SAN JOSE — Stanford nurse Mark O’Neill could have quit his job caring for Covid and desperately ill heart patients, joining the exodus of other healthcare workers seeking respite from the stresses of last two years.
Instead, on Monday he will walk a picket line.
‘I’m exhausted, but we have to press really hard for help with the issues we’re facing,’ said O’Neill, one of 5,000 nurses set to strike next week at the prestigious hospital. of Stanford and Lucile Packard Children’s Hospital after the collapse of three months of labor negotiations, with no future bargaining sessions scheduled. “We’re asking Stanford to change.”
Stanford nurses join a growing number of other American healthcare workers with shared grievances about staffing, wages, benefits and quality of life that have accumulated during the COVID-19 pandemic. Last Monday, 8,000 Northern California nurses staged a one-day strike at 18 Sutter Health facilities. Recent health care strikes have also taken place in Oregon, Massachusetts, New York, Montana and Alabama. A massive strike by 50,000 Kaiser health care workers was narrowly averted last November.
With a shortage of nurses, unions have new leverage and have become increasingly powerful voices in a tight labor market. Tired of the pandemic, many nurses are rethinking their careers. A new report from McKinsey has found that the share of nurses who said they were likely to leave their jobs in the coming year has risen to 32%, from 22% last February.
In anticipation of Monday’s walkout, “striking nurses” from across the country are being airlifted to the Bay Area and delivered by bus to Stanford’s top-ranked hospitals. Striking nurses are typically the highest paid nurses in the industry, with agencies like HSG and US Nursing paying Stanford replacements $12,000 to $13,000 a week.
“If you put your badge down, I’ll pick it up,” said Aleehya Carr of San Antonio, Texas, who hopes to work the Stanford strike. “People leave patients who still need help… Imagine if it was your mom or your dad.”
But regular nurses have their own set of frustrations with well-paid temps. That tension showed at Sutter Health last week, when nurses staged an all-day strike but were replaced all week by contract nurses.
“They’re being housed, they’re being taken to the hospital, they’re being fed, they’ve got lab staff and extra staff — whatever we want,” said Carol Hawthorne-Johnson, a registered nurse who worked in the hospital. Eden’s intensive care unit in Castro Valley for 30 years. “They also get different salaries and that’s what encourages nurses to come here.”
During the pandemic nurse shortage, hospitals have increasingly turned to well-paid travel nurses to fill the gaps, fueling resentment throughout the year.
To reduce her caseload next week and ensure she can provide critical and emergency care, Stanford may postpone some elective procedures, spokeswoman Julie Greicius said. But the biggest problem looms.
There are several reasons nurses have chosen this time to push for change, said Joanne Spetz, director of the Philip R. Lee Institute for Health Policy Studies at UC San Francisco.
For one, the contracts have expired, so it’s time to renegotiate. Nurses have seen their profits soar at Stanford and other major health systems even as COVID cases soar. According to the university’s 2021 annual report, revenue for the two hospitals exceeded expenses by $845 million, up from $107 million in 2020 — though some of that was due to one-time federal grants.
Nurses also know they are harder to replace – and want their contributions recognized in the form of better working conditions, protected vacations, higher wages and better benefits.
“Nurses have given so much during this pandemic,” Spetz said.
On a relative basis, nursing is a lucrative profession, and not just for strike replacements. But nurses across the country say they are exhausted from the long hours and understaffed, and traumatized by the scale of the death. From wave to wave, they risked being infected. They responded to repeated calls to work overtime. They missed family dinners and canceled vacations. They helped dying patients say goodbye to their families over video calls. They cried in their cars and fought deep fatigue on their long drives home.
“Nurses are fed up,” said Diana Mason, a professor in the Center for Health Policy and Media Engagement at the George Washington University School of Nursing.
“When you’re working short-staffed, there’s moral distress,” she said. “You know patients have complications that they shouldn’t have had, because you couldn’t be there for them.”
To be safe, hospitals must meet legal nurse-patient ratios. But that only sets the bare minimum, Mason and Spetz said. Few hospitals have solid strategies for adjusting these staffing ratios in response to very sick patients.
The Stanford nurses are asking for annual pay increases of 7% for each of the next two years and 6% in the final year of their contract, with $3,000 bonuses and ongoing mental health counseling.
This will increase staffing levels, they say, because it will be easier to recruit and retain workers.
Stanford is offering salary increases – 5%, 4% and 3%, as well as ratification and retention bonuses. In the first year, annual base salaries for entry-level nurses would start at $143,000 and climb to $211,500 for nurses at the top of the pay scale.
With so many nurses quarantined during the pandemic, Stanford has bolstered ranks by bringing in traveling nurses who work under contract. Stanford wouldn’t provide a count of those traveling nurses, but the union says it can approach 25% at some sites, like the intensive care unit.
But veteran nurses say it’s difficult to work with a rotating group of newcomers, who earn far more than they do. Because these traveling nurses are not allowed to work on the sickest patients, they say, the hardest work is transferred to the lowest paid veterans.
Despite the influx of traveling nurses, there are still not enough staff, they say.
While working overtime in the intensive care unit and later in the post-anesthesia care unit, Kathy Stormberg recalled times at home when “there weren’t enough hours of in a row to wash, dry and fold a load of laundry. . . .I canceled trips and visits from friends. I canceled dinner with my family.
For O’Neill, who lived in hotels for the first three months of the pandemic, “the hardest part was the time away from my family”, missing his young daughter’s new vocabulary and sense of humor . “FaceTime calls are not the same as a hug or a kiss.”
And overtime requests are constant, he said. “You will work a 12-hour shift and you will be asked to stay for another four hours. Every day we get at least one text message saying the unit is understaffed, asking “can I come and work overtime?” ”
“Nurses can’t even relax on their day off because they keep getting these texts,” Stormberg said.
Stanford warns the strike will be unsettling for patients and very divisive for its healthcare teams. “The impact can be deep and lasting and should not be taken lightly,” he warned.
But it could fundamentally change the status of many veteran workers, Spetz said.
“It’s really an opportunity to draw attention to the fact that nursing is a highly respected profession that requires a lot of skill and knowledge to do it well,” she said. “And often it gets overlooked.”
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