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Stanford, Packard nurses reject 'final' contract

Original post made on Apr 8, 2010

Nurses at Stanford and Lucile Packard Children's hospitals have soundly rejected a contract the hospitals have called their "last, best and final" offer.

Read the full story here Web Link posted Thursday, April 8, 2010, 12:04 PM

Comments (53)

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Posted by emmecj
a resident of Palo Alto Hills
on Apr 8, 2010 at 1:12 pm

This is crazy! They are trying to cut nurses who work with the sickest of sick people back to wages they had when they were 1st year RN's. Especially when the hospital is making money, lots and lots of money. All I can ask is if this gets thru and they cut wages dramatically, what exec gets it? Cause you know that is what these dramatic cuts are for, one or 2 guys need more cush in there huge salary. There is a reason this hospital is making so much money and it is not the labors of the board, but the nurses!

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Posted by a Palo Alto midtowner
a resident of Midtown
on Apr 8, 2010 at 1:27 pm

To the 2070 nurses who stood their ground and rejected the hospitals' proposals, I commend all of us. Let us give ourselves a huge pat in the back. This shows that CRONA and its membership body remain strong as ever and that they will not be intimated by the hospital administration. Let's continue to put up a good fight. CRONA nurses are the best of the best.

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Posted by watdth
a resident of Stanford
on Apr 8, 2010 at 2:07 pm

What a relief. Now the real work of negotiating can begin.

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Posted by a nurse
a resident of Duveneck/St. Francis
on Apr 8, 2010 at 2:28 pm

For those of you who sided with the hospital, I hope you're listening. Nurses as a whole are honest, hardworking people with a very firm moral compass. This package is simply WRONG - that's why 90% voted against it. Shame on you Stanford - if you need more money, cut a few administrators. What you're trying to do is put the weight of your decisions on the backs of professional nurses and patients.

Given the state of our current economy, I'll bet these same hardworking, honest nurses would have gladly agreed on a small or no raise, had the ladder of promotion been fair and recognized the great talents of their staff.

So glad I don't work there.

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Posted by Kathy
a resident of Palo Alto Hills
on Apr 8, 2010 at 3:23 pm

It is nice to see that this is NOT about the money! These nurses are the best around and any type of policy that would allow for a demotion of these individuals is just plain wrong. Good job Stanford and Packard nurses, stand firm for what you believe in.

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Posted by Anon
a resident of Another Palo Alto neighborhood
on Apr 8, 2010 at 3:30 pm

There are many aspects to a contract and people may vote against it for many different reasons. I don't know the details, so, I can't judge that. I'm wondering, though, why the nurses would be pushing for a big pay raise when prices have been flat over the last two years. It would be interesting to see pay graphed alongside the CPI over the last decade. I realize that there may be other issues besides pay.

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Posted by to anon
a resident of Stanford
on Apr 8, 2010 at 4:19 pm

Did you read the whole article? As mentioned above the nurses are angered by the fact that the hospital is trying to cut costs by demoting their senior more experienced staff by making unattainable goals. The hospital has one goal, cheaper nurses. How do they get it? Demote everyone, tell them they won't get a pay cut, they won't get a title change (they'll just make up new categories) in fact they'll even give you a decent raise for the first couple years and a bonus for signing the contract. Sounds good right? Sure, if you only plan on staying a couple years. Kind of sounds like the hospital is trying to "buy out" the nurses. Those nurses just simply they won't get equivalent raises in the years to come unless they jump through hoops to get there on their own time - but the deal looks pretty sweet in a time of economic crisis. It is a shame the hospital has so little regard for their nurses. All of this is not including the changes to the PTO system that could seriously cripple a family due to an illness. For nurses who are employed at a hospital, you would think the hospital would understand things happen, people get sick, and yes, sometimes this benefit of Paid time off that can be stashed away for a rainy day and health care that doesn't have to be paid for at cobra rates is better than a raise.

CRONA Nurses stay strong, and you deserve better!!

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Posted by watdth
a resident of Stanford
on Apr 8, 2010 at 4:29 pm

Reply to Anon: Please re-read the story. Nurses are not "pushing for a big pay raise." It's about so much more than that.

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Posted by kitty
a resident of another community
on Apr 8, 2010 at 7:00 pm


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Posted by Sandy
a resident of Los Altos
on Apr 8, 2010 at 7:56 pm

lets clarify the $3000 "bonus" for agreeing not to strike. That is only for the nurses who work a full time commitment of 40 hours a week. For everyone else it is prorated to your commitment ,not actual hours worked. Another example of the loops holes that made the contract stink.

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Posted by Jim
a resident of Charleston Meadows
on Apr 8, 2010 at 8:26 pm

"a nursing developement program that recognizes and rewards merits for professional nursing" in reality they developed a unfair point system to climb the professional ladder. Stanford's point system places a higher point value on publishing articles ( 5 points), editing books (15 points) , writing papers (5 points), then doing community service (1 point), medical missions to third world countries (1point) , volunteering (1 point). There is a larger majority of nurses that do volunteering then the academics. Bedside nursing is just as important as academic nursing. Didnt Stanford just send a group to Haiti after the earthquake?

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Posted by a Stanford/Packard nurse
a resident of another community
on Apr 8, 2010 at 8:41 pm

Reply to the comment from: "a nurse, a resident of the Duveneck/St. Francis neighborhood"

Yes, I agree that the nurses of Stanford and Packard would have agreed to miniscule raises if the promotion and ranking system remained fair. The fact is that since most nurses will be demoted by the hospital's new classification plan, even with the 4% the hospital is offering we'll end up taking pay cuts.

