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On Thursday, March 31, the contracts between the Committee for Recognition of Nursing Achievements (CRONA) union and Stanford Health Care and Lucile Packard Children’s Hospital expired, raising the possibility of roughly 5,000 nurses going on strike. The facilities are part of the Stanford University Medical Center in California’s Bay Area.
CRONA has stated that nurses will continue to work under extensions of the previous three-year contract and will hold a strike authorization vote on April 7. The last walkout at Stanford Health Care was in 2000, when nurses went on strike for 50 days.
Nurses are fighting for substantial improvements to wages, staffing, health care benefits and mental health support. Like their colleagues at hospitals and clinics throughout the US and worldwide, nurses at Stanford are confronting an increasingly untenable working environment more than two years into the COVID-19 pandemic, combined with a skyrocketing cost of living in the Bay Area, already among the highest in the US.
CRONA has stated that it is demanding an 8 percent wage increase for the first year and a 7 percent wage increase the following two years. With inflation running as high as 7.9 percent in February, these figures—likely to be whittled down by the union in negotiations—would entail wage stagnation at best.
Hospital management, for its part, is currently proposing a 4 percent pay increase for the first year and a 3 percent increase in subsequent years. The hospitals have also proposed to eliminate the cheapest health care option available for Stanford Health Care and Lucile Packard workers, who work under separate but similar contracts.
Nurses have already seen falling real income under the previous contract, which included just a 3 percent annual wage increase. The average inflation rate between 2019 and 2022 was just over 3.5 percent per year.
The south Bay Area is home to Silicon Valley, which has one of the highest costs of living in the country. Many workers are compelled to commute several hours each day given the astronomical cost of housing, with the average rent for a two-bedroom apartment in Palo Alto near Stanford exceeding $3,500. The price of a gallon of gas has hovered near $6 in the area, meaning that workers who were previously just scraping by will confront increasingly unmanageable financial situations.
The previous contract largely overlapped with the coronavirus pandemic, which has put further stresses on health care workers across the US and globally. Throughout the country the worsening conditions have exacerbated an already existing nursing shortage, with many nurses leaving the profession.
CRONA, however, has put forth no serious examination of the COVID-19 pandemic. In its newsletter, there is no criticism of state and federal abandonment of COVID-19 protections and no outrage over loosening CDC recommendations, nor is there data highlighting the continuing high daily death rates for both children and adults across the US.
The looming struggle at Stanford takes place amid a wave of strikes across multiple industries, sparked by the unchecked and continued spread of COVID-19 and rising cost of living, on top of decades of austerity measures. In the greater California Bay Area alone, thousands of workers are on strike.
Five hundred Chevron oil refinery workers in Richmond, California, are striking against a sellout four-year contract agreed to by the United Steelworkers (USW) and the major oil companies. The workers rebelled against the USW and voted down two concessionary agreements with below-inflation raises backed by the union, which were patterned on sellout deals the USW has worked to impose on 30,000 oil and petrochemical workers nationally.
Nearly 5,000 teachers and school workers are nearing the third week of their strike in the Sacramento City Unified School District (SCUSD). Teachers walked out on March 23 over COVID-19 safety concerns, severe understaffing, low pay and cuts to health care benefits.
Three hundred nurses at AHMC Seton Medical Center in Daly City, California, went on a one-day strike last Wednesday to protest the hospital’s failure to meet state staffing ratios. In the past two year, 62 registered nurses have reportedly left the hospital due to poor working conditions.
Registered nurses at 15 Sutter Health hospitals in Northern California went on a one-day strike on March 15 over what they say is the health system’s refusal to adequately address staffing, workplace violence and pandemic readiness. These Sutter nurses have been working under an expired contract since June 2021.
Further north in Oregon, over 4,000 nurses at Providence Health & Services are pushing for strike action, having worked for over two months without a contract as management has refused to meet nurses’ demands over low pay, staffing shortages, complete lack of hazard pay and inadequate benefits.
The malign neglect on the part of the ruling class in the handling of the pandemic has devastated hospitals across the country, resulting in over 1 million American deaths from COVID-19, and pushed health care workers to the brink. Workers are burned out and deeply exhausted by staffing shortages and additional burdens being forced on them, barely keeping the entire infrastructure from collapsing. “Sentinel events,” serious patient safety incidents, have reached their highest level since reporting of them began.
Nurses and other health care workers across the globe have been expressing their outrage over the recent victimization of RaDonda Vaught. Vaught is a former Vanderbilt University Medical Center (VUMC) nurse, who has been convicted of criminal negligence for a medication error which led to the death of 75-year-old Charlene Murphey.
Growing numbers of health care workers have recognized that Vaught is being used as a scapegoat by VUMC, which initially sought to conceal the error from federal health authorities. VUMC did not complete an examination of the policies that made the hospital at risk for such a deadly error.
Medication errors are a common expression of the drive to expedite patient treatment and cut costs. The tragic RaDonda Vaught case is rooted in the capitalist system, under which the health care industry is run as a business subordinated to profit interests, rather than the absolute prioritization of safe and compassionate care to patients.
As Vaught stated herself when speaking to the press after the announcement of the verdict, “There were a lot of missed opportunities. [VUMC] failed to acknowledge this until they were at risk of losing a lot of money. I think it was embarrassing. Not for me. For them.”
Nurses have rushed to RaDonda Vaught’s defense, taking to social media and writing in to the World Socialist Web Site with statements of support.
With COVID continuing, inflation surging, and health systems strained to the limit, anger is building among health care workers in hospitals across the world. Stanford Health Care and Lucile Packard Children’s Hospital are not exempt. Despite being touted as among the top hospitals for nurses based on working conditions and salary, the reality is that many workers are at their breaking point.
In a recent CRONA survey, 44 percent of nurse respondents stated that they were considering leaving Stanford and Lucile Packard Children’s Hospital in the near future. Assignment Despite Objection (ADO) forms have increased by 400 percent at Stanford Health Care between 2020 and 2021. ADO forms are filled out by nursing staff when they believe their assignment is unsafe for a variety of reasons, including but not limited to patient acuity, lack of proper education and poor staffing ratios. In April alone, Stanford has seen 34 ADOs.
Nurses at Stanford should look to the lessons of the struggle at Kaiser last year. There, nurses and other workers experienced sabotage at the hands of the Alliance of Health Care Unions, which canceled a strike by tens of thousands of Kaiser Permanente workers at the last minute last November and pushed through a concessions contract over widespread opposition. The agreement included below-inflation raises, did nothing to address chronically low staffing levels and committed the unions to helping management in finding further areas to cut.
To fight against the sellout deal, nurses and health care workers organized the Kaiser Workers Rank-and-File Committee, which fought against the information blackout imposed by the unions and the health care system and worked to mobilize health care workers in a common struggle for safe working conditions and protection against inflation.
To win demands for decent wages and benefits, safe staffing levels, reasonable working hours and more, nurses and other health care workers at Stanford must draw the necessary conclusions and build new alternative organizations. We urge Stanford Health Care and Lucile Packard Children’s Hospital nurses to form rank-and-file committees, democratically controlled by workers, in order to coordinate and carry out a struggle for what nurses actually need, not what the health giants claim is affordable.