It was 8 a.m., halfway between Stanford Healthcare and Oakland, and clinical nurse Mark O’Neill was worried he would not make it back home. 

He had been driving for nearly an hour and he felt like he could fall asleep at any second. This was his third graveyard shift in as many days, and by the time he had left the hospital, his head was swimming with what seemed to be the entire dictionary of heart disease: Coronary artery disease, valve replacements, heart transplants. He’d worked at Stanford for just over two years, but by this point, he had seen it all, he said.

“It’s difficult,” O’Neill said. “It’s stressful. I don’t know if you can even imagine what it feels like.”

For O’Neill and many other nurses, their work presents a puzzling contradiction. Located at the heart of the Bay Area, Stanford Hospital recently ranked 12th on a list of America’s best hospitals by U.S. News & World Report. But according to several Stanford nurses, Stanford Healthcare is an illogically run organization that seems to have minimal care for the physical, emotional and mental needs of its staff, especially during the pandemic. 

These tensions have sparked a renewed fight between Stanford nurses and Stanford Healthcare as they approach scheduled negotiations over fairer labor contracts. On Feb. 2, the Committee for Recognition of Nursing Achievement (CRONA), of which O’Neill is a member, launched a campaign against Stanford Healthcare in support of fairer union contracts. CRONA represents nearly 5,000 nurses across Stanford Hospital and Lucile Packard Children’s Hospital. The union seeks to address the very issues that O’Neill and so many other nurses have long complained about — overwork and understaffing within hospitals.

 What makes this fight especially challenging, according to CRONA president and registered nurse Colleen Borges, is the disagreements between both parties on numerous workers’ rights issues. One of CRONA’s aims is to allow nurses to take time off to care for their mental and emotional health, which has suffered during the pandemic. CRONA has proposed amendments to nurses’ pre-approved vacation policies that would ensure time off for nurses. It has also submitted several proposals that would bolster institutional mental health support and enable nurses to seek help when needed. 

But Stanford Healthcare has rejected all of these proposals, according to Borges. Stanford Healthcare leadership has even proposed roll backs of several clauses that CRONA secured in past negotiations, Borges said. One of these clauses protects nurses from being disciplined for violations of the attendance policy relating to sickness and family-related issues. One of these clauses protects nurses from having the attendance policy changed during the contract term. According to Borges, Stanford Healthcare has put forward the possibility of taking this clause out of nurses’ current contracts and thus gaining the right to revise the policy as it sees fit.

“I’m not going to mince words,” Borges said. “The hospitals are very far from understanding and seriously addressing what is happening for bedside nurses.”

Chief Nurse Executive and Vice President of Patient Care Services for Stanford Health Care Dale Beatty and Chief Nursing Officer and Senior Vice President of Patient Care for Stanford Children’s Health Jesus Cepero pushed back against Borges’ statement in an email to The Daily, stating that nurse mental health and safety is a “core priority” for Stanford Health Care and Stanford Children’s Health. 

“We currently have robust workplace safety programs and protocols in place in our hospitals,” Beatty and Cepero wrote. “As the science informs us, we modify and adapt our practices to heighten safety for our patients, families, employees and physicians.”

Borges emphasized the role of the pandemic in the labor dispute, highlighting the enormous burden COVID has placed on nurses in the past two years. The strain of the pandemic has caused nurses to feel “undervalued” and overworked, leading some to leave the profession. Pandemic-related stress is not limited to Stanford — approximately one in five healthcare workers in the U.S. have left their profession since 2020.

Stanford Healthcare has approached this issue by making nurses “more available to work,” Borges said, at a time when she and other Stanford nurses feel that they have already made themselves “available above and beyond their customary work.”

Beatty and Cepero acknowledged the impact of the pandemic, writing that Stanford Healthcare has been “fortunate to have been able to maintain nurse-patient staffing ratios at all times, flex our nurse staffing based on patient acuity and continue to do everything in our power to keep our employees and patients safe” at a time of great distress for healthcare workers.

CRONA vice president and staff nurse Kathy Stormberg warned against attributing too much of the current labor dispute to the pandemic. Rather, Stormberg said that the pandemic has “magnified” pre-existing issues more than it has created new ones. Many of the same concerns being discussed now, she added, have been raised time and again in previous negotiations between CRONA and Stanford Healthcare. 

The bottom line, according to Stormberg, is that Stanford nurses want a “sustainable career.” Burnout is a significant problem across the profession, she said. For younger nurses, the tradeoff might be between working longer hours for their employer and spending more time with their family. For older nurses like Stormberg who are closer to retirement, the conflict lies between the demands of her body and the demands of the hospital. 

“I can’t work three 12-hour shifts anymore,” she said. “But I could work a little less and if I work a little less I could work longer.” Working shorter hours, she said, could enable her to both provide better care to patients and mentor a new generation of nurses in need of her skills. 

Both Stormberg and Borges acknowledged the potential catalyzing impact that the dispute could have on employee and student unions beyond Stanford Healthcare. Stormberg pointed to the universality of nurses’ struggles, noting that CRONA’s founders initially formed a union for the purpose of tackling “things that were wrong” and that they “couldn’t find ways to address.” 

“I think that’s a story that a lot of other people at Stanford have had,” Stormberg said.

Katherine Whatley, a member of the Stanford Solidarity Network (SSN), a graduate student advocacy group, emphasized the importance of unity between graduate student advocacy groups on campus as well as between different labor unions in the Stanford community.

“We support any group on campus that is trying to encourage better working conditions and more equitable outcomes for people on campus,” Whatley said.

This article has been corrected to more accurately reflect the disagreements between Stanford Healthcare and CRONA and provide a more accurate description of a clause from a past agreement. The Daily regrets this error.

This article has been corrected to reflect that Stanford nurses and Stanford Healthcare have scheduled contract negotiations. The Daily regrets this error.