The hospitals are very clever with their contract proposals. No one on the outside understands how the proposed reclassification would lead to mass demotions, they only see the 4% wage increase and think the union must be greedy. You really have to delve into the numbers and look at multiple factors of demotions, reduced PTO, etc to understand that the hospital's plan will be a significant pay cut for the majority at a time when many nurses' spouses are out of work and they can least afford a pay cut.

We (Stanford and Packard nurses) aren't looking for big gains out of this contract, we are really looking to not lose anything else. Please look at all the issues before falling for the hospital's doublespeak and use of partial truths to convey misleading information.

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Posted by Me Too
a resident of Midtown
on Apr 8, 2010 at 9:26 pm

My guess is that the hospital goes to the mat on this. It is going to be tough on the nurses being out of work - not a lot of odd shifts out there for them to pick up. If the hospital need to change the cost structure, this is probably their best chance to do so.

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Posted by gwen
a resident of another community
on Apr 8, 2010 at 10:03 pm

We checked against what the most productive nurses are doing now, the ones who are on many committees and put in many hours of uncompensated work and are also experts in their field, and could not find ONE that would be able to qualify for CNIV under the new standards, most of them barely make CNIII, most of us would be demoted to beginner nurse status after working to make Stanford one of the best hospitals in the country. The hospital pretends that it is about the pay, it is NOT.

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Posted by OR Nurse
a resident of Atherton
on Apr 9, 2010 at 12:02 am

This was not an easy decision to make.....nor will it be if we decide to strike! Nurses today are aware of all of the economic challenges facing families today. In fact many of us are the primary wage earners for our families! Having been a nurse for 30 years the hospitals proposal was nothing short of a slap in the face. This is not about money. It is about professional respect and protection of our patients. We also need to set the climate for the newer nurses in order to keep the benefits we have gained during our nursing careers.
The hospital will say they are thinking of the children and the patients. Is this why they are offering to pay $5800 per week to scab nurses being bused in from Florida and Texas. They do not know how to care for our very special populations of children nor the complex adults. The work we do gets harder and more complicated with advancing technology. Please support us in taking care of you loved ones during this time. If scabs come in please remember they do not know your child or loved one. The managers, now doing care have not done so in many years and are getting a crash course. We may be at odds with the hospital, we are not at odds with the consumer. We know how much our patients need us. We have cared for many of the same children for years. If this does come to a strike, parents please be vigilant. Protect the children and question the Scabs!!

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Posted by Pediatric Nurse
a resident of Downtown North
on Apr 9, 2010 at 12:14 am

Really, when has this hospital done anything for the staff that cost any money. The motivation is strictly cutting costs and saving money. More into construction and remodel if we take it away from the nurses...then the doctors. They already have a stroke when there are too many medical patients in the hospital, god forbid taking beds away from insured patients. Children s Hospital Oakland serves a very different population and they manage to care for their 75% medical population, while LPCH cries over 25%. They are not demoting their nurses to balance a budget. Care around all of these issues will be needed. If you demot a level 4 nurse who has cared for sickest, been charge,done,, ecmo. Why should I work so hard. You pay for a level 2 pay for level 2 nurse thats what you get......

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Posted by Perioperative Team
a resident of Barron Park
on Apr 9, 2010 at 12:36 am

Thanks for standing strong during this stressful time! We can do this, and when you think you can't talk to someone for the strength.




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Posted by aww
a resident of Greater Miranda
on Apr 9, 2010 at 2:44 am

nurses have become obsolete you can have 3 medical assistants do 1 nurses job. the Hospital needs all staff memembers to fuctions correctly. the housekeepers are not well liked there. Nurses have come a long way, but they reach the top of the mountian and will be replaced for cheaper staff.. remember they are not doctors and administrators will cut corners/../

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Posted by Vince
a resident of another community
on Apr 9, 2010 at 3:43 am

I've been in healthcare for 20 years, and an RN for 10. I'm finding it hard to feel sorry for these nurses since the majority of them make over $100k. And if the majority of them are level 4, then obviously it's been too easy to achieve it and it makes sense to raise the bar. Leave it to the union to try and keep the bar from moving while simultaneously trying to crank up wages.

Keep pushing. There are scores of nurses who can promote themselves who are watching this closely...not because they think you are making the right decision, but they are looking forward to picking up a couple weeks of strike wages.

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Posted by mel
a resident of Menlo Park
on Apr 9, 2010 at 6:26 am

I thought it was the money and I was a little bit worried about the seeming greed in this time and economy. I'm glad I listened to all sides. I do not know about y'all but if this scenario--demotions, morale busting, hiring travellers and scabs that do not know the Hospitals' true population or my loved ones and friends, taking back and denying nurses what are due them,etc--really happens, then the Stanford and Packard we know are no longer. The many times my loved ones and I have sought health care at these Hospitals, the nurses have saved and cared for us like their own. Very smart bunch. One would think the doctors are the true movers of health care here, wrong!!! The nurses are really what the Hospitals call their "Backbone". I would like to see them get taken cared of before the Stanford coffers. The health of a community is only as good as the well-meaning intentions of its health care providers.

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Posted by A nurse
a resident of Duveneck/St. Francis
on Apr 9, 2010 at 7:29 am

To Stanford/Packard nurse -
You missed the whole point of my post. I am horrified by the contract that was offered, and proudly on the side of the nurses. My point was that had the hospital been FAIR about what they offered in terms of the ladder, that a smaller raise might have even been acceptable.

What they have "offered" is insulting and sneaky, with lots of hidden take-a-ways.

I am on your side.

