News

'Declaration of war' in nurses' contract impasse

Stanford, Packard nurses reject proposed terms, hospital moves ahead with some changes from unratified agreement

A bitter contract dispute between Stanford and Packard hospitals and their nurses' union has reached a stalemate, with the union accusing the hospitals of "a declaration of war" after the hospitals declared an official impasse and implemented a contract the nurses rejected in March 2010.

Stanford Hospital & Clinics and Lucile Packard Children's Hospital and the union, the Committee for Recognition of Nursing Achievement (CRONA), have had dozens of negotiations to try to iron out sticking points in the contract, which affects 2,700 nurses and expired March 31, 2010.

The hospitals made a "last, best and final" offer that was rejected by the union last spring. The hospitals then pulled out of negotiations. A federal mediator brought the two sides back together late last year, with both sides announcing a tentative contract in December. Nurses voted to reject the contract on Dec. 13, 2010, by 54 percent to 46 percent.

Stanford and Packard's joint Feb. 7 announcement would implement select provisions from the March 31 contract offer. Hospitals spokeswoman Sarah Staley said once an impasse is declared, the hospital can choose which provisions it will implement.

The hospitals will give nurses a 4 percent pay increase but will not make it retroactive to March 31, as was previously offered in the tentative agreement. A $3,000 bonus was to be given to nurses if a 10-day notice of intent to strike was not issued. The hospitals have withdrawn that offer, although the nurses have not issued a strike notice.

A key point of contention in the negotiations, the Professional Nurse Development Plan (PNDP), which was arguably the deal breaker in the tentative-contract vote, will be immediately implemented by the hospitals. That has outraged union leaders.

"We are very disappointed, but not surprised, that the hospitals have chosen to treat the nurses, once again, with disrespect and vindictiveness," CRONA President Lorie Johnson stated in a letter to the nurses.

"Everyone should understand that this is a declaration of war by the hospitals against CRONA and the nurses, and a blatant attempt to try and force us to accept a bad contract. The hospitals need to understand that such behavior on their part will simply worsen relations and not be to their benefit.

"As in the past, we urge all nurses to stand in unity and not allow the arrogance of a big business such as SHC and LPCH divide us," Johnson wrote.

Staley said the provisions being chosen are part of the December tentative agreement.

"It' very important to note that. These were what we agreed to. It is our sincere hope that everyone would continue to focus on excellent patient care and move forward," she said.

Greg Souza, vice president of human resources for Lucile Packard Children's Hospital, said the hospitals are disappointed that after more than a year of contract negotiations "it will not be possible to reach mutually acceptable contract settlements at this time.

"We feel strongly that our offers advance nursing practice and programs and provide our patients with the very best in patient care," he said.

The hospitals requested continued negotiations in a Dec. 23 letter to CRONA. The union attempted to get the hospitals to agree to some changes it felt would get the nurses to ratify on a second vote, but so far, the hospitals have not agreed, according to correspondence between union and hospital attorneys.

The PNDP continues to be the major sticking point, attorney Peter Nussbaum stated in a Feb. 3 letter to hospital attorneys. Under the hospitals' final proposal, Staff Nurse IIIs and IVs could effectively be demoted if they can't qualify under revised staffing qualifications.

Upper-tier clinical nurses can also be demoted and become ineligible to reapply for higher clinical-nurse positions for a substantial period of time because of a single warning for even the most minor alleged infractions. That could lead to potential abuses by managers who are vindictive or play favorites and would cause draconian cuts in the nurse's wages, Nussbaum said.

"Nurses with many years of experience ... who have unquestioned excellent bedside skills will be unfairly punished if the PNDP as proposed were to be implemented," he said.

Johnson stated in a letter to the nurses that the union had made the best effort it could during difficult contract negotiations.

"The tentative agreement that the negotiating team decided to present for a vote posed a difficult choice for our members," she wrote.

"As we explained at the 12 meetings we held, the proposed contract was the best we felt we could get from the hospitals. Accepting it would produce sweeping changes in our working conditions, while rejecting it might lead to the same or a worse result.

"It was for that reason that, as in 2000, CRONA did not make a recommendation and left it up to each of you to vote your conscience.

"The months ahead are uncertain. We have communicated with the hospitals and are awaiting their reply. The CRONA executive board, negotiation committee and team, all of whom are bedside nurses like you, will work even harder in the coming year to reach an agreement that is satisfactory to all parties concerned," Johnson wrote.

Comments

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Posted by Show-Us-The-Numbers
a resident of Another Palo Alto neighborhood
on Feb 8, 2011 at 3:56 pm

This article could have provided more meaningful information. For instance, how many nurses are represented? What is the average and mean salaries for the nurses. And what are the pension obligations of the Hospital. Without this basic information, the issues on the table for the Hospital and nurses is not known.


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Posted by Walter_E_Wallis
a resident of Midtown
on Feb 8, 2011 at 5:10 pm

Walter_E_Wallis is a registered user.

Numbers, smumbers. The hospitals are trying to redefine what an RN is, to the detriment of many of the senior nurses, with little if any improvement in patient care.


Like this comment
Posted by Fred T
a resident of Midtown
on Feb 8, 2011 at 7:55 pm

To Show-Us-The-Numbers

Number of nurses represented is about 2700

Not sure what the mean or average salary is and do not understand why it is relevant?

The majority of the nurses (Anybody hired after 1997) are covered by a defined contribution plan which results in little to no long term obligation by the hospitals.


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Posted by Stanford Nurse
a resident of another community
on Feb 8, 2011 at 7:57 pm

Thank you Mr. Wallis for your support. Folks like you make it a joy to care for the public.


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Posted by Show-Me-The-Numbers
a resident of Another Palo Alto neighborhood
on Feb 8, 2011 at 9:21 pm

> Not sure what the mean or average salary is and
> do not understand why it is relevant?

Mean and average are the two important stats about salaries. The cost to the employer, and ultimately the public, is explained by these numbers.

