Martha Marsh, CEO of Stanford Hospital and Clinics said the offer "reflects the high regard we have for our nursing staff and our commitment to nursing excellence."

I think not. Who are they kidding? A new contract that actually demotes nurses with multiple decades of service and has no policy to "grandfather in" those who can do the job but may not have a bachelor's degree is hardly an example of "high regard for nursing staff."

Regarding a "commitment to excellence" - Of course the economy is an issue, and of course nurses cost money. Funny how people don't complain when a professional nurse assesses a baby/child and their skills saves that patient's life. How about charging patients for the amount of nursing time they require (rather than including nursing care in the "room charge".)? How about a raise commensurate with the economy, but a new ladder which recognizes and supports the vast knowledge base and life-saving skills of their current staff?

I'm a nurse (with a BSN) and I don't work at Stanford, but this is ridiculous. If they want to make sweeping changes in the ladder, this is not the way to do it. The nursing profession should have handled the educational/entry to practice issue 25 years ago and grandfathered ADN's and diploma grads then - we'd be done by now.

What a shame. I wonder if management would like to decrease their salaries and be demoted? Just my two cents...

These stanford nurses are very unique, kind, knowledgeable, dedicated, patient and more. I know this because I am fortunate enough to have found them and I work with them. I am grateful everyday for them because they come to my aide when I need help. They help me care for my patients and make the workplace a wonderful place to be.

Sounds like the strike is coming. The hospital is probably not too worried - I'm sure there are plenty of nurses prepared to step in if they do go on strike. In this jobs environment, you can expect over-rich deals like this one to get re-written - recessions are good for that.

Funny how nurses want to be paid as doctors. Health care has become a business not about the patient anymore. I am a health care graduate in Business. Nurses were being paid this amount due to the level of work provided, but its funny how LVN's or the Medical Asst's are doing the work now. Why pay large amounts of money when you could 3 LVN's to do 1 nurse's job. Its a Business sense and cost effective in these tuff times.

With the coming "cost cuts" in health care, ie cuts in health care services as a bankrupt govt transfers power to itself over health care, this will become an ever more common story.

All health care providers will make less money. They already do..

All health care providers will have to see more patients in a day..this means less care per patient.

This has already been happening in all govt funded health care services from MediCal to Medicare. It will get worse.

That's life.

I wonder how many nurses voted for the party that just brought their latest job destruction bill forward?

Go check out how well the nurses/doctors/other health care workers live in universal care countries from Cuba to Canada to England to France, compared to our salaries here.

Check out how much "health care" citizens get in these same countries compared to here.

Be prepared to see the same thing evolve here over the next 10 years.

Gonna be a fun ride! Enjoy it.

the hospital gives "final offer" to nurses? yeah, right...the hospital knows darn well that without the nurses there is NO hospital...the nurses will decide what the "final offer" will be, not management...go nurses (and other ancillary staff that actually does the WORK)!!

Funny how management dictates how much to pay nurses. It's never the other way around. Management pays themselves their big salaries and bonuses first and then divides what is leftover for the workers who are the real backbone of hospitals.

For once, I would like to see the media report how much hospital administration and top executives make and what sacrifice they make to help out in this economy.

about time some of this was in the news

[Post removed by Palo Alto Online staff.]

Those salaries sound pretty good.

I so agree with Replacement Pro! If the nurses who care so much about patients can just leave them at the bedside, they can't care that much about the people they "claim" to care about. There are a lot of nurses looking to work at a world-class institution like Stanford. Bring them in! I know temp nurses who are ready to step in permanently - and do the work that is required to keep up with improvements in health care. They don't expect to make big money in exchange for standards developed 40 years ago. The hospitals have to depend on a good nursing staff willing to learn new procedures and techniques. Unions were initially a good thing, but now exist to protect non-performing dues payers.

Right On Replacement Pro! They should be thanking their lucky stars they have a job.

With today's market, they should be happy to have a job especially working at top notch hospital with very well paid.

Stop complaining!

These nurses complain that the public doesn't recognize them as "professionals"--well, start acting professional. Also, I urge the public to take a look at the offer and they will realize that it is not as bad as the union is making it out to be. These nurses have it easy! They need to take some real professional responsibility and recognize that they should feel blessed to have a stable, well paying and well respected job!

"Funny how management dictates how much to pay nurses."

Isn't that pretty much the definition of management? What did you want them to do, check patients' blood pressure?

Replacement Pro is correct that Temple University Hospital claims that it will maintain service at current levels despite the strike--but claims don't always match reality. Temple has hired 800 temporary workers to replace the 2,000 workers on strike--that's a mere 40% replacement rate. My guess is that service at Temple will suffer drastically, even if those 2,000 being replaced are only half as efficient and productive as they could be.
Replacement Pro also claims that the 2,700 union nurses at Stanford could be easily (and permanently) replaced. I doubt it. Nurses are in high demand right now (hence the long wait lists to get into nursing programs), and Temple apparently just snapped up a major chunk of the nurses nationwide who are looking for work right now. If Stanford has to look for replacements, it'll be scraping the barrel. If anyone in my family needs surgery while Stanford nurses strike, I think I'll send them to El Camino Hospital.
As for Stanford's proposal, one thing I learned a long time ago about being a good manager is that one has to give employees an opportunity to be rewarded for a job well done. If Stanford proposes to make promotion to Nurse III and Nurse IV virtually impossible for most of its staff, then what incentive will Stanford nurses have to excel? Looks to me as though Stanford is settling for mediocrity, which is a sad thing for a teaching hospital.

Strikes dont work when the economy is down. There will be many people who .....wait a sec....there ARE many people who are just waiting to fill an empty nursing spot. I dont particularly care for Healthcare business, even though I am a Health care worker. At the end of my day I dont count my hours, or count my patients, or any sort of accounting that has to do with monetary value. Because I know that the health care that I provide is as valuable as a human life, and many other lives depend on the care I deliver. I and millions of others are worth more than our weight in gold. Of course I believe healthcare workers and teachers should be the highest paid people in our society. I also know that is not the reality of our country. America used to be a moral, good, outstanding, example for the world. now its just a business. These Nurse unions realize that healthcare is no longer about caring for the sick, but about squeezing as much money out of every positive and negative situation as they arise.

I guess what Im saying is, the hospital wont close if nurses strike. Replacements are easy in this economy. The nurses would lose their job, and end up in a bad situation.

I dont particularly care for the nurses at Stanford, the service my family recieved while there left much to be expectd. Patients wandering the halls, erupting into other patients rooms, overall poor attention to detail. For example walking around in scrubs with soiled patches where theres pockets, uh uh a big no no for any professional. Also a clear sign that the nurse spends alot of her time with hands in her pockets. I dont want to pin bad things on all those nurses, but this is the general idea of how most people with no knowledge of healthcare see the staff if they encounter 1-2 bad nurses out of the 40-50 that are on duty.

Bottom line : Please strike, lots of people want your job if you dont want it on those terms.

The hardest part of Nursing is getting through school, and the internship. After that its cake. Dont fight for more, when you already have a 7 course meal being served on platinum platters. More isnt always better.