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Posted by Stanford Nurse
a resident of another community
on Apr 9, 2010 at 8:30 am

Thank you for all the support and willingness to see both sides. These comments from fellow nurses and our patients in the community are bringing tears to are the reason we are nurses. Because of you we advocate for fair working conditons and sound negotiations.

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Posted by Walter_E_Wallis
a resident of Midtown
on Apr 9, 2010 at 10:05 am

Walter_E_Wallis is a registered user.

Paying more for academic achievement than for actual performance is buying sizzle and neglecting steak.
I suggest everyone stay well until a more rational settlement is offered.

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Posted by RN
a resident of Stanford
on Apr 9, 2010 at 10:17 am

It is sad that the managers and the administrators are not held to the same high standards as the nurses. How many research articles do they have to write? How many volunteer hours do they have to do? How many projects do they have to do? And what do any of the above have to do with bedside nursing?

The chief nursing officer is the one who wrote and came up with the new "clinical ladder" without any input from the nurses who are affected by it. Nursing is a collaborative profession, but the new clinical ladder was anything but collaborative. This is what is truly is upsetting to most of the nurses, it certainly is not about money.

If Stanford tries to force this clinical ladder on its nurses, it will lose the "best of the best" nurses in the business. This is not how a Magnet Hospital for nurses treats its own.

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Posted by Both sides
a resident of Downtown North
on Apr 9, 2010 at 10:50 am

Well, it is always about money. That is what unions do and nursing is no exception. I believe the current salaries are fair and reasonable for the work performed and many of us would love to have such options in this economic environment. Maybe the Union could consider sparing us the drama and not using vulnerable sick people to scare the hospital into folding. Maybe the hospital could either fish or cut bait and stick to their last, best and final (how collaborative!) and end this thing with as little drama as possible.

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Posted by Retired RN
a resident of Old Palo Alto
on Apr 9, 2010 at 11:21 am

During the 30+ years I worked as a bedside nurse at Stanford I have experienced the anguish of negotiations and been grateful to CRONA for their support and integrity. I was incredibly lucky to retire with only an injured shoulder; lucky to have had the privilege of working with top-notch colleagues,educating new physicians and nurses, caring for the most critical patients, helping them get well, and educating them to stay that way. Long before such practices were common,bedside nurses took the initiative to wear gloves to protect patients when hospital administrators claimed it would "insult" people;bedside nurses petitioned for a non-smoking policy in patient care units. The intuitive judgment of an experienced bedside nurse has saved many a life as nurses could attest (if HIPPA allowed!). I would trust the colleagues with whom I worked to care for those I love and hope they will be there for me and our community. It is the EXPERIENCED nurse who must remain at the bedside to keep us safe and do what she/he does best.

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Posted by Bill
a resident of Crescent Park
on Apr 9, 2010 at 11:45 am

Wonder why the Weekly didn't ask the Union about the entry level salaries, average salaries and top salaries for nurses? All of these pay raises have to be absorbed in our healthcare costs. What additional labor will Stanford get for the 4% that they are offering?

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Posted by RN4
a resident of another community
on Apr 9, 2010 at 12:41 pm

I'm glad to see that so many people have posted on here. I would like to address regarding the bar being raised. I agree that the bar set for CN 3's and 4's is a bit low at Stanford and that it should be raised. However, it should be attainable and within reason. There are many of us who go above and beyond and DO function at the level of a CN II and IV. Under the proposed contract, many of us will be demoted to CNII despite the fact that we perform a multitude of specialty, leadership, and clinical roles. I say shame on the managers for allowing those who DIDN'T perform at the level of a CN III or IV to continue on at that level. I say shame on the hospital for wanting to demote those of us who DO function at the level of a CNII or IV. I am an ICU nurse. I perform a large majority of the specialty, clinical, and leadership roles available to me on my unit. Under the proposed contract, I will be demoted to a III and maybe a II because I don't publish articles, books, or speak at national conferences. Not to mention that I would have to do this ANNUALLY just to maintain by status. Who has the time to work full time AND publish? I work AT the bedside. I teach nurses who work AT the bedside. I teach advanced skills to physicians and other health care providers who work AT the bedside. While I agree that publishing and speaking are important aspects of professional development, I believe that equal credit should be given to both aspects of clinical nursing whether it's at the bedside, in an article, or at a national convention.

My salary does not dictate my worth. It's my skills that dictate my worth and I deserve to be recognized for those skills. I could care less about a raise. So, please do not feel sorry for me. I am not complaining about my 100K+ salary. Nor am I complaining about my employer wanting to raise the bar for clinical excellence. Feel sorry for me because Stanford is unfair and unrealistic in recognizing my clinical skills and professional talents.

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Posted by gary
a resident of another community
on Apr 9, 2010 at 12:55 pm

I am a scab from Texas and will be comming out if you do strike. Even though I will be taking care of your patients I truly hope that the nurses there get a contract that is fair and rewards all of you for all the hell that you have to go through during the negotiation process. May god bless and keep each of you and my hope is that we can give your patients the care they deserve

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Posted by RN
a resident of another community
on Apr 9, 2010 at 1:38 pm

It's not about pay, I hope that gets across. Yes we make great salary and yes its a crappy time financially, but look at what we do. The hospital wants to build, to take loans, to get the most bang for their buck. So they take demote the expensive nurses who have worked hard and long at Stanford/Packard to make the same nurses cheaper with take-aways. After all in this economy banks are really looking at your debt. PTO banks, benefits payouts, and salary are debts. How would a director of marketing in a "regular" business like to be demoted to a entry level jr., be expected to do the same job, but have their pay reduced by 10-20%? It would be insulting. Titles that we have worked a career for are on the line. Healthcare workers who spend a lifetime caring for others, would also like to be assured a little benefit if we get sick, injured, or choose to spend a career at one facility. I'm all for professional development, nursing should be no different than any other industry, however, we can't fix a national problem with this negotiation. Deciding to raise the bar should be done in stages and set at an attainable level for those who choose to have a life outside the hospital. I would prefer a nurse to be a clinical expert with ongoing professional development rather than an academic with no bedside critical thinking skills. I'm sure the public would agree.

