The last time that Stanford nurses went on strike against Stanford Health Care (SHC), nurse Fred Taleghani had no idea what was coming. The year was 2000 and Taleghani had only been at the institution for a year. At the time, the nurses’ union — the Committee for Recognition of Nursing Achievement (CRONA) — was far smaller than it is today.

“I wasn’t particularly prepared,” Taleghani said. “But I understood the importance of us needing to go out collectively.”

Over two decades after Taleghani walked out, nurses are lining up again to strike against Stanford Hospital and Lucile Packard Children’s Hospital. According to a Wednesday press release, CRONA has notified SHC of its intent to strike beginning April 25 — a decision that comes just days after a strike authorization vote, which saw 93% of nurses support a work stoppage. Nurses’ previous contracts expired on March 31 after months of negotiations between CRONA and SHC, who meet for scheduled talks every three years. 

The hospitals have “secured the services of licensed, qualified, experienced replacement nurses to ensure patient care remains uninterrupted” during a potential strike, according to Dale Beatty, the Chief Nurse Executive and Vice President of Patient Care Services for SHC, and Jesus Cepero, the Chief Nursing Officer and Senior Vice President of Patient Care for Stanford Children’s Health.

“Both hospitals will remain open and our community can continue to count on the safe, high-quality care it has come to expect from Stanford Health Care and Lucile Packard Children’s Hospital,” they wrote.

Taleghani, who is still a nurse at Stanford, sees parallels between CRONA’s 2000 strike and its current efforts to win fairer nursing contracts. The central issue at hand — the ability to attract and retain nurses — is something that Taleghani said has been complicated by the disconnect between nurses and hospitals in negotiations.

“The way the hospitals have presented the issues at the table, they’re seemingly oblivious to the current state of nursing,” Taleghani said.

One key issue that has been a constant throughout negotiations is staffing. SHC has “a definite staffing issue,” according to Stanford clinical nurse Rachel Gratz-Beken, who said this has impacted her ability to care for patients. According to Gratz-Beken, intensive care unit nursing shortages at Lucile Packard Children’s Hospital have sometimes pushed her nursing unit to care for critical patients. But her unit is often clinically inappropriate for many of the critical patients it receives. Caring for these patients takes resources away from her unit, which in turn exacerbates staffing issues, Gratz-Beken said.

“It’s a cyclical process,” she said. “It could be prevented if we had more critical care nurses to help out.”

Beatty and Cepero defended the hospitals’ previous efforts to increase staffing, writing to The Daily that both hospitals have “made significant investments in nurse staffing in recent years, even as many hospitals face unprecedented staffing challenges.” According to Beatty and Cepero, the clinical nurse population at Stanford Health Care has increased by 36% since January 2019, while the clinical nurse population at Lucile Packard Children’s Hospital has increased by 24.5% in that same timespan. 

Mental health has been another area of continued emphasis for CRONA, especially as staffing issues have placed a physical and mental burden on nurses. Overwork has been an issue for nurses, according to Taleghani, contributing to a “challenging recruiting environment” for the hospitals. Nurses have continuously called for increased paid time off as part of their efforts toward a better work-life balance. 

“This is not just about us,” Taleghani said. “It’s about making this into a sustainable career.”

According to Beatty and Cepero, the hospitals’ current package to nurses includes proposals aimed at furthering the hospitals’ “commitment to enhanced nurse staffing and wellness,” as well as “market-leading pay.” 

But according to registered nurse David Hernandez, while it is true that Stanford nurses have remained among the highest paid nurses in the country, this figure ignores the significantly higher cost of living in the Bay Area compared to other geographical regions. Many nurses live a significant distance away from the hospitals, Hernandez said, and these long commuting times have contributed to their sense of burnout.

“I’m not competing with a nurse in Wyoming to buy my first home here in the Bay Area,” Hernandez said. “I’m competing with entry level people getting hired at Facebook who are making pretty good amounts of money.” 

Beatty and Cepero wrote that while the hospitals “are disappointed that the union has chosen to strike,” their goal “has always been to reach a mutually acceptable agreement through good faith negotiations.”

According to Hernandez, CRONA remains “willing to work with the hospital to avoid a work stoppage.” Still, the union is also prepared to strike if needed to achieve a fair contract, he said.

“Am I hopeful that an agreement will be reached before the deadline? I’m hopeful, but I’m not counting on it. I’m fully prepared to move forward with the strike as planned,” Hernandez said.