I need to retain copies of my submissions.
Last night I poured my heart out, only to be spiked. Erased. Blue screen of deathed.
I suggested that, in the example of Professional Engineers, grandfathering had little adverse public consequences. Older folk tend to stick with what they are familiar, thus being the best guarantee against overreaching.
I took modest issue with the suggestion by some that Nurses were just not-quite-doctors but a co-equal partner in the healing arts. [given my druthers, nurses would run hospitals]. I chided the professions because they retained the quaint custom of addressing nurses by given, rather than [honorific, Family name] as accorded Doctors. I took issue with some correspondents who suggested implied that nursing had not advanced from the pre-Nightingale days when they were usually camp followers. {Kiddies, ask your Dad what that means.]
I even, subversively suggested that perhaps the adversary model of labor management might not be the best approach to critical services.
Editors - making the world safe for mediocrity.

When you are ill, you want a competent caring professional to evaluate and monitor your care. You want someone who is not new to the hospital, to the doctors, to the procedures as done at that institution. Replacement nurses need those nurses familiar with the setting to guide them for awhile so they can be as competent as those from the institution. Replacements may keep the institution open, but the care delivery will not be of the highest order. Thats the fact. Thats what happened last time. Its like a substitute teacher without a lesson plan thrown into a new school and a new classroom. Its variable and uneven and scary. I won't want to be a patient there if that happens.

... not to mention that the cost of bringing in scabs often exceeds the cost of complying with labor's demands. Sadly, it becomes an ego thing. Can't they just get along?

Many of you making these harsh comments are "on the outside looking in" (i.e. replacement pro). As a proud stanford nurse, I can tell all of you haters right now that this labor dispute has little to do with money and raises, and more about cuts in health care benifits and demotions. we are just trying to protect ourselves and our families. And, going on strike is the last thing on our minds (and most likely not going to happen). so please, check yourself before you call us a bunch of greedy unappreciative nurses.

I hope Stanford fires every last one of these striking union nurses. All these nurses care about is their greed (overpriced pay, generous benefits, pension) and job protection without accountability. Those salaries are out of control. No wonder health care cost have grown exponentially. Thank goodness for technology and innovation, it will make a majority of these nurses and manual labor obsolete in the future.
I hope Stanford levels all the strikers and replaces them all with eager qualified nurses whom will come to work each day happy to be there and to have a job in this economy at a fraction of the cost. Unions always with their emotional and non rationale arguments. So glad to hear someone is standing up to the unions in this state. The Palo Alto City Council and City Manager should learn and follow in the footsteps of Stanford Hospital. Fire away Stanford.

Richard, My wife was a recent patient at Stanford. Of the room rate of $7,500 a day, how much do you think the nurses got?

Checked on these points before you throw harsh comments
1)Strike will be the last thing to happen- non of us wanted to go on strike, BUT we have family like anybody to take care.If we allow the hospital management to manipulate nurses to be working and functioning as experienced nurse with 10-15-20-30 yrs expereince and be paid like a new comer or just like anybody who does not operate life saving machines,gives ,monitors and titrate meds continously according to what the patient needs to survive then that is an issue.We take cares of patients from other facilities that can't handle no more, I have work so many places and I have not been in a facility that have amazingly intelligent/knowledgeable nurses that even helps alot new doctors.- that is what they are trying to do.DEMOTE their nurses!!! and cut the pay in tyhe long run, but did the upper management even tried to cut their pay? do you haters know how much are they getting paid? They are being paid so much to be able to cut nurses pay.

2)Posted by LPCH nurse, a resident of Stanford, on Apr 5, 2010 at 12:38 pm

These nurses complain that the public doesn't recognize them as "professionals"--well, start acting professional. Also, I urge the public to take a look at the offer and they will realize that it is not as bad as the union is making it out to be. These nurses have it easy! They need to take some real professional responsibility and recognize that they should feel blessed to have a stable, well paying and well respected job!

RESPONSE, How do you define profesionalism? you need to learn to read fine prints and understand that the offer is not just all about money its about protecting rights,standing for the right thing and protecting the not just your self but the rest of the crew that we all know that one day will get old and be sicky and have no health insurance nor pension- after you have been injured so many times because of hardworks here you are 60 yrs old with no insurance and have no pension is that a future of a backbone in the healthcare supposed to be? how professional are you? to let it happen?
3) It is sad when people who spent all their working life taking care with people ends up buying out cobra coverage to stay alive.

to be continued...

1)Neighbors, Would you rather be taken cared of with a nurse who is into publishing books,editor of a nesw paper or someone who is expert in bedside,operates and trouble shoots life saving machine( machines that works in behalf of your heart? lungs? kidnes? when you get hospitalize.- thats how upper management wants to do just for them to cut expences in exepense of their nurses who are their backbone.
-Do you know how much upper management being paid? for what? for being able to save money by demoting there nurses? Did they evey try to think about cutting there pay themselves? to help cut cost?

2)one comment say's its easy to replace..., You have no idea how nurses in the critical care at stanford works and what expertise they have... not even from same hospital can function same as those nurses from one unit to another. I have work in so many hospitals and their of the same field for over 20 yrs but non would even get close to what stanford nurses does... you have no idea.

3) IF ever we go on strike, its not just about money. It is about respect and care we deserve. WE do care for our patient but we need it is our responsibility to protect our future , we don't want to be on our 60's-70's with no insurance,pension, moreover- NO INSURANCE after 12 weeks of being sick.
4) and one more good news, keep on working without gaining vacation hours? jackpot!

As far as I know, nurses don't just leave their unit/nurses when they go to strike- THEY give advance notice to the management for them to look for temp replacement... that is how it works.

This is an interesting chapter in what will be a long history of cost-cutting in US health care. It is hard to cut costs in a labor intensive business without cutting labor costs. So if we think that health care costs are "out of control" and want to change it, we can expect nurses, among many many others, to get squeezed.

Yup..we tried to tell the American people..the desire to "reform" health care was driven by, ostensibly, by the desire to make it so everyone had health care insurance. Obviously, in America, we all had access to health care, it was just that some of us wanted it to be "free" for all, without consequences to those who did not buy insurance in the first place.

This devolved into "reform" that had the goal of "cutting costs" in health care.

Which turned into measures that cut money going into health care...

which in turn will begin showing up as less pay for health care workers, and fewer workers per patient...

which turns into "less care"...

the only way to cut costs, as we have said from the beginning, is to cut care.


As with all socialist ideas, the results of policies is not a raising of all, but a lowering of all..yup, that bothersome "rich-poor" gap is less, but not because the poor are richer, but because the rich are poorer along with poorer poor.

What is that Chinese curse? "May you live in interesting times"..well, here they are. We got what we voted for, and it is only going to get more interesting as we run out of "other people's money".

We abandoned MLKs "Judging by content, not color", JFK's "ask not what your country can do for you but what you can do for your country", and this week abandoned Reagan's "peace through strength"..and are into a whole new generation that believes in "fairness" in outcomes as doctrine, even if it means everybody "fairly" sinks together.

Get out your bucket and keep bailing.

Good luck, nurses. Doctors hold the political power, and as time goes forward, the rest of us in health care will go the way of nurses, therapists etc in Europe...

Well said, Miranda.