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Posted by Ricky
a resident of Meadow Park
on Apr 9, 2010 at 1:56 pm

As a consumer of Stanford Hospital's services I recognize that most of the care given at the hospital is by registered nurses. They have a tremendous responsibility, especially in a teaching hospital that has residents that are just learning the ropes. I don't want a nurse that has spent a lot of time researching and writing an article for a professional journal. I want an experienced and skilled bedside nurse who has been at Stanford for over 10 years. To the extent that any change in the current contract for nurses does not value that experience and skill, watch out if you are a patient.

The hospitals are clearly using "economic" conditions in the country to attempt to neuter the CRONA union. Their attempt to demote all of the experienced and senior nurses will result in nurses leaving for higher paying jobs. What the article fails to state is the Stanford Hospitals do not pay the highest salaries to nurses in the Bay Area, other hospitals pay more. Highly experienced nurses have no trouble getting jobs as there continues to be a shortage of skilled and experienced nurses.

The hospitals claim that the new criteria for advancement is based on models from other prestigious medical centers is bunk, especially since they failed to mention those that are using such criteria. Beware of claims and assertions with zero information.

The "ball" is in Stanford's court. Negotiate in good faith instead of playing games. If your intent is just to bust the union, then lock out the nurses, clearly the cost to the community and Stanford will be painful. As I recall the nursing strike 10 years ago cost Stanford dearly and administrators were called on the carpet for what happened. History repeating itself.

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Posted by Stanford Nurse
a resident of another community
on Apr 9, 2010 at 3:28 pm

Thank you Gary....that was kind.

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Posted by rws
a resident of another community
on Apr 9, 2010 at 4:01 pm

I guess we are not living in the universe of out of control healthcare costs, when there is so much support for continuing to raise nurses' salaries. Lower salaries is what controlling healthcare costs means, people. If you are too sorry and guilty to put your foot down in each individual case, where do you think the cuts will come from? This is, after all, what Congress has mandated with the healthcare bill and the Medicare cuts. It's not all painless.

Is not this salary for a 40 hour week and a month of paid vacation? Many internists do not earn at that rate. They just work 80 hour weeks.

In these settings most nurses just have to keep on working to get promoted. Very little merit involved, especially when the union grieves for the employee who does not get promoted.

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Posted by RN
a resident of another community
on Apr 9, 2010 at 4:56 pm

comment on post by RWS. become an hourly employee if the compensation for the time worked is what you are looking for. The nurses aren't only seeking compensation. The point made to "just keep working to get promoted" is exactly what won't be happening. RN's will work essentially second jobs in and outside of the hospital just to maintain what some have worked over 20 years for. Many nurses work well over 40 hours per week and don't earn extra PTO, merit, or thanks. Starting full time nurses earn 2 weeks vacation per year but there is no guarantee to be able to take it. Perhaps insuring the uninsured or underinsured and providing comprehensive primary care is a better assertion to make to reduce national healthcare costs.

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Posted by a nurse
a resident of Duveneck/St. Francis
on Apr 9, 2010 at 8:57 pm

The hospital management is up to no good, again. I'm sure many in the community may not remember it, but a few years back they closed down the LPCH Telecenter, a wonderful nursing advice service for community parents/teens/children. It was a community gem whose nurses handled calls throughout the day/evening for everything from new mothers' breastfeeding questions to triaging ill children to talking to teens contemplating suicide. Those nurses were all extremely well educated, and most had more than 15 years experience. You know what the hospital did to them? They saw a pocket of experienced (ie. expensive) nurses and fired them all. (oops, I mean they ended the "program".) They did it very quietly so no one would notice. Now local pediatricians have to have their after hours calls shipped to another state to nurses who don't know your child or their pediatrician at all.....That was then.

And this is now. Stanford's offer is insulting. It's just amazing how they think it's OK to demote a good percentage of their most experienced nursing staff. Whatever happened to management and union representatives sitting down and working together to hammer out a deal?

Stanford nurses, if you end up having to strike - I, for one, would be glad to come bring you some coffee on the picket line.

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Posted by ICU Nurse
a resident of Stanford
on Apr 9, 2010 at 10:34 pm

I wonder what Patricia Benner thinks of the use of this PNDP? Has anyone written or talked with her? Is this what she intended? If so, it's very disappointing.

With a little bit of googling, anyone can find that hospitals use Benner's theory in much different ways than Stanford/LPCH is proposing. One hospital uses it as a reward - the nurses get a monetary reward and a luncheon - it's not a clinical ladder. Another takes parts of Benner's theory and integrates into their clinical ladder. Stanford/LPCH copied WORD FOR WORD the PNDP from BJH. Word for word. They changed areas in the document that said BJH to Stanford/LPCH. That's about all they changed. ISn't that plagerism? LOL!!

Anyway, my point is that I'm curious what Benner actually thinks. Is this what she intended when she wrote the book, From Novice to Expert that's been around for years for new graduate nurses? I have read a couple of her books and she focuses on the narrative (exemplar). I don't see how this relates to this PNDP.

btw, scab nurse who posted here wishing us well. You're a hypocrite.