If the average salary for nurses is $100K, $150K, or $200K (or more), this says a lot about whether they are fairly paid, or not.

Average Salary of Jobs with Related Titles At Stanford:
Web Link

The link above offers some insight into the current salaries of nurses at Stanford. The accuracy of the information is open to question, but the numbers seem reasonable. The web-page claims that the average salary for a Stanford Staff Nurse is: $88K, and that the average Staff Nurse salaries for job postings at Stanford, CA are 24% higher than average Staff Nurse salaries for job postings nationwide.

> The majority of the nurses (anybody hired after 1997) are covered
> by a defined contribution plan which results in little to no long
> term obligation by the hospitals.

This doesn't make any sense. Someone is obligated to pay the pensions. If not Stanford, then who? A better answer would be xx% at yy years--meaning that at age yy (or after nn years), a pension will be paid which is xx% of some salary base. (Of course, there could be other pension options, but this format would allow a comparison with the public sector.)

Suppose the average pension were $100K/year (no COLA), then a 30-year payout would see each employee getting another $3M in their retirement years. (COLAs would increase this amount.) Or the hospital employees could be on US Social Security. At any rate, the post-retirement cost of these nurses needs to be on the table so that the public can understand just how expensive the cost of nurses is to the health care equation at Stanford.

> A key point of contention in the negotiations, the Professional
> Nurse Development Plan (PNDP)

> The PNDP continues to be the major sticking point, attorney Peter
> Nussbaum stated in a Feb. 3 letter to hospital attorneys. Under the
> hospitals' final proposal, Staff Nurse IIIs and IVs could
> effectively be demoted if they can't qualify under revised
> staffing qualifications.

> Upper-tier clinical nurses can also be demoted and become ineligible
> to reapply for higher clinical-nurse positions for a substantial
> period of time because of a single warning for even the most minor
> alleged infractions. That could lead to potential abuses by managers
> who are vindictive or play favorites and would cause draconian cuts
> in the nurse's wages, Nussbaum said.

While it's not likely that Stanford Management will explain to the public why they are seeking these new employment rules, they must have their reasons. Over 100K people die in hospitals every year for reasons that are classified as "avoidable". This includes errors by staff at every level. Stanford, and every hospital, is liable for malpractice awards in these cases, and ultimately the taxpayers and insurance rate payers must foot the bills for these errors (not to mention those who lose their lives due to hospital errors.)



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Posted by cardiac nurse
a resident of another community
on Feb 8, 2011 at 9:41 pm

Nurses at stanford do not receive a pension. Stanford makes a 5% base pay contribution into your retirement account which is basically a group of mutual fund, which you have the option to contribute additional tax defered dollars if you so choose. But the money that ends up in the account is a reflection of time, your contrabution and the market in general. We are not like the police and firefighters who will be paid our salary until we die. The way in which the economy is today and the slim chances of ever actually seeing any social security, a nurse really needs to do much more than small Stanford contrabution in order to prepare for retirement. By the way Show me the numbers... why the negative tone towards nurses???


Like this comment
Posted by Affected nurse
a resident of Midtown
on Feb 8, 2011 at 10:04 pm

To show us the numbers,

Stanford and Lucile Packard Children's hospitals do NOT have a pension plan. They participate in a defined contribution plan. They contribute 5% to a nurse's retirement annually, they also offer matching up to an additional 4% if the nurse contibutes 5%. This money is then put in a TDA account. If all of that money is lost (due to economic downfall) the nurse is OUT of LUCK!!! We do not get a defined pension upon retirement like other institutions. We barely get a "good-bye" when we retire. As a matter of fact, we only get a one-time lump sum of approx 25K for retirement healthcare for life!!!
The article above does not explain the provisions the hospitals chose NOT to implement: 1.) $1.00 raise for relief nurses (where other hospitals give their relief 25% more (averaging $8-$9/hr) in lieu of all benefits. 2.) 1% increase in retirement contribution for nurses with 10+ years (currently at 4% would have gone to 5%) if the nurse also contributed. 3.) A small 15% increase in the one-time lump sum money a nurse receives for retirement healthcare (approx $750.00) FOR LIFE!!!- All of these were previously offered and then removed to be punitive.

As far as people being injured or dying at the expense of "hospital errors", the new PNDP system will not improve that statistic, and may make it worse. This program pulls the nurses focus away from the bedside. It focuses on nurses presenting and publishing, rather than nursing performance at the bedside. To the hospitals, a nurse, is a nurse, is a nurse.....

Lastly, this has never been about wages for the nurses. Currently Stanford and Packard are at the middle to bottom when it comes to nurses salaries in the Bay Area, and the small wage increases the hospitals have offered (and we accepted) will not even catch-up to other institutions. In fact we will fall behind even more as other Area hospitals like Kaiser just got a 15% raise over 3 years without any takeaways. If a managed healthcare system such as Kaiser can honor and respect their nurses, why can't the richest hospitals in the area do the same? Stanford and Packard are trying to build their hospitals using the savings they will get from the nurses. If the hospitals need funds, they should take it from the multi-million dollar salaries enjoyed by the "leaders" of these institutions.

If you live in this area, as I do you should be concerned. Expert, skilled, caring, and compassionate nurses are leaving. The empty halls of those new buildings will echo.......


Like this comment
Posted by Their reasons
a resident of another community
on Feb 8, 2011 at 11:23 pm

Show-me says
it's not likely that Stanford Management will explain to the public why they are seeking these new employment rules, they must have their reasons.
Yes they have their reasons.
They are putting their big money into building a grand, luxurious hospital. And the top salaries that go with it.


Like this comment
Posted by unappreciated
a resident of Old Palo Alto
on Feb 9, 2011 at 3:21 am

"We firmly believe that these provisions reflect the high regard we have for our nursing staff and our commitment to nursing excellence" and that is why we will give you... (really?)

