Widgets Magazine

Nurses await reply to counter-offer; hospitals say talks over

Stanford Hospital & Clinics and Lucile Packard Children's Hospital are still at odds with their nurses. (ARNAV MOUDGIL/Staff Photographer)

Stanford nurses have submitted a counterproposal to Stanford Hospital & Clinics and Lucile Packard Children’s Hospital as negotiations for a new contract remain deadlocked.

The two parties’ old contract expired in March after months of negotiations failed to satisfy the demands of the hospitals and nurses. Two weeks ago, 2,302 out of 2,700 nurses represented by the Committee for Recognition of Nursing Achievement (CRONA) rejected the hospitals’ “last, best and final offer.”

Though CRONA accepted the wage proposals from the hospitals’ last offer, it finds contention with other points; in particular, the union’s counterproposal centers on a new professional development program and paid time off.

Negotiations between the union and the hospitals have soured in recent weeks, with CRONA representatives accusing the hospitals of rejecting multiple requests to meet and discuss the situation.

“It was obvious from the beginning that the hospital had no interest in talking to us,” said CRONA lead attorney Peter Nussbaum.

Lucile Packard spokesperson Sarah Staley stated that the hospitals are not interested in further bargaining.

“The bargaining process was done in March,” Staley said. “I think it’s fair to say that what we’ve proposed is competitive, generous and fair. If what the nurses propose is within the parameters of our last, best and final offer, we would certainly be up to hearing those.”

CRONA is awaiting the hospitals’ response to its counterproposal, which is expected this week.

According to law, both parties must continue to follow their old contract until a new contract is in place. However, negotiations remain stalled, and the hospitals could attempt to declare an impasse, which would effectively institute the hospital’s latest proposal.

Nussbaum said if the hospitals did so, the nurses would not rule out the option of going on strike.

Professional Nurse Development Program

Central to the current dispute is the hospital’s proposed Professional Nurse Development Program.

Within the hospitals, nurses are ranked according to a four-step hierarchy, in which employees at nurse-four status are the highest ranked. The hospital’s new development program rewrites the requirements that nurses must fulfill in order to move up the ladder or retain their current status.

CRONA representatives claim the new point system sets unattainable standards for nurses and downgrades years of experience in favor of article-writing and symposium attendance. Under the hospital’s last proposal, nurses would not only have to satisfy the point requirements, but be evaluated by a panel in order to receive promotions. Nussbaum called the interview process “totally subjective.”

“Experience is more important than diplomas,” said CRONA president Lorie Johnson, who is also a nurse in Stanford Hospital’s Cardiothoracic Intensive Care Unit. “A nurse who is not able to publish and cannot present himself or herself flawlessly in front of a panel will not get promoted.”

CRONA’s counterproposal requests that the hospital institute an appeal process for nurses who fail the interview.

Nussbaum believes that the program is a “wolf in sheep’s clothing,” designed to demote a large number of level three and four nurses. He claimed that under the new program, with fewer nurses able to attain senior status, the hospitals will save $15 to $20 million annually.

Responding to the claim, Staley said accusations of financial motivation are a “complete misrepresentation” of the hospitals’ intention.

“We feel strongly about [the program] because it advances nursing practice,” she said, “and we hold ourselves to a high level of performance.”

The hospitals would not say how many nurses’ statuses would be affected or whether the program would have any significant financial effects.

Paid Time Off

The other key issue concerns paid time off. The hospitals stress that although they would not offer employees separate accounts of guaranteed sick leave, vacations and holidays, nurses would be able to save and carry up to 520 hours of paid time off.

CRONA’s counterproposal suggestions mainly deal with the way in which paid time off is accrued and compensated. For instance, the union suggested that a staff nurse who has a balance of 480 hours of paid time off ought to have the option of using the time within 90 days or be paid for up to 80 hours.

The Stanford Packard Facts website lists accrual hours compared to a number of hospitals, including the Daughters of Charity hospitals, the John Muir Health System and the Sutter hospitals. The Stanford hospitals claim their maximum accrual amount is the highest.