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Posted by LPCH Nurse
a resident of Charleston Gardens
on Apr 10, 2010 at 3:33 pm

I would gladly forget the 4% raise for recognition of my professional achievements and hard work. I have been a staff nurse 4 for years and a nurse for 30+, have a masters degree and choose to do bedside care because this is what I love. There is no way I could achieve the 45 points necessary to be a staff nurse 4 in the new system - despite volunteer medical mission work, committee work, special projects and all the rest. This is about so much more than the 4%.

The hospital began advertising for scabs BEFORE they began negotiations. What does this tell you?

They have never negotiated - just threw their best offer on the table and said take it or leave it. Over 90% of us choose not to take it. What does this tell you?

In this troubled economic time, for that number of nurses to reject a contract with a generous set of raises should be a giant red flag. Look at why we said no. We are not greedy over paid robots. We take care of you, and your children, in life threatening situations.

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Posted by LPCH Nurse
a resident of Charleston Gardens
on Apr 10, 2010 at 3:34 pm

ps - what about the $145,000,000+ profit the hospitals made last year......check it out!

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Posted by A Noun Ea Mus
a resident of Professorville
on Apr 10, 2010 at 4:55 pm

It's almost as if the Stanford management has hired the same consultant "guns" that CPA used regarding the (soon to be continued?) "negotiations" with SEIU.

Don't negotiate just throw something down. Tout phrases like "going forward" and describe it as if you are educated engineers trying to fix some structural problem.

Plus now mix in typical arrogant Stanford spin for effect. Using the supposed "commitment to excellence" as a clearly contrived ruse to merely reduce wages. But in the process they infuriate the very professional core of the nurses who have worked their long term.

And when people see through the ruse it's so much worse. If Stanford/LPCH is truly in a need to reduce wages for a valid reason then that could be laid out, looked into and would obviously effect any negotiation.

But this is something else. I have to wonder if any of the top nursing managers themselves even believe the ruse?

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Posted by Ken
a resident of Midtown
on Apr 10, 2010 at 7:53 pm


There you go, again. You keep suggesting that the world will end if your SEIU puppet masters don't get their way. No way, buddy. You were threatening a strike before, with CPA vs. SEIU. Bring on the strike(s)!

We shall see who wins, in the end. Remember, there are a LOT of people who are willing to break the picket lines, in order to get a job.

Feel lucky?

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Posted by A Noun Ea Mus
a resident of Professorville
on Apr 11, 2010 at 5:07 am

Gee Dirty Harry lives in Midtown. Probably hangs out at Starbucks. :)

I wasn't threatening a strike as regards CPA and SEIU. I am not an SEIU member and am not a CRONA member. It's my guess that the CPA SEIU folks can probably eventually force real negotiations as they've filed a complaint. I only said that IF such a strike were to occur I would jump in and be VERY active in support. Maybe even lucky.

In my above post I was merely pointing out the cookie cutter sound bites and strategies. Such inanities are the stuff that roving consultants weigh in with.

Web Link

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Posted by Anti-union
a resident of another community
on Apr 11, 2010 at 5:02 pm

Unions do not have a place in healthcare. A "voice" has a place in healthcare. When you became a nurse you took a vow to take excellent care of your patient. Yes, I know, pay, PTO, etc are all important and should be rewarded with an honest day's work. However, when you walk out on your patient because you are going on strike, then you are not honoring why you became a nurse.
Having read the posts, fairness is one thing but all of you have forgotten the most important thing: "THE PATIENT". Stay at the bedside, have conversations with administration, get them to see your point by being adults, not walking out. That is childish if you think that you will gain anything by walking away.
If you go on strike you need to think what you gain:
1) No pay
2) No benefits
3) Walking a picket line and yelling at your replacements who believe that patient care comes first
4) You do have the potential of losing your job....something the union doesn't tell you in the fine print of your contract
5) you pay union dues which could have gone towards your salary or benefits.

So think about it.. a "voice" is what is needed, not anger, not throwing a tantrum and walking out, not paying an organization who benefits whether you strike or not....they get your dues and if you walk out, they still sit in their suits and get paid and hold out for bigger things. What do you get? A Big Fat NOTHING!

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Posted by stanford nurse
a resident of Another Palo Alto neighborhood
on Apr 11, 2010 at 9:36 pm


Lets be clear, we are not touting a strike at this time. It is the hospital that has been publishing all of this Strike talk. Even saying the hospital will give a $3000 bonus for each RN if they receive no strike notice. The hospital is masking the contract with what seems to be generous wage increases for the public, when in fact the concerns of the nurses lie much deeper. Cuts in benefits, an Unattainable new development program, and lack of incentives for experienced nurses to stay. We, the union ARE trying to use our unity as a "VOICE" to make it be known that we disapprove of their proposal. That their offer is a slap in our face. Our negotiating team has made many attempts to negotiate with the hospital, however, the hospital is not interested in negotiating. They are more interested in forcing their plan down our throats whether we like it or not. Sure we already make a fair wage, but this is not about the raise or bonus. We are fortunate to have a job in this stressful economy. We are looking out for our future, our families.