CRONA Nurses will vote to REJECT this offer. It's full of take-aways and devalues and downright insults nurses, especially senior nurses who have made incredible life-long contributions to the hospitals.

From the article:

'Christopher Dawes, president and CEO of the Lucile Packard Children's Hospital, said in a statement that he believes the new offer "achieves the goal of establishing a generous and comprehensive contract for our nurses that advances nursing practice and programs."'

"Advances nursing practice and programs?" This professional development program is meant to drive out invaluable senior nurses who cost the hospitals more - and deservedly so - to make room for less-experienced and therefore less "expensive" nurses. It's about cutting costs and HAS NOTHING TO DO WITH HEALTH REFORM.

Some of the criteria for the bedside nurse to meet the Nurse III and Nurse IV levels include authoring original research articles, writing a chapter in a textbook, editing textbooks, writing evidenced based policy or an editorial in a journal. These are just a few of the completely unrealistic requirements for the bedside nurse. And not only do nurses have to accomplish these things to be promoted, a CN III has to do it EVERY YEAR to maintain her/his Clinical Nurse level (earn 30 points). CN IV's have two years (earn 45 points). So how does this right here make sense?? A lower level nurse needs 60 points in the 2 years that a higher level nurse needs 45 points? How the HELL does that make sense? Oh wait, there's always less expected from the top, right? Make perfect sense. Sheesh!

So not only do the hospitals expect nurses work all of their 8, 10 or 12 hour shifts every week, they will be required to do formal academia type work on their own time. YES, their own time. How does this make one a better bedside nurse? How does it "advance nursing programs and practice?" Does the patient lying in that bed or their distraught family really care if the nurse who is managing their care has done has written a yearly research paper? Would YOU be concerned if the nurse making life-saving, on-the-spot decisions was stressing over meeting her point requirement while she or he was managing YOUR care??

If it were me or my loved one, I would want my nurse focusing on me.

As evidenced by these unrealistic and unattainable goals for almost all nurses at Stanford and LPCH, almost every nurse - no matter their senority - will be demoted and be unable to advance at all...what thi$ whole thing i$ really all about.

Without a doubt, the clinical ladder for Stanford and LPCH nurses needs updating, but not like this.

One last thing. The commenters here who say there are plenty of nurses ready to step into our jobs. Yes there are plenty....they're called SCABS and I wouldn't be surprised if those making the comments are the SCABS that are currently being trained now.

It is ABSOLUTE NONSENSE that any of this is related to Health Insurance Reform that was recently signed into law.

It's nonsense.

This is about a group of extraordinary professional registered nurses fighting for their rights against an administration who has lied and broken actual federal labor laws in the process.

Like the commenter, "looking at the main issue" said....YOU HAVE NO IDEA.

@ you lie in the bed you make...

The Stanford nurses strike in 2000 was about the SAME issues. The nurses went out for 51 days.

This is nothing new and has been happening to nurses all over the country for decades. And like I said, it has NOTHING to do with health reform.

Nursing is the single highest cost for hospitals. Of course when hospitals need to make cuts, nursing is always the first thing they look to to save money. The problem with this is that hospitals ARE nurses. They are run by nurses and without nurses hospitals cease to be. For anyone to minimize that FACT just doesn't understand what nurses do - the scope of nursing practice.

Why do hospitals hate nurses?

@ Replacement Pro, et al...are you scabs?

Usually scabs say things like ... "how could nurses leave their patients to go on strike?" Scabs complain that striking nurses value money over patients. "They deserve to be fired!" And they say it with such conviction.

But tell me this, what responsible RN who cares so much about leaving their patients because of a lack of respect and recognition from their employer would cross a picket line for a brief training and orientation period; walk onto a completely unfamiliar nursing unit and begin managing patients with unfamiliar physicians, unfamiliar work flows and unfamiliar co-scabs with managers who haven't worked at the bedside for YEARS? What responsible RN would do that while earning $6,000 week plus living expenses?

Sounds to me the scabs are confused who are unethical. THEY are the ones who are not professional and put patient safety and well-being at risk. It's precisely because SCAB RN's are willing to cross that picket line that critically ill patients have to be transported to other facilities...because SCABS can't manage their care. Scabs give the hospitals power. It's disgusting. I'm ashamed of RN scabs and am embarressed by their existence - they are the worse of the profession.

Please listen up.....we are not planning a strike...soembody else is. We are trying to work this out.

The so-called Stanford/LPCH "commitment to excellence" is really nothing more than a cynical plan to commit themselves to cutting off any possibility for very educated and experienced nurses to advance.

Just two things to just maybe peek at in order to show this typical Stanford cynical manipulation and spin..

1) Why isn't then a commensurate "commitment to excellence" for the nursing administrators? So now a BSN or MSN grad will be stuck and/or driven down the wage scale while meanwhile their nursing administrator may only have an ASN degree, never have to publish, etc.

2) Assuming that the "Commitment to Excellence" agenda gets established. If one looks at the details involved it is VERY doubtful that the nurses are out there who will fill these slots. If then, say, 4 years go by and these positions aren't filled to any significant degree, will Stanford/LCPH then either A) pay whatever the "market will bear" in order to be "excellent"? (if you paid $5,000 per shift the people will be "out there". Or B) admit that this whole scheme was concocted in order to drive down or cap RN's wages and that the patient care card was just a cynical ploy?

This is typical Stanford double-speak. They want to develop the Dish area and so want to cut down the number of hikers. So they play the "nesting bird" card and post a grown person as a guard. They want to do a wage reduction for nurses and concoct this ploy. Yet if one follows either to the logical conclusion a similar ploy thread is evident.

And as regards..

"Why pay large amounts of money when you could 3 LVN's to do 1 nurse's job."

This is legally and clinically absurd. If you have one shred of knowledge as regards the clinical and professional realities of modern in-hospital healthcare (and especially an ICU, trauma, etc.) I invite you to go and be taken care of by 3 LVN's instead of 1 nurse.

Sounds like a bunch of crap. Something seriously wrong when the new so-called "development program" is so stringent that the "majority of experienced nurses" won't qualify. If there were nurses on the review board, then it might be OK. But with no nurses on the review board, you know that the process will be seriously abused by the Hospital Admin.

Are they proposing to replace the current performance review and promotion process completely with this new "development program"? Sounds like the equivalent of letting a bunch of non-engineering managers that don't even work at Boeing doing Boeing's engineer performance reviews and determining who gets promoted. I don't think that would fly here either.

In addition..

Yes there are "replacement" nurses out there. Recently the CHW network came very close to a nursing strike. The replacement agency was charging $1,200 PER SHIFT for the replacement nurses.

And when one looks at the typical mindset/experience of these replacement nurses who typically work for these temp agencies (and especially the ones eager to travel and be scabs and betray their fellow nurses) they are a mix of both the experienced and the inept, the adaptable and the chronically dysfunctional. Plus when one looks at all the various specialty arenas of Stanford/LCPH, computerized charting and passwords, protocols, etc.

"It's going to be a bumpy ride". I would not want to be a patient (or have a loved one or friend be one either) during such a strike concocted off such a dishonest agenda.

Paragraph three lists specifics of the hospital offer. Where is paragraph four with the union's counter offer?