4 percent wage increases for all nurses - while kaiser nurses will get 5%
Paid Time Off (PTO) similar to what other employees receive at the Hospitals - so you can have less amount of pto for emergencies
New Extended Sick Leave (ESL) and Bereavement Leave benefits - to try and make up the fact that we are giving you less pto however, you won't be able to use the ESL right away
A new Professional Nurse Development Program providing career development opportunities for all nurses - because it's more about your degree than your experience


Like this comment
Posted by Move Along
a resident of Meadow Park
on Feb 9, 2011 at 7:38 am

This just seems like a typical pseudo-public employee union contract dispute. This played out with the SEIU contract in Palo Alto a couple years ago, and will play out 100s or 1000s of times over the next decade or two. Government employers (and those with government payers, like hospitals) screwed up during the long boom as the tide generally rose and the peasants didn't complain. Now we'll have 20 years of retrenchment and the unions will squawk every step of the way. I don't blame them, but their compensation is going to come down as gravity re-asserts itself.


Like this comment
Posted by Stephen
a resident of Duveneck/St. Francis
on Feb 9, 2011 at 8:15 am

Just as a point of reference, the 5% plus up to 5% matching in addition contribution to a 403b plan is what every employee (e.g. faculty) at Stanford receives rather than a defined benefit pension.


Like this comment
Posted by Mike
a resident of Crescent Park
on Feb 9, 2011 at 9:38 am

When it comes to pretty much any aspect of their own business issues, Stanford business units seem to consistently work out strategies and plans for their implementation, and then have the resolve and expertise to make it happen.

Our own PA city council should look at Stanford as an example of how to get results that matter.


Like this comment
Posted by Show-Us-The-Numbers
a resident of Another Palo Alto neighborhood
on Feb 9, 2011 at 10:38 am

> Stanford and Lucile Packard Children's hospitals do NOT have a
> pension plan. They participate in a defined contribution plan. They
> contribute 5% to a nurse's retirement annually, they also offer
> matching up to an additional 4% if the nurse contibutes 5%

Thank you for this information. The Stanford Hospital Benefits web site talks about a retirement investment program, but provides no specifics:

Web Link
Web Link

What we're presented with, however, are only a couple small numbers: %5 (Stanford/employer) and 4% (matching contribution for employee contribution) for an retirement account. So, what do these numbers mean?

Total Lifetime Compensation

Using a starting salary of $75,000, and applying a 4% yearly increase, this brings nurses a salary that jumps to $106K/year in 10 years, and $158K/year at year 20. By year 30, a Stanford nurses salary would be $233K, and at year 40: $350K/year. Under this compensation model, nurses will make about $4.2M by year 30, and about $7.1M by year 40.

The "defined contribution" claimed by people posting (but not provided in the Weekly article), will also yield the following "nest egg" at year 30: $570K and $1.5M. (Note--nurses are not prohibited from engaging in other post-retirement income generating activities. Married nurses will likely also have their spouses' post-retirement income also.)

The employees 5% contribution seems to be optional, whereas ordinary people (not Stanford employees) are generally required to pay 7.5% of their own salary into the Social Security tax fund (self-employed people pay 15%). This gives Stanford nurses a 2.5% to 7.5% pay differential against most ordinary workers.

Social Security might payout $250K to $350K over a twenty year period (based on a 15% of salary "contribution"). To make matters worse, if a person dies before drawing out this money, the money paid into the SS (as a tax) is lost. It can not be claimed by a person's estate. Whereas, these retirement accounts belong to the nurses, and the money can be claimed by the estate of someone who dies prematurely.

All-in-all, Stanford nurses (based on this model) would make about $5M
for 30 years of service, and almost $8M for 40 years of service.

The Daily Post today claimed that Stanford nurses make between $110K to $120K. The average number of years that nurses must work to make this kind of money is not in the Post article. Under the 4% yearly salary increase, this will jump salaries to the $180K-$200K range in just 10 years. There does not seem to be any productivity increases being offered by the nurses to justify this kind of salary increase.

The result of these salary increases results in increased cost of health care, which already consumes about 14% of the US GDP.

> Stanford and Packard are at the middle to bottom when it comes
> to nurses salaries in the Bay Area,

If you say so, but the papers are not reporting this claim as fact.

What's also NOT being reported by the papers is the total cost of employing a nurse (salary + benefits + post-retirement healthcare + etc.) Labor unions work the media relentlessly (like this Weekly article), but NEVER talk about the total cost of compensation .. which affects every organizations' bottom line and that organization's customers.




Like this comment
Posted by Show-Us-The-Numbers
a resident of Another Palo Alto neighborhood
on Feb 9, 2011 at 10:43 am

> The "defined contribution" claimed by people posting (but not provided
> in the Weekly article), will also yield the following "nest egg" at
> year 30: $570K and $1.5M.

This should have been:

The "defined contribution" claimed by people posting (but not provided in the Weekly article), will also yield the following "nest egg" at year 30: $570K and $1.5M at year 40.


Like this comment
Posted by neighbor
a resident of Greenmeadow
on Feb 9, 2011 at 10:47 am

It is my understanding that the #1 obstacle here is not about money (at least not directly), but as some have said, is about redefining the role of nurses in hospitals. Stanford wants their nurses to be research staff and clinical staff combined. This doesn't really make sense. University medical centers typically have two tracks for faculty -- a research track, and a clinical track. Some do both, such as faculty who are clinicians who also do clinical research, but many with the same qualifications choose a staff/clinical position. Those who may not have any research responsibilities. How could Stanford reasonably expect floor nurses to suddenly become researchers? And how can that expectation not impact the quality of patient care? If a nurse must use part of her shift to write or analyze their data, then who cares for their patients during that time? Or, is Stanford expecting them to accomplish this without compensation, doing the research on their own time?

It would be good to get a clearer picture of Stanford's intent and their idea of how this will impact patient care.