There is already a shortage of nurses. If the hospital refuses to take care of the nurses who provide care for their patients, who is going to take care of the patients when the experienced nurses leave the hospital for better jobs? Yes, there probably is a line out the door of nurses waiting for the opportunity to work at such a first class hospital, but the hospital as we know it will not be the same without those experienced nurses to guide the young. Without the lure of a great learning experience and mentorship, nurses will choose to work elsewhere for more pay and less stressful work. Without those nurses, there will be an underdeveloped staff and patient outcomes will sacrifice, the hospital ratings will fall. For those of you who think we are overpaid, I challenge you to spend a day in our shoes. There may be days where we may be slow, but there are many others that feel like each day is its own marathon. Many times we participate in activities that benefit the unit or hospital on our own time, we don't get reimbursed for things we may do to help increase unit morale. We can not simply be replaced by LVN's. Our jobs will not be obsolete because each patient is unique and require critical thinking to provide the best care. There is just too much to say about the matter, but hopefully this helps clarify some of the information for those not involved.

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Posted by ICU Nurse
a resident of Stanford
on Apr 11, 2010 at 11:37 pm

Anti-union said: "So think about it.. a "voice" is what is needed, not anger, not throwing a tantrum and walking out, not paying an organization who benefits whether you strike or not....they get your dues and if you walk out, they still sit in their suits and get paid and hold out for bigger things. What do you get? A Big Fat NOTHING!"

You are obviously a scab. What you write in your entire post is exactly what scabs say. They accuse nurses fighting for their rights as being unethical by "walking out" on their patients. I do love being a nurse but I don't do it to be taken advantage of or to be walked all over by a hospital that will at every chance they get and who have shown to be disingenious.

Our union is US. They don't wear suits nor do they sit anywhere. They are the very bedside nurses that we all work with. This union represents no one except the nurses of SUH/LPCH. Our union dues are minimal compared to what the offical members of the union do. We go out and they walk with us - they're bedside nurses.

Educate yourself on the issue. You sound like a fool. Pretty ballsy of you to call us childish. Have you ever had to stand up for your rights, or do you just wait around for the easy way out and cross picket lines to make your thousands of dollars sitting on your own butt?

You're a perfect example of why scabs are so dangerous. You just don't know anything about what's going on....that will carry through with patient care as well. Scabs do this for one reason and one reason How ethical is that!?

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Posted by ICU Nurse
a resident of Stanford
on Apr 11, 2010 at 11:48 pm

And like "stanford nurse" said....NOT ONE nurse I know including myself wants to strike. We want to come to an agreement with the hospitals that is doable. Simply doable. The hospitals NEVER even gave us a chance. Why have they lied and why did they break a labor law during "negotiations?" Why are they doing this?

Many in the Bay Area consider Stanford Nurses to be snooty. It's NOT the nurses. Stanford nurses have some asskickery going on. Amazing nurses with a wealth of knowledge and experience. Unfortunately the administration of this hospital thinks they're the best thing since sliced bread. They're not. Stanford is not.

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Posted by The Facts
a resident of Stanford
on Apr 12, 2010 at 2:19 pm

Everyone should probably axctually read the Hospital's Proposal and save a lot of effort and time.


No one will be demoted.

No one will receive a pay cut.

Everyone will receive an 8 percent pay increase over three years.

Those who qualify or chose to excel to the level of a Clinical Nurse will receive 12 percent increase over the next three years.

Yes they will receive less of an increase if they don't meet the higher level of qialifcation, but no one is being demoted and no one is getting their pay cut.

There's a lot of people out there who would love their pay and benfits and 8% in pay increases in the contract.

Stanford Nurses are some of the highest paid nurses in the Country and certainly the bay area.

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Posted by ICU Nurse
a resident of Stanford
on Apr 12, 2010 at 3:36 pm

Reply to The Facts: This common political saying can be applied to you and your nonsense:

"You are entitled to to your own opinion, but NOT to your own FACTS."

What you just posted above may have *some* merit, however eventually every nurse who doesn't meet the PNDP requirements for CN III or CNIV WILL be demoted and thereby take a cut in pay. Not only that, but for someone who has worked 10 years for Stanford I would like to think that I would be recognized for my commitment, experience and skill that I bring to work with me. I would like to think that my experience means more to the hospitals than that of a learning nurse who has been around for only a short time. I have much respect for new nurses, but there is a difference....a HUGE difference.

It has been pointed out NUMEROUS times that meeting these requirements will be like having a second job and nearly imp[ossible for ALL. Most criteria must be done on a nurse's OWN time. The requirements are academic in nature and are so unrelated to bedside management of patients by an RN.

Hospital management values writing chapters in textbooks and attending national conferences higher than skillfully managing life-sustaining technology. They value writing journal articles more than they value volunteering in the community. It doesn't make sense and patient's should take note of this intention by the hospitals.

To make a statement such as you did above completely minimizes the FACT that this hospital proposed Professional Nurse Development Program (PNDP) is out of touch with reality.

Many of us have said that it's NOT about the money. It's about who we are fundamentally as bedside nurses.

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Posted by ICU RN
a resident of Stanford
on Apr 12, 2010 at 3:44 pm

One other thing. If I ever became an Advanced Practice Nurse such as a Clinical Nurse Specialist (who btw, are NOT subject to this PNDP) or if I ever decided to become a management person and get into seriously writing policy for the hospital, I would EXPECT that I would have to do the types of things that the hospitals are requiring in their proposed PNDP. What are the requirements for those who portend to know what's best for bedside nurses? Certainly NOT their own PNDP!

I am a BEDSIDE nurse, allow me to excel at THAT. Require me to become expert in the area of BEDSIDE nursing.

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Posted by stanford nurse
a resident of another community
on Apr 12, 2010 at 5:45 pm

To the anti-union post...