Where is the assessment of the neutral third party brought in to help the negotiations?

Where is the reporting of facts instead of vague statements like “vast majority” and “most”?

Nurses have a job that is physically and emotionally demanding and deserve better reporting of the situation than has been offered here.

Can't disagree with you Budd.

Since nobody's taking the time to formally talk or report about it, except the union attorney who has made several public statements and the hospital who has been tooting their own horn, here is the website of the nurses union - Committee for Recognition of Nursng Achievement (CRONA):

Web Link

Take a look at the Development Program counter proposal by the nurses. It's a much needed change and it's doable. While you're at it take a look at the Newsletter of March 26th, Vol 17 and the link below it. More good reading is in the March 31st Newsletter, Vol 20. Just browsng through those newletters you will see that the hospitals have NOT negotiated in good faith. They've done nothing but lie and mae "mistakes."

Here's the hospitals website:

Web Link

So who should trust this website or anything the hospitals say after looking at CRONA's newsletter of March 26th, the link below it (NLRP paperwork) and then reading this statement that CRONA received fromm the VP of Patient Care Services and CNO of LPCH:

"I did learn that the way I was describing the medical benefits and LOA was incorrect. I want to apologize for creating any further confusion. In fact, as per your document, the change means that a nurse would have the option of using their ESL and PTO to supplement their disability. If their paid time was exhausted before the 12 week period ended, the hospital would cover their medical benefits. Once the 12 week period ended, if they are still on LOA, they would need to pay their own medical benefits unless they are covered by another category. Thank you for bringing this discrepancy to my attention and again, I apologize for any confusion."

Pam Wells
Vice President, Patient Care Services and
Chief Nursing Officer
Lucile Packard Children's Hospital at Stanford

It's a bunch of bull.

I also found another interesting story related to Stanford's bright future in building both a new hospital and the city of Palo Alto. PA residents and those who donate to the hospital should be outraged.

And they was to help nurses improve their what with that PNDP, change the benefit package how?

Give me a break!

Forgot the link to the article in my post above regarding building the city of Palo Alto.....

Here's the link: Web Link

It is sad that Stanford management are not held to the same standards as the nurses. My manager could never take care of a patient...she does not even remember how to give morphine.

The first professional development courses, about 40 years ago, were held in Vegas and on cruise ships. As a Professional Engineer I have noted the same about PD courses for us, and have always maintained that continuous practice, with its daily accommodation to an ever changing field is itself educational enough. The real need is for teachers and regulators and administrators to occasionally dip their toe back into the real world.

Then Walter you would be amazed at the specifics of the so-called "Commitment to Excellence".

As if two nurses working in the same Neonatal ICU could then each carry one separate practice patterns based on the research papers they had written.

And IF the so-called "Commitment to Excellence" was valid then yes the nursing administrators would be held to even 1/4 of the same standards and expectations.

But it's not and they aren't.

Thank you to those of you who are probing the reporting and trying to understand the real picture. This will all work out.....just a little challenging right now. Too many rumors floating around out there. We would love nothing better than to get back to business as usual....our patients! And we will!

are the nurses voting????? did they vote....is there a strike

"Nursing is the single highest cost for hospitals. Of course when hospitals need to make cuts, nursing is always the first thing they look to to save money."

wasdth or whatever..please remember this thought above that you wrote.

Management must look forward 5 years..if you believe that the "reform" bill just passed with the ever increasing restrictions on health care and payments over the next 4 years has nothing to do with this negotiation, you got another think coming....if you think that an ever increasing govt control of health care has nothing do to with this negotiation, you got a second think coming.

Got hope, anyone?

Always have hope......and by the way we voted on contract only today and if contract is not accepted by members then we hope to return to the bargaining table. We would like to work this out through negotiations.

We are hoping for the best for all.

we don't want to strike. we have families and plenty of us are one income families... we have to protect ourselves and our future. hoping we can come to an agreement. the hospital needs to recognize us as being the backbone of this institution. we are what makes this hospital commendable. we help the community. we take care of our patients because this is what we choose to do as nurses.

Just a thought since everyone's talking about the economy and cut-backs. How did Stanford Hospital make $147 million dollars in profit in 2009 "in this economy," and still want to cut back more from the nurses contract. Who's the one being greedy now? What's the hospital's priority, penny pinching to save money for the new hospital they want built in 10 years, or patient safety? I think it's pretty obvious.

What do Stanford and LPCH physicians think about all of this?

Do they agree with the hospitals who give them a place to do the amazing work they do or are they sympathetic with the nurses whom, for the most part, have an amazing working relationship with and whom they depend upon to collaboratively manage patients at the hospitals? Especially in the ICU's.

Not asking which "side" they're on, but sure wish a physician would identify themself, anonymously or otherwise and share an opinion.

"are the nurses voting????? did they vote....is there a strike"

The vote that took place by nurses on Wednesday was to reject or accept the hospitals last, best and final offer.

It was NOT a vote to strike.

The union made many counterproposals to the hospital's offer, every one rejected. Many of the union's counterproposals were close enough to what the hospital offered that they represented pay cuts for nurses and angered some of the union members, but the hospital still rejected all of the counterproposals.

I have worked in other hospitals across the country and never have I found such a commitment to excellence and such a desire among even the longest serving nurses to learn and grow professionally. The current promotions process is attainable, making nurses want to go the extra mile to achieve higher rank.

The problem with the proposed promotion requirements is that they are so stringent that few would be able to obtain them, so many will stop trying. When that happens the quality of nursing at Stanford will suffer.

If the hospital had approached the union with a proposal for very small wage increases due to the difficult economy the union the union membership might have felt sympathy. If the hospital had asked for a cap on PTO but promised to staff the hospital well enough that nurses could actually use their vacation time, the union might have been more receptive. Instead the hospital proposes a promotions process that would end up demoting most nurses, and calls it a commitment to excellence. The union is not deceived.

One previous comment cheered on the Palo Alto City Council to resist unions, but how much less financially pressed would the hospital be if the Council wasn't demanding that Stanford build them a new police station, Caltrain station, many new units of affordable housing, and other expensive demands in return for the privilege of expanding the capacity of the hospital to better serve Palo Alto and surrounding communities?

The hospital claims it just wants to bring nurses' benefits in line with those of its non-represented staff. Of course it does! It decreases the benefits of those without bargaining power, then implies that the union is unreasonable when it tries to do the same to them.

Some may claim that the nurses make outrageous salaries, yet most of them commute to Stanford because few can afford to live in Palo Alto unless they moved there 20 years ago.

In the end, the hospital needs/wants to pay the market price for nurses. My understanding is that, compared to comparable hospitals across the country, the current costs are high, in substantial part driven by the promotion policy, which ends up with far more nurses at the high end of the scale than elsewhere, due to the higher levels being easier to achieve than elsewhere. It is 'structurally broken' from a cost point of view and the hospital management is trying to fix it so it doesn't get worse, and so they can bring costs in line going forward.

If that's correct, it is unfortunate, since this kind of change is disruptive for the nurses, who understandably are upset about "demotions." That "downward stickiness" in wages is a big human/economic problem - for instance it helped fuel the great depression, since we would up with massive unemployment instead of just much lower wages. But current management is facing up to the problem created by past management's taking the easier / higher cost path.