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Posted by Stanford nurse
a resident of Barron Park
on Feb 9, 2011 at 10:48 am

I have been a Stanford nurse for 15+ years. The majority of the nurses I work with are disappointed with the way our union (CRONA) has handled the last few months of negotiations. The Professional Nurse Development Plan (PNDP) is challenging but we can handle it because we are indeed professionals and believe there is always room for improvement, even as top tier nurses.


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Posted by Ronna Devincenzi
a resident of Another Palo Alto neighborhood
on Feb 9, 2011 at 11:24 am

Seems like once a year for the past few years, I've had the occasion to visit a sick friend in the hospital. Each time, these people & their families have remarked about how wonderful their nursing care was. I always left feeling good about the warmth and professional care that was being given to them.

It must be difficult for nurses to have to work with people at that time, not only the patients, but their families and even friends, like me, and also to have that kind of responsibility, that involves life and death.

These nurses are UNSUNG HEROES. I say: Give them what they want. They work for it. We all benefit from it. We can SEE the result of what they do, and they are NEEDED. There's no sitting back and paper-shuffling, where they work. There's no dodging phone calls, or being unresponsive. They are on the front lines of life.

So to quibble about what they're asking for, in light of the reasonable platform they present, amounts to greed on the part of the hospital. For the public to question them (in light of how much, for instance, the City of Palo Alto management makes, with its perks and benefits) compared to these nurses, is outrageous.

Put smiles on the faces of these heroes - people that are needed. We all win. So far, the hospital should be ashamed. These nurses make the lives of hospital management easier too. End the stalemate, and move onwards and upwards equitably, with decisive leadership. Lastly, to all nurses: Thank you!


Like this comment
Posted by Stanford nurse
a resident of another community
on Feb 9, 2011 at 11:46 am

Thank you Ronna!!! May you be blessed with good health and happiness!


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Posted by Area Resident
a resident of Woodside
on Feb 9, 2011 at 12:36 pm

I am a patient (cancer survivor) at Stanford. The nurses are the best in this institution! I do not quite understand what the hospital is trying to do, but obviously a majority of the nurses are struggling with this. It sounds like they want to demote a lot of people who are already very qualified and caring individuals. They should work with the nurses to come up with a plan that works for both sides. I just do not see a good reason to do this when they were able to come up with the money to both pay Palo Alto and build a hospital. I think that whatever the nurses need is a drop in the bucket compared to that! I hope I do not need a lot more medical care, but if I do I want those nurses taking care of me!


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Posted by Taxpayer
a resident of Downtown North
on Feb 9, 2011 at 12:48 pm

Ronna says: "These nurses are UNSUNG HEROES. I say: Give them what they want. They work for it."

So should we just ignore the fact that health care costs are increasing much faster than the average family's income. And let's ignore the fact that Stanford nurses are starting to make as much as doctors. Is it relevant that they have significantly less education than the docs? So you want us to "Give them what they want" and bankrupt the rest of us.

The Stanford nurses are starting to sound as greedy and manipulative as the pafd. I believe once the citizens understand the $'s involved, the nurses will lose what little support they have.


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Posted by Arch Conservative
a resident of Menlo Park
on Feb 9, 2011 at 12:48 pm

During my 12 day stay at the Stanford Hospital a couple of years ago,I found the nurses, with one exception, to be totally incompetent and uncaring. Their English was terrible- especially the Filipinas. I vowed never to go back to the Stanford Hospital. The food was terrible- but that was not the nurses' fault.
Also, my insurance company was billed for PT and OT in the amount of about $1.5K which was never done.


Like this comment
Posted by John
a resident of Another Palo Alto neighborhood
on Feb 9, 2011 at 1:06 pm

@ Show-Us-the-Numbers:

Sorry, but your calculations are completely wrong. The 4% pay raise is a one-time raise, not an annual raise.

You incorrectly assumed that the 4% raise would be annual, so you over-estimated the nurses' average annual pay by up to about 50% for the first 10 years and up to about 350% over 40 years.

Under the hospital's proposed compensation model (and assuming the same $75K salary that you assumed), nurses would make about $78K/year after 30 years, not the $233K, and their cumulative earnings would be about $2.3M by year 30, not $4.2M. And keep in mind that under the hospital's proposed new professional development plan, there would be very little opportunity for most nurses to increase their pay grade.

So, Show-Us-The-Numbers, you are right that the numbers are important, but what the numbers actually show is that the hospital's proposal is a raw deal for the nurses.


Like this comment
Posted by Mary
a resident of Duveneck/St. Francis
on Feb 9, 2011 at 1:19 pm

All research, writing for publication will be on the nurse's own time. We will not be paid to do this work or have additional time off to do this work. Additionally, there is little support to learn how to do this work as few nurses at the bedside or in management have done this. If there were a PhD Nursing program at Stanford we would have many more resources available to us. This is not the case. I am an expert clinician. If I wanted to be a researcher or an educator or a manager I would have done that by now. I have 30 years of pediatric nursing experience and a Master's degree in pediatric nursing. I love my job and my peers at work. It is the reason I continue to work for Packard. I just want to know where the nursing leadership is in these institutions? They have repeatedly refused to look for a more reasonable compromise in the PNDP criteria. Some of the managers don't have BSNs. Most do not do research or published anything. Oh, but that is OK.....right. Looks like the nursing management has drank the Kool Aid, gave up their voice and does whatever they are told by the hospital's finance executives. Congratulations you have "met expectations"...let's demote you! (You have to exceed expectations to be promoted...)


Like this comment
Posted by Show-Us-The-Numbers
a resident of Another Palo Alto neighborhood
on Feb 9, 2011 at 1:21 pm

> Sorry, but your calculations are completely wrong. The 4% pay
> raise is a one-time raise, not an annual raise.

The model proposed is based on watching every labor union in the US demand (effectively) automatic pay raises every year. We have seen this since the introduction of labor unions in the US before 1900.

The pending contract between the nurses and Stanford is for a what, 2-3 years? Do you really believe that at that time there will not be another demand for another pay increase? The Hospital (and the rate payers) understand that, even if you don't.

