The on-call nurses, who often work late at night, said they are sleeping in their cars between assignments. Though some said they have asked for a bed in the hospital, they haven't been given one or they were reprimanded when seeking a spot on their own.
The hospital insists it is in compliance with the contract, and a room is given to any nurse who requests one. But there is a huge discrepancy between the hospital's and the nurses' claims, in what appears to be a breakdown in communication.
Since at least 1998, Packard Hospital's contract has required that on-call nurses who request a sleeping room be provided one.
The contract states that a patient-care manager or supervisor must "identify a location to sleep for those nurses on restricted or unrestricted on-call who have worked a minimum of 16 consecutive hours or who have less than eight hours before their next scheduled shift begins."
Four sleeping locations were designated in a 1998 agreement but are subject to change: patient rooms, the post-anesthesia care unit isolation room, the perinatal diagnostic center and at the Packard Children's Day Hospital.
But a number of nurses said they were never told about the contract provision. One nurse who has worked in the obstetrics unit for two decades said getting a sleeping space has rarely been supported.
"When people ask, the managers say, 'We'll see what we can do.' We're the last resort. Nurses are supposed to make do because that's what nurses always do," she said.
A hospital spokesperson said nurses need to request a space. The location can change, but a patient room at the day hospital is most frequently used. The hospital does not track the usage of accommodations, spokesperson Kelly Frank said in an email.
"We've been able to comply with all nurse requests for sleep space," she said.
Transport nurses in the obstetrics and gynecology unit disagreed and said they are left to sleep in their cars, which creates unsafe situations.
New hospital construction has exacerbated the problem, nurses said. Nurses must now either park farther away and walk or wait in the dark for a shuttle, they said. A rash of auto burglaries has them worried.
The victim of the Jan. 23 burglary is an on-call nurse whose car was burglarized who is assigned to ride with patients on helicopters. She sleeps between transport assignments. The nurses are required to be near or in the hospital during their shifts and to be reachable by phone.
But the nurse said she lives about an hour away. She sleeps in her SUV on days when she comes off transport work at 3 a.m. and is scheduled to work on the hospital floor at 7 a.m., she said. Other nurses who live out of the area said they do the same.
On the night of the burglary, the nurse was parked in a lot across from the hospital at 770 Welch Road, where Packard has a clinic. She parked in a spot that was illuminated and was closest to the hospital, she said.
She was sleeping soundly and awoke to the sound of breaking glass at about 3:40 a.m. A man with a gun in his hand grabbed her purse from the front-seat center console, snatched a bookbag and rifled through the glove compartment before jumping into a getaway car driven by another person, she said.
In a statement to the Weekly last week, hospital spokesperson Robert Dicks said the nurse put herself in harm's way.
"The nurse involved did not request of a patient care manager or supervisor an in-hospital sleep space. Space would have been available had it been requested. ... The nurse involved in this incident chose to rest in an area that is not controlled by the medical center," Dicks said in an email.
But the nurse said she was never told she could request a bed or that the area had increased crime. Had she known, she would not have slept in her car.
Other nurses, who spoke on the condition of anonymity, supported her claims.
"If there is a room, it is the best kept secret in town," one nurse said.
"I have not heard one transport nurse in my unit say that they knew of or made use of this contract provision. ... While there may be contract language regarding on-call sleep room or space, the stark reality is these provisions are on paper only," she said.
A nurse who commutes from the Central Valley said conditions have her seriously evaluating her job.
"The burglary has made me much more aware of my surroundings. It's really not safe. I've decided that I don't want to be a transport nurse anymore because I fear for my safety," she said.
In an email last week, Lorie Johnson, president of the Committee for Recognition of Nursing Achievement (CRONA) union, stated: "CRONA is very concerned about the safety in the parking lots, and we have been raising these concerns with the hospitals for several months, including asking for improved lighting and security features. CRONA is also concerned that hospital managers and supervisors may not be complying with their obligation under the contract to provide sleep locations for on-call nurses. ... The easiest way for the hospital to comply would be for there to be designated sleep rooms."
Dicks said in an email: "Hospital leadership clearly communicated to CRONA information on safe walking paths and parking areas controlled by the medical center. ... Additional lighting is being placed along the safe walking paths of travel we have recommended to CRONA, and in parking areas controlled by the medical center." A security detail patrols the designated parking lots and offers door-to-door escort between the medical center and parking areas, he said. Nurses said the door-to-door service has not been consistent in the past.
Frank refuted nurses' claims that they have not been notified about the sleeping space since the burglary.
"We have taken this unfortunate incident as an opportunity to have safety discussions with nurses on all of our patient units. Not only do we want to be absolutely certain that everyone understands the process for requesting sleep space, but we also are actively communicating other important safety measures," she wrote in an email.
CRONA and the hospital held a meeting on Tuesday to specifically discuss the matter. The hospital and union are also currently in contract negotiations, a union attorney said. Union officials did not return requests for additional comment after the meeting.
Stanford Hospital's contract has the same provision, but a spokesman did not return a comment about how the hospital is handling its sleeping-room requirements.
Packard nurses did have a final observation:
"While it may be true that the hospital is not responsible for our safety on public streets or adjacent private property, it is most important to look at the systems and practices the hospital has implemented that put the nurses in harm's way while traveling to and from work and while on call," one nurse said.