I bet the past practices did in fact create a better, happier, more effective nursing staff. Unfortunately it cost too much. That story will play out in many different places and ways over the next 10 years, as we try to bring healthcare spending in line with our needs.

Great comments and so true! The hospital union Crona is noted for its flexibility and willingness to baragin at the table. The bargaining by the hospital has been substandard---and is the cause of this unrest.

In response to all the venom towards nurses, let it be said that we have NOT voted to STRIKE. We have rejected a contract that will demote nurses, some of whom have 30 years of bedside experience! This is like demoting a Major in the Army to a Private to save money. Would you stand for that?
The hospital is also attempting to severely depower our union, CRONA. The money portion of the contract is what the hospital is offering us to buy our acquiescence to being demoted and devalued. It is the bedside nurse that is with the patient 24/7--your loved one, your neighbors, your friends. We care for the sick and the dying. We are not stupid or idiots. We value our professional practice and are licensed to perform complex duties that LVNs are not permitted to perform. We are patient advocates and part of a team that comprises all individuals involved in care of the patient; MDs, nursing, pharmacists, respiratory therapist, physical therapists, occupational therapists, etc. Nursing is a profession that requires extensive training and continuous re-certification. We are not bedpan carriers or housekeeper. Please do not devalue our work as the hospital is trying to do.

just few thoughts
1) The hospital upper management always say's THEY HAVE BEEN NEGOTIATING WITH CRONA IN GOOD FAITH.
in contrary it comes out from straight from the upper management's mounth that,they will never negotiate with what they want.What they have propose is what the upper management want and it is a take it or leave it.- now is that a bargaining? is that what they call negotiating in good faith? that's

Facts:
1)all what they are trying to do trying to cripple the union. Remember, CRONA is the voice of nurses, any disrespect they have show to crona also means they have no respect to theri nurses at all.
2)what they were trying to do is not something new, is not something because of economic issues.- they made 140+ million last year and they have done this 1970's and yr 2000.
3) They said, they were trying to do this for nurses to be encourage further nurses to seek further schooling- because they care about the nurses.--- the fact is, schooling cost a lot of money and needs a lot time.
a) the hospital who is using the PNDP they are trying to implement supports their nurses. They have a school that wouldn't require nurses to use their family time in the middle of traffic.
b) they have supported their nurses huge part of the tution compare to the stanford's 1000/yr? wow ! and they only said there are scholarship out there? well, would it be able to take care of 2600 nurses?,what about the waiting list of the schools around the area?
Now, it does not require one to be genius to be able comprehend what upper management's reason behind, it's not because they care for their nurses, it is not because they wanted to encourage nurses to be more academically incline and it is not either for the patient's sake for they are imposing PNDP that gives huge credit/points if the nurse do newspaper editing, publishing books and the like, rather being able to take care and trouble shoot devices that works in behalf of the heart,kidney,lungs because the units requires you to be able to operate those.. again so sorry for the rest of the nurses. mind you, CRONA is nurses voice...

lost of nurses do what stanford RNs do. i have worked in a the icu for 6 years. no resource RN, no lift teams, our lead has patients. we DONT get overtime just because we work 12's. we never leave the unit for breaks, we eat at our desks. i traveled there once and made 5x what i make at home. getting 4 hours OT just because you work 12s, and other things like lift teams make CA nurses spoiled. Lift teams, are you kidding me, my lift team is my back. and my hospital is a level one trauma, we do thousands of transplants, we are world class as well and so are the nurses. give up some other things and maybe you get what you want, but you cant have it all. i worked there and a icu nurse threatened to call the union because he was asked to take three patients. i have never seen anything like that in my life, and he had two really easy patients, a third would not have compromised anyones care. we save lives and give world class care and were tripled all the time, we just rely on eachother. i have a whole hospital that would beg for half of what stanford RNs have. beside their pay. they get treated better than most of the county! i would be thrilled to have half of what CA RNs get, but we dont get that. but we still save lives, and give outstanding care.

1) one more thing, cutting the PTO accrual( vacation hours accrual) thats the term and method of earning vacation hours at stanford and most hospitals.( for you out there that don't know nurses makes their vacation time. Do they really believe that by doing that to their nurses supports their nurses aiming more academicaly incline? how? can they enlightened me? and if at some point I will be buying cobra, 1800-1900/month for those who have family, where do I get that money? they want me not to accrue any vacation hours that can be use when I get sick or family member, when I am not making anything because I am sick and no more PTO and I needed buy the cobra coverage , that is a lot of stress for people who is part of the team that saves life, do they think nurses will be able to concentrate taking care of patients when they put nurses in this position? neighbors, it is sad but thats a fact- thats how upper management is doing.

Stanford and LPCH RN's will NOT be intimidated nor bribed.

No one wants a strike. Hopefully the hospitals come back to the table - this time in good faith.

Nurses overwhelmingly REJECT last, best final offer

Web Link

for Julie, we work 12 hrs and we don't get paid over time for the last 4 hours... where did you get your info? Do you realize why years ago a lot of nurse have left nursing because of back injury ? Do you know what is the highest incident in the hospital/nurses environment? please do try to check on that....and because hospitals became under staff because nurses were injured became too much to handle due to so much stress that ultimately affects the care give to the patient? That was the reason a study was done, why there were a lot of errors that sadly resulted deaths? impairment of patient.. over worked,understaff,injured nurses thats when CA RN brought their voice to the federal court--- to lestened and find solution that ultimately saves lives of the patients while protecting nurses and allowing nurses to have a more healthy life when they reached the retirement age... now if you were to be ask, what is your solution? I felt sorry for you and the rest of the nurses who does not have a voice even to bring up solution to save lives.I have worked in state that made me took care of 6 patients in tele and my nurses had 8-10 patients and I know why tons of errors were made that resulted death and impairement to patients and made nurses retire even before the retirement age because it is either they were badly injured,or overly stessed out that there family suffers & I refused to work in that environment,because I don't want a single patient suffers because of that reason, and I want to have a quality life with my family and want to stay healthy when I reach on my retirement age.I hope and pray that won't be one of the injured nurses even before they get into the retirement age. Try to read news, try to be a apart of change to save lives and healthy retirement age. Because we california nurses cares and have voices.
you may think that that california nurses are spoiled, but we don't think it that way, we brought this issue to the congress,state for a reason to protect life and it was approve. One may have an easy assignment for that day but did you forget how many days a year has? If you opt to disregard, and don't care patients life and the life of people who saves life then I would say you deserve to go back to where you usually work but I felt sorry for the people around the area where you work because ultimately it is there lives that gets indangered we don't need nurses who doesn't care for patients, who does not even know how to do simple analysis.
good luck with your back, and good luck to your patient,and good luck for your life when you reach the retirement age, I hope you will get there... peace be wirth you...

In reply to Julie:

Stanford nurses are not "spoiled." There is an expectation of excellence and providing the recognition nurses deserve is part of that.

Just because you have no resource nurse or you eat your lunch at your desk or you dont get paid overtime - does that make it right? Does that make it something that can't be challenged or changed?