The Hospital is in the throws of planning, and financing, a $3.5B (or more) expansion. This will be paid off over the next 30-40 years. Over that same time frame, the Unions will be demanding ever higher salaries. Anyone who suggests otherwise is simply naive.

If the numbers suggested turn out to be wrong, that's admitted under the title of "model". The nurses union could have provided this information, but they did not. The Weekly could have provided this information, but they did not. So, a reader (such as myself) made a stab at trying to put some perspective on the situation.

If the assumptions are wrong, then the results would be easily corrected if the nurses union would provide the pay increases that they will be demanding from Stanford Hospital when these (yet unsigned) contract expires.


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Posted by Sue
a resident of Mountain View
on Feb 9, 2011 at 1:48 pm

"...disrespect and vindictiveness", "declaration of war" are very charged & inflammatory phrases. I get that CRONA & atty Nussbaum are trying to incite outrage from the public in their battle, but I'm not impressed.

Without knowing what Kaiser RNs were paid before their last raise, I can't know how to compare their compensation with Stanford's. Why is this an issue anyway?

I've been hospitalized 7 times in the last 3 years, 5 times for surgeries & twice for resulting staph infections. Some of the nurses are great & some are horrible. There were a couple of inexcusables who should never be allowed near any patients.

Nothing is perfect, but please don't say that PNDP is all bad. I shouldn't have to argue with a nurse about re-gloving in between bedpan service & staph-infected wound cleansing. Fortunately my visitor chimed in & said "I'm getting a supervisor!" That worked. Not all nurses were adept at setting IV needles, either. As a patient, those are the things that matter to me. Nothing is perfect, even nursing quality. Courtesy is appreciated as well.

Nurses work hard & deserve fair compensation. If Kaiser does it better, go work there. This is a tough economy. Some people have had to take pay cuts. Johnson & Nussbaum are not helping their cause or enhancing my perception of the nurses' professionalism with their quoted remarks. Cool the rhetoric, please.


Like this comment
Posted by Getting real...
a resident of another community
on Feb 9, 2011 at 2:21 pm


I agree with those who say that if the nurses at Stanford find better salaries and benefits at other institutions, then they should move on. They should have no problem at all getting a job somewhere else because of their superior skills and experience. Most of us are being significantly impacted by the current economic environment, and for one, I'm very sick and tired of union members wanting to be special - somehow exempt from cutbacks. I'm sure others will gladly fill in for those who can't accept the existing offer!


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Posted by Cary H.
a resident of another community
on Feb 9, 2011 at 2:23 pm

Just a sidebar question-
Why were the nurses unions so angry and constantly protesting Meg Whitman when she was running for Governor? Reading this article about pay and benefits, the issues are between the nurses union and the hospitals. What were their issues with Whitman? Or was it a different union?
Thank you


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Posted by Stanford nurse
a resident of another community
on Feb 9, 2011 at 3:34 pm

You have to wonder how we got to this place.....well I believe it has to do with miscommunication and basic disrespect for nursing. It won't improve until dialogue is respectful and open to real compromise.

Until then, I'm sticking with the nurses. They support me at work and care for my loved ones.


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Posted by Sharon
a resident of Professorville
on Feb 9, 2011 at 4:17 pm

I've been a stanford ICU nurse for over 30 years and I have about 300K in retirement 403b. The Hospital does not respect us its Their Way or The HighWay! They only care about building a new hospital by reducing our pay to help build it.


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Posted by Respect
a resident of Greenmeadow
on Feb 9, 2011 at 4:23 pm


Stanford nurse, I'll bet that everyone who has an opinion on this, regardless of what "side of the fence" they're on, has a great deal of respect for nursing! That's not really the point, though. I know a whole lot of people who have endless respect for nurses - but who also see nurses who don't want to make concessions when their own jobs and families and circumstances are being impacted. It's about fairness - not respect - what is fair in the current marketplace. Also, I think the perception that labor is bankrupting the state with pension payouts isn't helping nursing in this situation. There's a perception that labor, in general, can retire at 55 with full benefits and big pensions, and non-labor doesn't have that security.

I just hope that it gets "settled" soon - and that both sides can find some room to make concessions.


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Posted by mary
a resident of Duveneck/St. Francis
on Feb 9, 2011 at 5:26 pm

Most of us will be demoted to a Clinical Nurse II over the next 2 years. This current offer clearly spells out what is required to attain and maintain Clinical Nurse III and IV. It does not spell out what a Clinical Nurse II is required to do. We have asked for this to be specified. The hospitals will not give specifications. It is up for the administration's interpretation at any time I guess. Why would anyone agree to that? Spell it all out. This has been a difficult and hostile negotiation from the start. Ads were placed in New York for replacement nurses even before negotiations began last January. They expected a strike. They tried to buy us. They tried to fool us. They put on a full court press campaign to promote this contract telling us how great it was. And now they are strong arming us. If anyone needs a union it is us. Most of us just want to work, do a good job and go home. We are not politicians or fanatics.


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Posted by Supports Nurses
a resident of Southgate
on Feb 9, 2011 at 5:28 pm

All of the above considered, I believe the nurses should get what they ask for. Costs for everything are up everywhere. Services they provide for health care is worth every penny. Costs could be cut elsewhere. These people deserve to be paid well. They give back to the community in more ways than one - being consumers in Palo Alto and Menlo Park.

If one compares them to city employees, it should be mentioned they'd not blame volunteer pink ladies, if a patient was not happy with what they were doing. The buck would stop with them, and with those at the top, as it should. Nurses earn the pay. It's unfair to compare them to over-paid & under-accountable city employees.


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Posted by Stanford Nurse
a resident of another community
on Feb 9, 2011 at 8:02 pm

I am also wondering why Stanford has so many managers. Other comparable large hospitals are not so "top heavy". Stanford also spent lots of money this last winter Holiday on indoor decorations thru out hospital. Previously each hospital unit paid for their own decorations that were saved over the years. I am really questioning hospital expenditure choices.


