Stanford nurses secured new contract improvements last month following negotiations between hospital administrators and the Committee for Recognition of Nursing Achievement (CRONA).

Founded in 1966, CRONA is a labor union that represents registered nurses at Stanford Health Care (SHC) and Lucile Packard Children’s Hospital (LPCH) campuses across the Bay Area. Announced on April 6 and scheduled to expire in three years, the new agreement was approved, with 75% of CRONA members voting in support.

The nurses advocated for training to protect immigrant patients, provisions for artificial intelligence (AI) usage, new ways to address workplace violence, greater clarity on scheduling work shifts and a new holiday. CRONA also negotiated 4% annual wage raises to keep up with Bay Area living expenses from 2025 to 2027, among other terms.

Identifying topics for negotiation involved surveying the union’s members, who number more than 6,300, according to CRONA Vice President Kathy Stormberg, who served as a bed-side nurse at SHC for 22 years.

On Jan. 20, the Trump administration rescinded a policy from the Biden administration that limited Immigration and Customs Enforcement (ICE) from entering “sensitive” locations, such as schools, churches and hospitals. CRONA new contract includes a provision for nurses to be trained on how to interact with immigration law enforcement without bringing potential harm to patients.

“We felt fortunate to be in negotiations at this time to be able to address something that was so of the moment,” Stormberg said. “Hospitals should be places where anybody can come to receive care. We have a unique position of a relationship of trust, which is important to protect.”

Although housed in a connected building, Stanford Hospital and LPCH have two separate contracts with its nurses. One of CRONA’s goals was therefore to ensure the two contracts aligned, especially regarding nurses’ scheduling for shifts. 

Given the 24/7 scheduling required of hospitals, nurses frequently work on holidays and weekends on unpredictable schedules — a sign of limited job sustainability that often drives people out of healthcare, Stormberg said. CRONA used this year’s negotiations to increase the predictability of shifts.

Previously, nurses would receive schedules pre-populated with shifts on every other weekend around two weeks ahead of time. CRONA asked the hospital to release the nurses’ schedules three weeks ahead of time and assign nurses to shifts every third weekend instead.

“It’ll really allow people to attend the wedding or the soccer game. Those things largely happen on weekends, because that’s when most of the people in our lives aren’t working,” said CRONA area representative Erin Poh, who has worked in labor and delivery at LPCH for 15 years. “That’s all about the sustainability of our working lives, so that really impacts me.”

Making these scheduling changes was a smooth process with LPCH. However, SHC resisted the labor union’s request for scheduling changes until the very end of the negotiation period, according to Stormberg. 

In a statement to The Daily, SHC Senior Director of External Communications Courtney Lodato stressed the hospital’s gratitude toward their nurses. 

“[Our] commitment extends to our recent contract negotiations where, together with CRONA, we worked hard to reach an agreement that our nurses can be proud to support,” Lodato wrote.

As part of their push for greater workplace sustainability, CRONA negotiators secured the addition of a new holiday. For nurses, holidays not only mean higher pay for hours worked but also the opportunity to have those shifts off every other year, easing long-term burnout.

The labor union asked to have Juneteenth acknowledged as a holiday, but their request was refused, according to Stormberg. On the very last evening of this year’s contract negotiations, the hospital counter-proposed the day after Thanksgiving as a new holiday instead. 

“The Friday after Thanksgiving is a time most of the people in white collar jobs take for granted,” Poh said. “But [nurses] have to work all the time, so it’s nice to know that you’re going to get some remuneration for it when we have to take time with our family.”

Additionally, Given the rise in predictive machine learning tools and AI trained on patient cases, Stormberg spoke to The Daily about a need for nurses to maintain their agency in clinical judgment. CRONA added an agreement to their contract that these new technologies will not be used in healthcare settings with the purpose of eliminating the nurse’s role in patient care. 

While there have been no instances of AI replacing nurses where most CRONA-affiliated nurses work, the labor union “wanted to be proactive rather than reactive,” Stormberg said. 

Such AI tools may recommend a certain treatment plan based on the patient’s reports of pain, injury, vital signs and other clinical features. The contract allows the nurse to override the AI recommendation based on their judgement, placing value on the human-to-human connection that drives patient care.

“I don’t think any of us who are healthcare providers who are called upon to make clinical decisions and judgments think that computers should be taking over what we do,” Stormberg said. “We think humans should take care of humans.”

To improve the work environment for nurses, CRONA also focused on the process for addressing workplace violence. According to National Nurses United, eight in 10 American nurses experienced at least one form of workplace violence between 2023 and 2024.

These incidences of assault may occur during interactions with patients or their family members who are not in possession of all their faculties, meaning there isn’t always malicious intent behind the workplace violence that nurses encounter. CRONA leadership strove to increase agency among nurses to change to a new patient case without intimidation or pressure, according to Stormberg. 

The union thus negotiated a new policy in which supervising managers must offer nurses who have experienced assault the option to switch to a different patient case while a coworker takes care of their prior patient. 

“Nurses have taken a really strong stand, and in our contract as well, to make sure that we’re all safe and that nobody should be subjected to violence in the workplace, if possible,” Poh said. “They’ll also do some violence prevention training for nurses who are interested.”

In their efforts to create safer, more sustainable work conditions for nurses, Stormberg sees the diversity of CRONA’s membership as a source of strength. 

“To take all of those people who come from different backgrounds and bring them all together into saying ‘We are united as one to support ourselves, each other and our profession,’ I think it’s really amazing,” she said.