We have an inhouse union and nobody is sitting around in their suits. The union officers are at the bedside with us. Crona is not like a large union. Unless you ae really behind hospital walls you can not know what goes on. Just as I don't know what goes on at your place of employment. Patient care has improved over the years because past nurses went on strike. I know because I have taken care of 14 sick patients in other facilities that do not have unions and it is pretty scary.

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Posted by CaliNurse
a resident of Stanford
on Apr 14, 2010 at 12:58 pm

The Stanford nurses were presented with the "Last, best, and final offer" and rejected it. This is true.

As far as I know it was really the ONLY offer. The Hospitals rejected everything the nurses (represented by CRONA  or Committee for the Recognition Of Nursing Achievement... which is the Union comprised of Nurses that work at Stanford) placed on the bargaining table. So in essence there was not any negotiating to speak of.

What I don't understand is how so many people interpret what is going on between the Nurses and the Hospital(s) and there is such vast discrepancies in so many of the interpretations. I've read many of  the comments on some of the major news sites and can clearly see that people don't have all the facts and then do not truly understand the information they do have. 

Below is an attempt to help people understand what is happening. It is long. But it is factual and I hope that after reading it you will have a better understanding that the nurses are not acting out of greed. It's really more of an issue of FAIRNESS and RESPECT.

A Magnet hospital is one that has embarked on an extensive review and systematic evaluation of its nursing practice by the American Nurses Credentialing Center (ANCC). They must meet stringent quantitative and qualitative standards that define the highest quality of nursing practice and patient care. Becoming a Magnet hospital means that the organization must meet over 65 standards developed by the ANCC. Those standards must be demonstrated in a very extensive written document and validated and confirmed by site visits. A small percentage of hospitals nationwide have achieved this noteworthy status. Stanford is a "Magnet Hospital".

For those that do not understand why Stanford nurses are upset about the contract proposal offered to them by the hospital administration please try and picture yourself as a patient with a serious illness requiring inpatient hospitalization.
Would you want old Florence Nightingale to be your nurse or would you want an experienced, dedicated Stanford nurse? What is the difference, you might ask? A mere 3 or 4 decades ago nurses were just short of hand maidens. They took care of custodial needs, reported observations to the doctors and carried out tasks ordered doctors. Today's nurses have evolved into a much more intricate position in the health care system.

Nursing is a PROCESS, not a set job that can be accomplished by routine tasks. There are no correct building codes to adhere to, no absolutes in structural configurations, no bonuses for making more profit on an individual case, no guarantee that the outcome will be the same each time even if the calculations are done correctly. A human being is a complex structure and no two are the same. Not even identical twins.

Nursing assistants (aides) are being phased out. Primary care, where the nurse takes care of everything, is becoming the norm (especially on the night shift.) Thus, the nurse in most instances will ultimately be responsible for all aspects of the patients "care" when hospitalized. Unlike years ago, nurses ARE held accountable for everything they do. They must be familiar with all the medications they are giving, the correct dosing, the mechanisms of actions, the adverse reaction and side effects, and the course of action to take in the event of problems. They not only follow the doctors orders they must know if they are correct. They are the link between positive and negative patient outcomes.

In a teaching hospital especially, it is imperative that the nurses be constantly aware of every aspect of everything that is happening. One mistake can be the demise of the entire treatment plan. The doctors are the diagnosticians and are wonderful at Stanford but the nurses are their bridge to success.
I can say this with certainty since I have worked at Stanford for 30 years. I have been witness to many situations that if it were not for the keen skills of the bedside nurse the outcome would not be positive.

Nurses deal with the physical, psychological, and material aspects of a hospitalized patient. They deal with bodily fluids (excrement, blood, vomit, sputum etc), infectious diseases, hazardous chemicals and radiation, emotional distress, heavy lifting, mechanical instrumentation and troubleshooting and a myriad of other situations on daily basis. Nursing is not a simple task oriented job. Not only does it require knowledge, observation and assessment skills, physical endurance and compassion, it also requires a high degree of intuitive perceptive skills that comes from experience. Stanford has a very high proportion of very experienced nurses. It is because of those nurses that the teaching is fostered and the level of service is maximized.

We are not Stanford nurses because of the wages. We are Stanford nurses because it is our calling, our niche, our abilities to provide optimal care to people that need it because we've developed those skills through years of dedication and teamwork in practice and commitment to the nursing profession and to Stanford.
We are not complaining about our wages. Granted we do need our sustenance to survive thus we do need a paycheck. What the problem is, goes beyond that. Someone else had commented that should a General in the Armed Forces be demoted to a Corporal to save money that they would have a right to be upset. Well, that is what the hospital administrators are effectively proposing to do in a round about way and it is very demoralizing to the vast majority of experienced nurses that have been working at Stanford for most of their career. The hospital wants to change the “Clinical Ladder” that essentially ranks nurses by their skills and productivity and make it so difficult to achieve the highest rank that most of the nurses that have been promoted to the higher levels would be reduced to the same level as a brand new nurse. Like saying the only way to stay a General is if you can serve in two different wars at one time in two different countries. What the hospital has proposed in order for the nurse to remain at the highest level would require a time expenditure nearly equivalent to having a second job only it is on your own time. The requirements and point system for their proposal is exhausting even to read (it's over 35 pages in length). The process for application is tedious plus the 45 points needed in 4 different areas (every year) are in many ways not even connected to what a bedside nurse does. Like 5 points for writing journal article, 3 points for taking a semester course. And a whooping 15 points if you write an original research article. And that doesn't include the 27 annual continuing education units needed (12 units/year over the 30 every 2 years required to maintain an RN's license.) This process also includes rewriting a resume every year and presenting your completed application packet in presentation form to a panel. It like reapplying for your job every year.