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Posted by Neighbor
a resident of Greenmeadow
on Feb 9, 2011 at 9:18 pm

Whoever believes nurses salaries are getting close to physician salaries must be kidding; not even close!

And for those who believe all unions negotiate annual increases -- the abuses of some unions has lead many to conclude all union workers,particularly public unions are alike. I am a member of a public employees union. Our average annual raise over the past decade was1.6%, leaving us 13% behind increases in cost of living over the same period. We have always contributed 6.5% of our salaries to retirement, plus 7.5% to social security. We must be at least 62 before we earn the max % per year of service. This is not a complaint, just an attempt to convey a more accurate picture of pensions and compensation. Generally, it is the outliers and abuses that make it to the news outlets, leading to misperceptions of reality for the majority.


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Posted by Allen P.
a resident of Evergreen Park
on Feb 9, 2011 at 9:30 pm

One also needs to look at how this local imbroglio plays into the larger picture of rising healthcare costs. Why it costs so much more to get decent healthcare within the U.S. compared to other countries where the general health of the citizenry is actually better. Rising healthcare costs and the unbelievable rise of costs to get a college education seem in tandem. I know some great, dedicated nurses, but it's like the health industry has become too competitive with this group and that group jockeying for position and survival.


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Posted by Sarah
a resident of Midtown
on Feb 9, 2011 at 9:47 pm

I am a nurse at Stanford, and I am all for "accepting cutbacks" if the playing field were leveled. I do ALL the work and I am getting ALL the cutbacks.... Why don't the leaders of this fine institution put their money where their mouth is? Once they "cutback" on their salaries, I would be happy to follow. A CEO or CNO (chief nursing officer) or COO making $600,000+... That is RIDICULOUS. The cost of healthcare is not rising because of the nurses at the bedside. I agree Stanford is "top heavy" thin out the management staff, put millions back into the bank.


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Posted by Mandated Payments
a resident of Leland Manor/Garland Drive
on Feb 10, 2011 at 5:12 am

Allen P.: Your claim that our rising healthcare costs are so much more than other countries who have "better" general health in the citizenry implies that 1) It is true that other countries have cheaper health care and better health ( no evidence for either statement) and 2) that if it WERE true that other countries have "better health", there is a connection between medical care and "better health". Health can be defined in many ways, but the most critical factors have to do with eating, smoking, drinking, sleep and exercise habits. None of these have anything to do with medical care, and everything to do with individual choice.

We have to stop confusing medical care with taking care of ourselves. We are the fattest country...this has a lot to do with our diabetes and cardiac levels. No amount of medical care can fix fat...

We are also the most litigious, with liability costs through the roof compared to "other countries". We also pour the most into our elderly medical care compared to other countries. Over half of our Medicare is spent in the last 6 months of life, struggling to keep people alive who are on their last leg. "Other countries" do not do this.

Last, "other countries" do not pay for non-traditional medical care such as chiropractors or counselors, nor do they insist on paying for language translation services.

Much of our costs could be cut far back if we addressed tort reform and allowing us to pay for insurance which only covers what we want to cover, such as catastrophies as we used to be "allowed" to buy, not what is mandated we cover.

This would affect our costs tremendously, tying what we pay for health care to what we WANT to pay for, instead of forcing us to pay for everything under the sun.

As for the nurses, I love nurses. I am in health care myself. At the same time, I am a great believer in the market forces, and if someone can get a better job elsewhere with pay, benefits and ranking more to their liking, I say GO for it.


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Posted by To Mandated Payments
a resident of another community
on Feb 10, 2011 at 8:42 am


VERY well stated - you've hit the nail on the head!


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Posted by Member
a resident of another community
on Feb 10, 2011 at 8:54 am

I was on the negotiating time last time for the nurses. The hospital representative told us their goal in implementing this Clinical ladder was to "eliminate as many Staff Rn III & Iv's as possible. We want to be like Kaiser or UCSF where a nurse has to vacate the Staff RN III or IV slot before someone else fills it." Their goal is to save money, period. Under their proposal you could do everything they require to achieve one of these Clinical positions and they can deny you. There is no appeal process that involves an independent evaluation. There is also nothing in the hospital that rewards an excellent bedside nurse; they are focused on degrees and publishing. We nurses look at their proposal as a smokescreen for demoting people without recourse.


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Posted by Resident
a resident of South of Midtown
on Feb 10, 2011 at 9:37 am

On the one hand, I do not want the nurses, whom I believe ARE the unsung heroes of the medical world, to suffer. I have a huge respect for what they do and how they save the lives of patients. I also think hospitals and doctors DO treat them disrespectfully when they are the fundamental achievers of patient care.

On the other, we are a dual employed couple with kids, barely making it in Palo Alto (for the schools). We have had salary CUTS for the past three years, not raises. We get no employer contribution to retirement and really minimal health insurance. We both have graduate degrees but can only find work at small organizations, for salaries comparable to what is cited above (though not as much) as the average. Others I know have been unemployed, some for many months.

There are lots of folks like us around here. We are the unsung victims of the economic stratification going on, part of the middle class dissolving away. I look at those represented by unions, ESPECIALLY teachers, city employees, etc., and feel like WE as taxpayers are the ones bearing the huge burdens and paying the costs of what union-represented folks can get from employers.

So I just don't know. It would be nice if everyone could get a 4% raise. It would be nice if everyone had employer contributions to a retirement plan. It would be nice if this country were more respectful of all its workers. Since those things aren't true, then what to think about this situation?


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Posted by Jack
a resident of Downtown North
on Feb 10, 2011 at 9:44 am

No other hospital in California requires a staff nurse to publish in a professional journal each year to keep there pay grade. Why should a nurse have to spend time outside of work doing research without compensation in order to write an article. This sounds stupid. Doctors don't have to do this, neither do other medical professionals. Nurses are not part of Stanford's academic system, they are health care professionals. If Stanford Hospitals want to save money they should look FIRST at management instead of trying to gut the front line workers of our health care system. How many nurse managers have published in a professional journal in the last year? Last 10 years? Come on Stanford fess up!