  • Colleen

    This new “professional nurse development program” IS a cost savings to the hospitals. I have a Masters in nursing, hold a pediatric nurse practitioner license, participate in nursing shared leadership (a shared governance program in which nurses and management collaborate on key patient care issues), sit on many hospital and unit wide committees and improvement projects, work as a resource nurse, and have delivered quality patient care to oncology patients at Lucile Packard Children’s Hospital for the past 16 years, and I DO NOT QUALIFY for a Clinical nurse IV under the new proposal. Currently I am a staff nurse IV and I have worked hard to attain this status. Under the new proposal I will be demoted to a Clinical nurse II and continue to do the same work for less money. For many years the hospital has claimed that there are too many Staff nurse III and IV’s and many of these nurses do not deserve it. However, the hospital has failed to utilize the current provisions in the contract that enables the manager to demote a nurse if s/he is not meeting the existing requirements of these levels. The new “professional nurse development program” will demote the vast majority of our nurses under the pretense of “helping us grow”. I fully support the growth of our profession, but I do not, and never will, support a program that demotes expert bedside clinicians. I am already a clinical nurse and nothing will ever substitute the knowledge gained by hands-on “real-life” experience.

  • Kathy

    Unfortunately, the hospital failed to mention above that on any given day, a nurse can get cancelled from her shift. We need this PTO time to cover our pay and maintain our medical insurance. Unlike in the corporate world, our days of work are NOT guaranteed. If the census is low, as it had been in the neonatal intensive care unit recently, nurses get canceled. Right now, many of the nurses only have 40, 50, 60 hours of PTO. Even by the hospitals estimates VERY FEW nurses carry a balance of 520+ hours. They also failed to mention that many other hospitals have a no cancellation policies, therefore your days of work are guaranteed-STANFORD/PACKARD do NOT have this policy. You may be wondering WHY this is significant? Again, the hospital failed to mention that they are proposing changes to our medical insurance. In our contract now, a nurse has a protected 6 months of medical insurance in case of illness. As long as she is out on an authorized “medical leave”, and she continues to pay her portion of the insurance costs, the hospital will continue her medical coverage. Under the hospitals new proposal, they are cutting that medical coverage down to 12 weeks!!!! That means, if I get sick (break my back, Cancer, etc…), I will LOSE MY MEDICAL INSURANCE after 12 weeks, and be forced to pay for COBRA. A hospital proposing to take medical insurance away from a care provider seems ridiculous to me! Just as the article states, the hospital has chosen not to seperate PTO (time off) from sick leave, therefore this proposal is just too difficult to agree too. We cannot think about one without thinking about the other.

  • Mary

    The hospital wants us to “advance our nursing practice” and “hold ourselves to a high level of performance”. In essence it wants us to be “the leaders” among other medical institutions in every way, BUT salary, retirement, medical coverage, retiree medical health care, etc… I guess they think the “Stanford Name” is reason enough to stay here. I guess I will take my years of nursing experience (obtained at Stanford) to another hospital that will value me and what I have to contribute.

  • Susan

    It’s very upsetting that the nurses of these two hospitals are being disrespected so profoundly. Where is the “shared governance?” Isn’t Stanford a Magnet Hospital?


    “Magnet status is an award given by the American Nurses’ Credentialing Center (ANCC), an affiliate of the American Nurses Association, to hospitals that satisfy a set of criteria designed to measure the strength and quality of their nursing. A Magnet hospital is stated to be one where nursing delivers excellent patient outcomes, where nurses have a high level of job satisfaction, and where there is a low staff nurse turnover rate and appropriate grievance resolution. Magnet status is also said to indicate nursing involvement in data collection and decision-making in patient care delivery. The idea is that Magnet nursing leaders value staff nurses, involve them in shaping research-based nursing practice, and encourage and reward them for advancing in nursing practice. Magnet hospitals are supposed to have open communication between nurses and other members of the health care team, and an appropriate personnel mix to attain the best patient outcomes and staff work environment.”

    But then again, some will argue that the whole Magnet credentialing thing is about as valuable to the the actual BEDSIDE nurse as the initials MSN are on his/her name tag. In other words, Magnet is a monetary reward and status symbol for the hospital not a reflection of shared governance between a hospital’s nurses and it’s administration. The nurses current contract negotiations with SHC is evidence of this arguement.

  • Susan

    It’s another no.


    “Counterproposal by CRONA Reviewed. Final Offers Stand”

  • Julie

    I agree with you Susan!

  • Mary

    Absolutely AGREE with Susan!! Now the Magnet rating is tied to hospital reimbursement…….You would think Stanford would WANT to retain its Magnet status (achieved through the same excellent nursing practices that they are now trying to get rid of)????

  • julie

    These nurses stood their ground (and I salute them every one!) and look what happened…………