For decades nurses around the country have been trampled on by hospital administrations at the expense of both the nurses and the patients well-being and quality of life. It's been a matter of contention for almost as log as modern nursing has been in existence. I personally watched my dad's nurse in Michigan try to juggle a 12 patient assignment with one LVN on her 4th 16 hour shift in a row! Leaving out all the details, I can say that dad's care suffered tremendously and so did the nurse.

You seem to be complaining about nurses demanding to be respected and recognized as the professionals they are. There are no longer lifting teams at Stanford. Instead, the hospital has invested millions of dollars in new lifting equipment. Nurses need and deserve this equipment. It also cuts down on workman's comp so it benefits the hospital as well.

You're right Julie, lots of nurses do what Stanford nurses do and ALL OF US do it well and with pride. Nursing ratios in the State of CA are law. CA is the first state in the nation to enact such a law, but many more states are gaining momentum on this. By CA law, no ICU nurse can take more than 2 patients and even the 2 patient assignment is based on acuity. Stanford ICU's have some of the highest acuities in the area. Occasionally, 2 nurses are assigned to 1 patient. You make it sound like Stanford nurses don't rely on each other. Nothing could be further from the truth. If you've worked in an ICU at Stanford, you know this. One thing is for sure, we are centainly not sitting around filing our nails.

Remember also that the cost of living in the Bay Area is one of the highest in the country. You cannot compare what nurses make here without taking that into account. And as it is currently, Stanford has been and continues to be behind in wages and benefits compared to other area hospitals.

"i have a whole hospital that would beg for half of what stanford RNs have. beside their pay."

Then stand up and get things changed. I would NEVER take a job in any state that leaves me saying the types of things you are saying about your place of employment. I would quit nursing first because it would jeopardize not only my license, but my patients.

Wishing you the best and hope you travel back some day! We'll make sure you get all your breaks and help you boost that 200 lb patient every two hours! :)

You get as much crap as you allow yourself to take.

I don't know who said it... maybe it was me! It speaks volumes.

someone said and compared the pay for nurses at stanford to other countries, please do your reseach first,you can have a house from 3rd world countries with backyard with the size of 1500 SF would cost you 25,000 dollars up, where do you find that in america? that is one yr rent of a 1 bedroom apartment, may not be enough anymore!think.. think... think....

Julie, take a closer look, I have work in a state that allows 80-12 patient in med/sug/tele, and I have given you a closer view on that on my previous comment. I will tackle the ICU part this time. None of those hospitals even allows nurses have 2 patient bif you have a fresh case, any fresh case will be 1:1 it ranges from hospital to hospital but it at least 6 to 24 hrs from the surgery.YOU HAVE NO IDEA , why do you think we have patients from even city away,state away, country away? think... think.... think....

correction 8-12 pts not 80..

patient safety hummmm...well what that nurse said i'll call my union rep before ill take a thrid. i just dont see that as patient safety, as that patient had to wait for someone to come in so they waited in the ER in guessing. if they would have had a critical code or two...who watches the icu patient waiting for a nurse to come in. and as far as the back thing goes. im just saying that your fighting to keep things, and most of what you have, the rest of us dont. sorry your getting equalyzed with the rest of the country. being an RN is hard work. Period, and i have had a fusion L4L5S1. and i still do my job. i love my job. and have never ever thought of refusing an admit. and i have never worked at stanford, but at kaiser, those RNs spent the majority of their shift sitting and sitting. for 1`3 weeks i watched them sit for 60% of their shift. the rest of the country is running their butts off. Welcome to the life as an RN. it will never change. the cost of health care will not allow anything else. when i was there many many RNs made 90/hr for a 12 hour shift, the last four of their shift was time and a half for 135/hr which 60% they sat on their butts surfing on the wed.. im happy to take three critical patients with a good team of other nurses and do it for half that, with no overtime after 8 but funny thing was when i was there i turned my own patients using proper body mechanics. and i had core staff ask me not to do that because they may be expected to do the same. and that was really said to me..i got grief for asking for a scoot up ...i was told wait for the life team. what BS. it is about TEAM nursing. i think union nurses need to at least try and open their eyes to the way nurses manage everywhere else in the US that isnt union. we do great medicine too. we have awards and accolades. we do it with hard work , sweat, and the ability to adapt when necessary.

To the jerks who said nurses are a dime a dozen, the hard part is nursing school and the 3 LVN's for the price of an RN ( LVN's cant administer IV meds.. guess we will make sure they care for you.. this means no Pain meds and no antibiotics o and no emergency meds to save your life).. Do you even have a clue what a nurse does?? Spend a day with a Standford Nurse or any nurse in a hospital and see what you are saying then...let me help you it might go something like this.... Wow you work hard long days, you have people's lives in your hands, you are a social worker ( dealing with sick and dying patients and families)..You go above and beyond for your patients (I have clocked out and sat with people who had no family and were dying so they didn't have to die alone). Nurses are not in nursing for the money.. I have been a RN with my BSN for 11 years. Let me tell you ignorant people out there who think nurses are over paid.. You are wrong we are unpaid and under appreciated!!!!! If you haven't spent a day in a nurses shoes dont talk. Try being a nurse back East with no ratios. I have taken care of 11 patients at a time!!! Go Stanford Nurses!!!

oh and ps...i do know, so dont think i dont...ive traveled all over, and worked in lots of different icus. ive done level 1 trauma in the unit.. and can say the nurses at the kaiser hospital in CA worked the least, and helped the least, and and were so concerned about getting theirs, that it seems that the patient is hardly involved. it made me ill watching them complain about the littlest thing. last night i was tripled with a GI bleed getting lots of blood critical high amonia levels, a post surgical on cardizem and neo, and a afib w/ rvr, on cardizem. had a great night, left on time, was organized, patients got great care and two got a bath from ME. my typing is piss poor though

[Portion removed by Palo Alto Online staff.]

how can a nurse function and execute a better job to 3 critically ill patient when each of them have drips ranges from 8-12, bleeding and machines connected compared to 2. YOU HAVE NO idea.... and it is not just stanford,most university hospitals and HUGE wel known hospitals who takes care the most criticall ill patient including those you have taken care whom you can't handle no more were transfered to hospitals like stanford. Sorry if we california nurses are not like you, we don't put our patients life at risk, we don't put our families life misserable, and we wanted to stay healthy on our retirement age.
you have back injury? just wait and see, one of these days you will remember what I sayed.LEARN to read and comprehend the whole issue, what we are fighting for before you jump in and assume that you know.
1) You have not work at stanford ICU- clearly not the type of unit from any of the place you have worked.
2)staffing issue was made into law, it is LAW it became a law of a valid reason.--- patient safety PERIOD. if someone or some other places you work does not help you at all then you go and make a proper complain, if you were right and thruthful you will be heared unless you deserve to be left alone at work?
3) and sometime you need to use your brain to analyze, sometimes individual like you don't realize why such thing were being run the way you describe on those places you have work, like what I have said if something is not right in the place you work, bring it up to the proper person, and don't be jumping around pretending you know what we were fighting for...

and one more thing Julie, you said you have had a "fusion L4L5S1" ? right and because of that you want everybody to have the same? the system won't change? of it wouldn't if you don't know how to find a solution. Working condtion in california used to be like anywhere else, but We california nurses and community don't want to just leave it that way that's why we have the CA law about staffing, if you and the place you have been working with has no guts,no concern for patient safety then that is your choice.Have you done a research on how many back injuries and affects nurses? you have the fusion? you are lucky you are still working with same strength like anybody else because if you look at the research on back injuries? definitely not fun, I my self have back injury and I don't think I will able to work at bedside for as I wanted, thats how I feel. Have you experience from a setting position and trying to stand and you would need few minutes to find a right position for you to be able stand straight? We don't want any of these type of injury anymore, cost a lot more for the hospital and cost a healthy life that definitely will affect you family and love ones life.

