CRONA president Lorie Johnson said. “But the difference is that the program that Stanford and Packard have chosen to implement is the most stringent we’ve found across the country.”
Johnson also alleges that the motivations behind the new program are purely financial.
“[This program] has a lot more obstacles for a nurse to get promoted, which is why CRONA has always contended that the program is a means to cut costs,” she said. “We’ve been told many times, directly by the hospital, that there are too many nurses at the higher level and it costs the hospital too much.”
The conflict has been exacerbated by the complexities of the proposed program. CRONA accuses the hospitals of bringing the program into negotiations before giving nurses enough time to understand it.
“[The administration] expected the nurses to understand every detail of it when in fact their own management team, most of the time, did not know the answers to the questions,” Johnson said. “Now we have a better understanding than the majority of the management team at the hospital.”
For their part, the hospitals suggested that the nurses would find the offer more amenable if they better understood the details of the program.
“There are components of the contract that our nurses would benefit from thoroughly understanding,” Staley said. “We’re working now to better communicate to our nurses the value contained in our offer.”
Although the nurses have granted the CRONA administration authorization to call a strike, both parties believe that a strike is undesirable.
“A work stoppage benefits no one,” Staley said. “It doesn’t benefit our nurses or patients who depend on us for care. There are much more instructive ways for us to achieve contract resolution.”
Nonetheless, the hospitals have contingency plans in place and would likely hire nurses from outside the area in the case of the strike.
“All efforts are in place to ensure that our patients would remain our number one priority,” Staley said. “Patient safety would be absolutely paramount and we would do everything to make sure that families that depend on us will not be compromised.”
The nurses are also wary of striking, but see it as the only solution if negotiations continue to fail.
“A strike is a last resort,” Johnson said. “It’s not something we’re going to do without much thought.”
Johnson also invited the hospitals’ administrations to join nurses in an open forum where nurses can ask questions about details of the program. As of this past weekend, the hospital had not yet responded to CRONA’s request.
The federal mediator who has worked with both parties since last summer requested that they return to the table this Thursday. If negotiations go well, the two parties can begin to craft a new tentative agreement.
“We hope that we are going to resolve our differences,” Johnson said. “It can be done, in our opinion. We’re hoping it can be settled so we can go back to serving our community.”