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Posted by Walter_E_Wallis
a resident of Midtown
on Feb 10, 2011 at 6:36 pm

Walter_E_Wallis is a registered user.

Jack, you've got it. Mandatory publication leads to such crap as "Studies on Optimum Urinal Height" or "Effects of Global Warming on Childbirth". Competency in the use of new machines and medical products and procedures, usually obtained on the job, is more than enough to define competency. There is little correlation between independent research and competency, since deviation from standard procedures is not encouraged. This is a shuck.


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Posted by Marianne
a resident of Duveneck/St. Francis
on Feb 10, 2011 at 8:36 pm

Wow--they got a pay raise. Lucky them. As a teacher with 6 years of university education and innumerable extra training courses, which I paid for myself, I wish I got paid as much as nurses. Instead, I have had a pay cut, hours cut (furlough), and a 15% increase in my health insurance costs. All in all, quite a significant reduction to my pay check. Nevertheless, I am still expected to do the same amount of work in fewer hours, and to keep increasing student results.

Nurses, suck it up. You are no longer the under-paid, over-worked nurses of yesteryear. In some instances, nurses are making more money than doctors.

It's time to share the pain the rest of us are feeling.


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Posted by Stanford Nurse
a resident of another community
on Feb 10, 2011 at 8:52 pm

I salute you Walter! Pure attempted trickery on the Hospitals part... and not even that clever at that!


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Posted by Walter_E_Wallis
a resident of Midtown
on Feb 11, 2011 at 8:27 am

Walter_E_Wallis is a registered user.

Marianne, compare hours worked, shift work and summer vacation.


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Posted by mmmmMom
a resident of Downtown North
on Feb 11, 2011 at 4:48 pm

I am a RN working in another local hospital. I SUPPORT THE STANFORD NURSES 100%!!!!!! Most of the negative statements posted here can be directly attributed to the media manipulation carried on by the administration @ Stanford. And if not Stanford's mis-information, then the usual ignorance of the reality of the current healthcare situation, & hosptial Nursing. Some the stuff that has been written here is so bad it is disturbing. Where are you getting your info people? Do you realize that right now Nurses are being laid off, or forced to transfer out of their area of expertise - even after MANY years in their specialty? I am shocked that you write as if you have any real grasp of what Nurses do, or how we operate within the whole spectrum of the heathcare system. Too much ER & Grey's Anatomy, I guess.

Bedside Nurses are the heart & soul of patient care at any hospital, & if you think they are over-worked & underpaid then I suggest you follow 1 of us around for a few days. (Don't forget about working night shift, weekends, & Holidays, either.) Yes, there are sub-standard Nurses, just as there are sub-standard teachers, lawyers, engineers, dentists, etc. Keep in mind that PART of the reason there are less than stellar Nurses is that some of the most intelligent, competent women left Nursing because of the low pay, enormous physical & emotional drain & strain that is part of the job (how many Nurses over 50 do you ever see?!?), the difficult shift work, exposure to potentially fatal disease, & lack of respect from hospital executives. Gee... kinda sounds familiar doesn't it???!!??

As Nurses, we genuinely care about our patients, & most RNs feel that our profession is more than a just a job - we consider it a calling. If hospitals such as Stanford continue their shameful treatment of Nurses, then not only will the best RNs leave hospitals like Stanford - the entire country's shortage of well educated, competent Nurses will only get worse. Unless you NEVER expect to get sick during the rest of your life, I suggest you read ACCURATE accounts of the current state of Nursing in the country, & support Nurses everywhere.
YOUR LIFE MAY DEPEND UPON IT!


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Posted by Peter Carpenter
a resident of Atherton
on Feb 11, 2011 at 5:00 pm

mmmmMom states:"Nurses are the heart & soul of patient care at any hospital, "

The Stanford Hospital is designed as a research institution and not as a patient care institution. Stanford declared its values back in the 70's when it closed its School of Nursing. Nothing at Stanford counts if it isn't published.

It is a great place to go if you want to be a research subject but it is not nearly so good a place to go if you are 'just' a patient.


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Posted by mary
a resident of Duveneck/St. Francis
on Feb 11, 2011 at 7:59 pm

I have worked at Packard for 20 years. Most of the time I have worked 36 hours per week. I never once saw the Chief Nursing Officer until this round of negotiations. I would not have been able to pick her out of a crowd. This whole thing could have been worked out with a collaborative approach. What a shame that those that lead are so disconnected from those who deliver the care. The hospital may get all it wants despite our objections. You can't make people respect you if you are not respectful and you can't make someone hear you if you won't listen. How will she lead when no body will follow??? A famous MD once described Packard as being like a beautiful woman with syphilis. She is really pretty on the outside but really sick on the inside. Seems he was right.


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Posted by Walter_E_Wallis
a resident of Midtown
on Feb 12, 2011 at 7:11 pm

Peter, Designation as a Research Institution does not lessen the patient care responsibility, nor does admission to a Research Facility excuse poorer care. Any experimental treatment of a patient is allowable only after full consent, such consent revocable at any time.
No more Tuskegee syphilis experiments.


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Posted by Disillusioned
a resident of another community
on Feb 14, 2011 at 11:29 am

I'm appalled at the scope of misinformation that is being pushed as though it were fact. CRONA members, hospital employees, concerned neighborhood citizens, EVERYONE -- do your due diligence and read. Go to the available resources and read everything: www.stanfordpackardfacts.com www.cronafacts.com The facts and details are all out there.


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Posted by Stanford nurse
a resident of another community
on Feb 15, 2011 at 3:27 pm

To the best of my knowledge the nurses unions have strongly backed safe patient laws. One of those very important laws was safe staffing ratios.


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Posted by Stanford nurse
a resident of another community
on Feb 15, 2011 at 4:03 pm

To the best of my knowledge hospitals do not promote safe patient staffing ratios.