It is a law, and ICU SHOULD NOT take 3:1, if you do that, because you are endangering not just 1 but 3.If the unit is full, or have no nurse to take care of the patient-- the action is, they should be transfering a patient out( one of the less critical one or should I say no longer critical) to step down to be able to cater critical one.And while waiting for the movement done, a crisis nurse should be called to watch over the patient. that is critical thinking, Now if you don't even know how to deal with it and have no idea how to handle it then you might not fit to be in the critical care area and you should reconsider it. Nursing is not just about having patient as much you think you can, it is about how are you going to take care of your patient safely, maybe you don't even know that Kaiser has a crisis nurse. KNOW YOUR RESOURCES before jumping around, and again 2:1 ICU is a LAW and it became a LAW FOR A REASON.

Stanford nurses give the best care in the Bay area...yet they are not the highest paid nor do they have the best compensated nurses in terms of medical retirement benefits. Stanford nurses know what other institutions give to take care of their nurse employees, yet Stanford nurses stayed and remained loyal to Stanford all these years. The management took the opportunity of these hard times to give such a proposal counting on the economic facts of today and that nurses will just agree to whatever it will give them. HOWEVER, these Stanford nurses have families to protect, health to maintain and a future to live for... for themselves and the future of in-coming generations of new nurses. Bedside nursing is a tough job: they help fight for your life everyday... perhaps when those who put their thoughts based on what they think they know and what they don't really know about nursing across the bay area...when they do get sick they will know what makes a very good bedside nurse and that you will wonder what a Stanford nurse could have done do to make a difference in your life outcome if you were cared for by a Stanford nurse. Big institutions are because of the very people that make it.

To reply to you ignorant people out there spouting your nonsense about how we get paid so much, we should strike so another nurse can take our jobs, get it right here people. CRONA does not want to strike. CRONA has been attempting to negotiate for months. We CRONA nurses could give a rat's ass about a pay raise. We want the ability to be able to climb a REASONABLE clinical ladder, and to have those 20, 30 and more year nurse swho taught us, to be able to remain clinical leaders. Without these nurses, you would have half assed replacements to take care of you and your families. With no way to appeal except through the people who reject your promotions, where is the reasonable there?

[Portion removed by Palo Alto Online staff.] You have no idea what will happen if we end up on strike. Stanford and Packard nurses are MAGNET. We are the best of the best, WE ARE NURSING EXCELLENCE. So if you want scabs to come in and work 7-10 twelve hour shifts in a row and make 10, 000 dollars to take care of your families and yourselves, then feel free to NOT support us. We are more than willing to negotiate, we are willing to work for our smae contract with modifications, but to shut out an entire 2 hospitals of nurses from being clinically excellent and not to compensate them for that, is ludicrous. Ask a nurse for a copy of the PNDP, and the new contract, then please give your opinion after you've compared the current with the new.

I must say to all those who have commented about "plently of nurses to take yur job," "loyalty to patients," and how it is unethical to go on strike and that we are "a dime a dozen." I would like to see you guys come and do out job for 12 hours... 12 hours of being on your feet, caring for patients, giving cytotoxic and other high risk medications, monitoring, assessing, caring for a fresh post-op liver transplant patient with multiple tube and drains coming from all sorts of body parts, all the while being yelled at by family members and in some intannces being hit... come do my job... in fact I dare you...

Nursing is a profession but unfortunately because we don't wear suits and ties we are considered blue collar by many. There is a reason nursing school is so tough... it is by far nothing close to "cake" once getting a job.

People who are making these ridiculous comments are poorly educated and think it is all about money... I wish it were so. If this was strictly based on the raise being offered, I would sign here and now... but that is just not the case.

EDUCATE YOURSELF before you go JUDGING. And don't be angry at unions becuase you don't have one behind you.

In Her Own Words: Brenda Gieser, RN
April 8, 2010 ·

Hello!

My name is Brenda, and I will be your Registered Nurse today.

I will be administering medications prescribed to you. I will make sure you do not have allergies to these medications, and if you do have an adverse reaction to the medication, I will use my critical thinking skills and take action! I will be watching for signs the medication is working for you as well. I am the eyes and ears of the physician.

I will deliver your baby, or grandchild, or niece/nephew in case the physician does not arrive on time. I may need to perform a vaginal exam even though we may have met only moments ago. I will be precise, yet quick as I realize how uncomfortable this is for you. I will assist you with breastfeeding, watch for hemorrhage, make sure your bladder is functioning after the trauma of childbirth, and I will intervene as needed within my scope of practice.

I will address and assess your pain needs before, or when, you ask for pain medications. I will help to re-intubate your preemie neonate in the middle of the night when he extubates himself. In other words, if your new baby stops breathing, I will save his life and help him start breathing again. I will make sure your IV is running, make sure there is no sediment or air bubbles, and if your IV infiltrates, I will take action!

I will initiate CPR if your heart stops or take action if your heart has irregular rhythms. I will check your new surgical incision for bleeding, and use my critical thinking and experience to assess if the amount of bleeding you’re having is excessive, or normative post-operative bleeding, and reinforce the dressing and call the physician as needed.

I will apply a new bag to your colostomy or other stoma, and do so with integrity, and a manner that helps ease your discomfort and embarrassment and anxiety. I will offer you and your family education about ways to troubleshoot if/when problems arise with your stoma.

I will educate you and your family about self-catheterization, and do so in a manner that is respectful. I will lift the heavy CPM machine, making sure you get your therapy as ordered, pre-medicating you with pain meds. I will educate you about your new joint, pain management, importance of routine stretches and exercise, etc. I will remind you of limitations with your new joint.

We may discuss uncomfortable subjects such as intimacy with your partner and how this may be affected by your surgery or procedure.

I will suction you if you are a patient with HIV/AIDS, and I will attempt to be assigned to you for continuity of care, not because you are an easy patient to care for, but because studies show continuity of care is best for the patient.

I will also care for you if you have MRSA, VRE, H1N1, or other communicable diseases.

I will put myself in harm’s way when an out of control psychotic teen threatens himself, his peers on the unit, my colleagues or myself. I will care for a 6-foot-3-inch tall homicidal male adult who towers above me. I will care for a major depressive adult female that I have seen at the State Fair, yet not mention this due to confidentiality and patient privacy.

I will care for an elderly patient with dementia who needs to be fed her meals, bathed with dignity, lifted out of bed with equipment requiring two or more staff despite the fact we do not have enough staff. I will crush her pills and ask peers if she prefers applesauce or ice cream best, so when I feed her the meds prescribed she might take them. I will assess for skin integrity each shift.