Nursing is stressful enough. The rate of burnout is high. The long-term physical ailments bedside nurses end up with are quite significant. So all that being said, is it unreasonable for the nurses to want adequate retirement benefits. To have reasonable Health Insurance with reasonable co-pays for medication. To be able to save their PTO (paid time off) to use at a later date should they need to take a medical leave of absence. To have their medical insurance continue while on a medical leave for 6 months (as it stands now) instead of having it cut back to 12 weeks and then having to pay the inflated COBRA rates. (As well as not being able to save or use the PTO to pay for it).

What the hospital has offered looks good to the lay person. They have offered us wage increases. Or so it seems. But if you look at the entire package it is actually full of reductions. In the long run the amount of PTO( sick leave/vacation pay/holiday pay) is actually decreased. The ability to save it up is reduced. The medical insurance drug co-pays will be increased. (The insurance premiums have already been increased for the HMO.) The retirement plan is not in line with what other institutions offer. And the medical retirement plan still requires out of pocket payment's and if you have to retire early before Social Security kicks in how do you do that if you aren't able to work because you're just to physically exhausted and weakened to do what you've been doing for 30 + years as a bedside nurse. Who's going to take care of the nurses that have always done the care-giving. We need to be thinking about that. We need to feel that if we give 30+ years of our lives to making Stanford one of the best Hospitals in the country (even the world) that we aren't forgotten. That we deserve better. That it is not right to take away things that we have planned our lives around. And to be placed in a situation that devalues the scope of what the nurses have given to Stanford over the course of the past 30 to 40 years, well that's of significant issue.

It's not about the about our lives, our healthcare , our retirement benefits and it's also about our dignity. To be respected as the TEAM PLAYERS that we have been. Working at the hospital, FOR the hospital, WITH the hospital, to assure that it is the BEST it can be. That is what we were told when the Hospital was awarded “Magnet Status”. “We were the Best.” Now, however, we are not good enough.
Most nurses do not work a full 40 hour week. A few may, but most do not, can not, it's just too much. And after working in a stress filled healthcare setting for a very long period of time it can take a toll on your health. So, many older nurses cut back even further. So the figures you see posted as to annual salaries are not as accurate as you might think. And think about it, wouldn't you want the person taking care of you to be healthy. Nurses are exposed to the worst of the worst  and are risking there own health on a consistent basis  in order to do their job. Sometimes a patient is admitted to the hospital before they know what is wrong. H1N1, RSV,  TB, meningitis, c-diff, Herpes Zoster, just to name a few of the infectious diseases a nurse may be exposed to before it is diagnosed and isolation protocols are implemented. Nurses place their own lives at risk on a daily basis for the people they want to help.
The changes the hospital  proposes are not truly for the betterment of the hospital and the nurses. It is for the betterment of the hospital's budget. That's the bottom line. And they are NOT in a deficit either. They boasted  of the profit they made in 2009 that was well over 100 million dollars. Keep in mind that Stanford is a non-profit institution. So what you see on the surface, what stands out for most out in the public sector is that Stanford offered the nurses a generous wage increase and that nurses have plenty of paid vacation time. That nurses make a lot of money and that they are greedy for not accepting what the hospital so graciously offered. That is just not accurate. It is not true. It is just plain wrong.
The hospitals contract proposal, with all of it's take-a-ways will save the hospital 20 million dollars a year. How on earth could that possibly be offering the nurses any type of INCREASE?

So when I read some of the other news sites comments and see statements like “nurses are an abomination” or "nurses are greedy", I feel that I must respond and say that in all my 32 years as a nurse I have never felt so demoralized and humiliated as I do now. And all along I thought I was helping people live, be comfortable, feel safe, saving lives or helping them die with dignity.

Was I wrong?

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Posted by Stanford nurse
a resident of another community
on Apr 15, 2010 at 8:14 am

Sounds like union busting to me. And poor labor relations. How
can negotiations be fruitful when nurses are
mad. Doesn't work--they aren't as productive either.

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Posted by cabgpatchkid
a resident of another community
on Apr 15, 2010 at 1:46 pm

Regarding the statement that nurses are mad and less productive.

I can tell you that the sick call rate on my unit since the vote has exploded. I don't like to assume that someone isn't really sick, but people are pissed off. Stanford will lose the best of the best of their nurses because of this. I guess that's one way to cut their payroll.

Today the hospitals sent a leter to the nurses. They said take it or leave again.


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Posted by Steve
a resident of Barron Park
on Apr 20, 2010 at 11:50 am

Stanford Hospitals failed to negotiate 10 years ago, the result was a strike by the nurses which cost Stanford and its reputation dearly at the time. It lost many good nurses who took jobs as neighboring hospitals for better pay and benefits.

It appears that Stanford wants a body with a license, experience and nursing skill at the bedside are secondary. By law hospitals are required to have licensed RN's but the law does not mandate the skill or experience of those licensed. However what hospital would want the reputation of having nurses that don't have the skills and experience required to give excellent care? Stanford has the answer, saving money is more important than retaining their most experience and loyal RN's. Who is doing this "cost-benefit" analysis? Maybe the hospital management should consult with an expert at Stanford Graduate School of Business and get some sound advice.

How are scabs going to work the new computer systems at the hospital? Hopefully whoever is running the hospital will wake up and at least make an effort to communicate and negotiate. CRONA is a relatively small union and Stanford sees that as a weakness it can leverage to either break or neuter the nurses union. I think they may be underestimating the strength of these women and men.

Stanford step up to the plate and make Stanford an excellent institution that respects ALL of the professionals who work so hard for our community.

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