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Posted by mary
a resident of Duveneck/St. Francis
on Feb 16, 2011 at 6:58 am

Dissillusioned,

The site that you direct us to is Stanford and Packard's spin site, meaning you are reading their propaganda and BELIEVING it! It is not like the information there is false., but it is not spelling out things completely...shall we call them half truths... They just don't tell you everything....they leave out the icky parts. It is pretty typical "Stanford speak". The true communication is in what is NOT said most of the time.


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Posted by Crona nurse
a resident of Fairmeadow
on Feb 16, 2011 at 2:49 pm

Best of luck to all of my fellow nurses with the vote in the AM.

The public should be concerned. Despite the falsehoods, misinformation, and outright lies being spread about the Nurses and their issues with what the Hospitals are trying to do, this is also ABOUT you. Without the ability to keep or attract top flight nurses to the facility, its ultimetly you that will suffer. You can have the newest building in town, the best equipment, the best doctors, but its still going to be that nurse thats with 24/7 while you are there that will make the difference. The good bedside nurse will know how to keep you out of trouble or know what to do when you are in trouble. A second rate nurse may or may not. Which nurse would you like caring for you?


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Posted by Stanford nurse
a resident of another community
on Feb 16, 2011 at 9:13 pm



Nurses are kind.


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Posted by Disillusioned
a resident of another community
on Feb 17, 2011 at 10:51 am

@ Mary: stanfordpackardfacts.com. I'm reading the tentative agreement that was signed by the CRONA president, Lori Johnson: Web Link

The contents of this tentative agreement are the same points that are being communicated to the community on stanfordpackardfacts. It's not spin, not half-truth, not propoganda, and not 'Stanford speak'. It's THE tentative agreement signed by the CRONA president.

The contents of the tentative agreement did not change after it was signed. It appears CRONA changed its mind. What happened? It looks like spin is indeed occuring, but CRONA is the group doing the spinning, not from the hospitals.

Mary, please educate me. What are the 'icky parts' that are being omitted? Are the 'icky parts' part of the tentative agreement? I prefer to read and understand for myself as opposed to hearing the "facts" second and third-hand...




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Posted by Stanford Nurse
a resident of another community
on Feb 17, 2011 at 2:48 pm



Crona never officially recommended the tentative agreement signed in December. Crona wanted its members to decide for themselves by reading the contract.

I read the contract and I felt it was not good for me or the hospital.

Now parts of that contract are being forced on me and other nurses.


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Posted by mary
a resident of Duveneck/St. Francis
on Feb 17, 2011 at 3:42 pm

Dear Disillusioned,

What are the icky parts? Well, if we never had an impasse and had a ratification vote on the tentative agreement in Dec I would still have voted no. This is why.

1. All requirements are clearly spelled out in the contract for Clinical Nurse III and Clinical
Nurse IV, No requirements are identified for Clinical Nurse II. It is a wide open blank for
management to "fill in" with whatever they feel is necessary. My boss made a point of
telling all of us at our last evaluations that it was "really OK to be a Staff Nurse II, things
were going to be much more rigorous at the next evaluation and people would be
demoted. Most of us did not get the highest rating for anything. Really, are we all that
bad? 30 years of pediatric nursing experience and a master's degree....I pride myself
the patient care I deliver. I would like it all to be spelled out so there aren't any surprises. What do I have to do to keep my job.

2. The one written warning and you are demoted clause bothers me. Hospitals are complicated institutions with opportunity for mistakes readily available. Safe patient care
is important. If mistakes are being made, they need to be identified and measures need to be taken to prevent them. Nurses will be hesitant to report mistakes as it could result in a demotion of their peers or themselves.

3. All registered nurses are not eligible to participate in the Professional Nurse Development Plan...new system of promotion. Very clinically able registered nurses who do not have a benefited position are not eligible for promotion under the new system. I think that is wrong.

4. Transfer of Paid Time Off to and Extended Sick Leave Bank is an issue for me only because if you never need the Extended Sick Leave it will accrue but is not able to be cashed out when you retire or quit.


We have an experienced labor law attorney...30+ years of experience. He has argued before the US Supreme Court. He says this is the worst negotiation process he has ever been involved in. The hospitals never intended to negotiate but rather dictate. The union has made concessions, more than the hospitals. Still we are having a strike vote. How awful. The tone of these negotiations has been hostile from the start. I have read both side's positions. I have gone to the meetings. I have talked to management at length. I understand the offer.


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Posted by Gee
a resident of Another Palo Alto neighborhood
on Feb 21, 2011 at 4:05 pm

Some good points, Mary, but I have questions or disagreements in some areas.

1. The Professional Development doesn't apply to Staff (Clinical) Nurse I or II, so I understand why there's no description of them. However, did the recently expired contract have a definition of those positions? If not, then has management already just "filled in" whatever they wanted? If the last contract had it, I haven't read that the new one will have it taken out, so wouldn't the language remain the same? Basically, what defines those levels now?

2. This is a very valid concern and I understand why nurses would be worried. I'd at least hope that there's strict criteria as to what actions deserve a written warning (vs just a verbal or lesser step).

3. What types of positions are the non-benefited nurses? Relief? Temp? What's the current salary range for those positions? I'm guessing around $45-$65 an hour? Why do you think they deserve the same advancement and benefit opportunity as full time "benefited" nurses? I can see both sides of this issue.

4. I read that nurses will accrue PTO at the same rate as before (same number of total hours off per year), and that there is now an additional Extended Sick Leave to help with longer-term absences. In addition, there's insurance being offered for people who want more protection in case of major illness. The days of banking 1000+ hours have been gone for almost every major employer in the SF Bay Area and beyond. That's very expensive for any company to keep on the books. A 500+ hour PTO bank, plus ESL, is a lot better than most companies offer. Who has better PTO accrual rates and maximums that you know of?

Best wishes on a fair resolution, and I hope it happens soon.


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