I will hold your hand when you are dying, or when your loved one is gravely ill. I will update and revise the Care Plan each shift as needed. I will document, document, document. I will get a second RN to verify the Insulin I give. I will get a second RN to verify my waste or return of medication, and document as such.

I will call a physician in the middle of the night to advocate for my patients even though I know this specific physician might be perturbed and attempt to invalidate me.

I will attend annual Competency Days to keep up to date on CPR, Infection Control, and other important pieces of information related to my job. I will dispose of medications in one of four disposal buckets, according to hospital policy.

I will keep up with my CEUs to maintain my professional licensure. I will conduct myself in a manner becoming of a professional RN, on and off-duty. I will attend seminars and read research articles and study while off-duty as to keep myself professionally astute.

I may go eight hours without taking a sip of any beverage or using the restroom, or work overtime during a snowstorm or a weekend or a holiday not because of overtime pay, but because patients may not have adequate staffing and my colleagues will end up having an awful shift with inadequate staffing.

I will attend committee meetings that discuss patient care, patient satisfaction and advocacy for patients, family and neighbors.

I will pray for my patients, colleagues and the leaders impacting those of us who are caring for patients professionally.

As many of us know, we are called to this profession. This is not just our job.

And, I will do this all without overtime, as to avoid disciplinary action. This is why I am here today. This is why we are here today.

Nurses deserve a fair labor contract. Nothing more, nothing less.

[Post removed due to same poster using multiple names]

interesting comments. the nurses are working so hard they are on facebook updating their status on COMPANY TIME! Nurses deserve respect but they must also not be stagnant and be willing to respect the rest of the team, ie.e residents/interns.. IT IS in the patient's best interest to implement evidenced based practice. experience DOES NOT = COMPETENCY. Just because you have been doing the same things for the last 20 some years does not mean that it is the right/best thing to do. Nurses are often incensed when "nurses are portrayed/treated as handmaidens", mandated updating of knowledge,education and skills is a huge step forward in refuting this common misconception.

To Jenine, updating FB does not mean the nurse is not competent- for your information we have annual competency ,the whole nine yards of all the machines and procedures we do to save yours,your family,and love ones lives thats why the more yrs of experience you have the more competent you are, might not be 100% but 90% or more does,And we have continuing education to maintain our license and be updated with current research.And matter of fact we do guide the new doctors and thru keen assessment,experience,expertise,knowledge we do bring up ideas to the Doctors to help find the right treatment and for your information we are not only making sure we as nurses carries out doctors order but to make sure the orders written by doctors are right because if it happens that a nurse carried out a wrong order, we nurses are liable as well. I hope you have seen that part.

@ Jenine, again bedside clinical skills are not being taught in masters does having MASTERS does not mean you are competent, but I would say for you to effectively work in the management team having a masters would definitely be of big help.

correction what I mean was thus having masters not does.

To Jenine,

Know what you are saying. Company time on facebook? Nurses have 2 15 minute breaks and 1 30 minute breaks. How certain are you that these were not written on these breaks? Stagnant? Nurses are bound to renew their license every 2 years with corresponding Continuing Education hours plus the education hours needed for nursing specialties. Nurses update themselves and serve the unit they work in by staying active in various committee and life-saving machine expertise. Nurses are adept to change...but to change that is fair. So Jenine, think and know before you write.

Minnesota nurses support you!!!

could a nurse who may strike answer this....do you have hostile feelings toward nurses that would work in your place for the strike?. because i read about the temple nurses calling the nurses scabs. do the striking nurses expect the patients to go home??? what about the ICU . do we send people home with their vent, thier drips...close the hsp while they strike??? i know they want the HSP to cave but thier not. why is it the nurses fault that works for the strikers???i would think they would be grateful someone will take thier spot.

we the string nurses @temple call scabs what they are. we are on the line fighting for safe staffing, reasonable insurance increases,management to come to the table and bargain in good faith, respect and most importantly our first admendment right. in case you need to be reminded, nurses are pt advocates. it is unfortunate that we had to go to the point we are at now,but i guess that is what happens when management puts profits before patients. the scabs that occupy our institution are a disgrace to the profession. by allowing yourselves to work as scabs, you are indeed telling management not to bargain with us,we don't deserve to be treated with respect,and that scabs will do ANYTHING if the price is right , even if it means allowing an icu pt with 2 heplocks,and a monitor to walk out the unit and onto our strike line. maybe the scab nurse that was suppose to be monitoring the pt was being over worked after working 6 twelve hour shifts in a row and then sitting at the bar in the hotel downing 4-5 drinks, saying "a patient is a patient is a patient."

CONTINUED ANSWER TO WHY WE CALL A SCAB A SCAB we tried for 6 months to bargain with management; we also got "the first worst and only offer".and that was if they came to the table. most of the staff has been at the institution for 10 plus years, with a good percentage of the staff having20 or more years giving them the salary that was quoted in the papers.i would venture to say 50% or more are certified in thier speciality. we love our profession, and our community, unlike the scab that told the reported "we have no ties to this hospital, we don't have family members here we can just leave". that's what we want for the scabs to leaveso we can get back to taking care of our patients ,in our hospital,in our community because we the professional staff out on the picket linehave ties to the hospital and community. most importantly WE CARE. so wear your title well "SCAB".

To the STANFORD NURSES: Keep the respect for our profession strong.Hopefully your management team respects you and is willing to negotiate a fair labor contract. will keep you in my prayers and know that the PASNAP team over here in the east are supporting you as we fight our battle. WE as nurses know that striking is only done as a last resort.and that everything is not done for monentary reasons.

I feel that the SCAB title is a little much. I am all for your cause in dealing a fair contract. The only problem is that you did walk out and picket and that is perfectly fine. Remember that your patients need care. To see a sign that reads SCABS = MALPRACTICE is a bit much. In my opinion strike nurses walked out on there patient population. In legal terms that is called abandoment or negligence. View it as it is. On a side note I have heard patient satisfaction has increased by 12%.

SCAB is a completely appropriate term and has been around for an eternity. It is what it is. SCAB is a nasty term for a reason. You're going to have to live with that one, Somnus. And if you are a SCAB, shame on you.

Oh and btw, striking is NOT abandonment nor negligence. That's ridiculous. Nurses do not walk into the hospital, accept an assignment creating a legal duty and then walk out on the assignment. THAT would be abandonment. Negligence is something completely different. Sheesh!

Get your facts straight. You sound uninformed and your abandonment/negligence argument has absolutely no merit.

We do not want to STRIKE. We want to NEGOTIATE. How is it negotiating when the nurses are given the "Last, Best and Final Offer" and told the only way they (the Hospitals) will look at any further proposal is if it falls within their "Last, Best, and Final Offer". If the last best and final offer were reasonable then we would have accepted it. duh. So how is telling us "if it falls within those parameters", they will look at it, "otherwise don't bother," any type of negotiation?
What the Hospitals are saying is "Take it or leave it", "we do not want to negotiate."
Who doesn't care about the patient's?
Give me a break. This is just ridiculous!

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