This is a very nice and fair-minded summary of the state of negotiations..

CRONA continues to ask the hospitals to negotiation, while simultaneously accepting many if not all of the wage related proposals.. Hospitals continue to be non-responsive..

I think binding arbitration shows CRONA's true willingness to negotiate fairly, the hospitals refusal (I'll go out on a limb and predict they won't agree to binding arbitration) reflects upon the weakness of their offer..

Not sure why the hospital would roll the dice with an arbitrator. Seems like they think they hold the cards here. "Last, best & final offer" is pretty clear - they are done negotiating and think they will ultimately prevail.

I doubt Nussbaum expected the hospital to accept the offer of binding arbitration. But it's part of the dance leading to the resolution of this. It's also good PR for CRONA when this all turns out badly for the myopic cookie cutter consultants/negotiators who concocted this ruse and scheme.

The nurses don't want to strike. But from my contacts I very seriously doubt the nurses will accept Stanford (and it's underling LPCH) offer. They don't hold "all the cards" if the nurses will strike. If anyone has chest pain during such a strike I seriously suggest you tell the paramedics to risk a longer drive to El Camino, Sequoia, Kaiser,etc.

Definitely a very bad time to be trying to be a hard-*&^^ about your job as a nurse.

I wouldn't be risking it, nurses. Health care reimbursement is under assault, this Admin has just passed a huge bill that nobody who voted for it actually read, and which daily reveals laws that will undermine the amount and quality of care available in our health care system from birth to death.

So any right minded health care provider organization is looking forward 4 years when the last of the ...uh..poop...hits the fan and they see their dollars shrink.

Definitely not the time to be negotiating as health care workers, especially in a very high cost teaching hospital environment so reliant on govt dollars which simply ain't there any more.

Stanford Hospital comes off looking like a coal mining company in this. Since the nurses have made the Professional Nurse Development Program their number one priority, I can't understand why Stanford is unwilling to negotiate this issue or consider the nurses concerns. I guess Stanford never makes mistakes.

There was a long-ish strike a few years ago - people forget, but cost structures are long-lasting. My guess is that is why the hospital wants to take advantage of the economic conditions to address what seems to be a fundamental problem with the makeup of their workforce.

The strike will probably happen by June. This could be a way to fix the fundamental problem of Standford/LPCH's administrative ways.

If only actual, real facts were made public, the community could truly understand the problem at hand.
1. Under the proposed professional development program nurses will be required to earn points to qualify for higher clinical levels with increased pay scales. An expert bedside RN could earn maximally half of the points needed to be one level up from a new grad. The remaining half of the points needed would have to come from a variety of "on your own time" projects which include a range of academic endeavors (publishing) as well as clinical projects (advanced certifications, serving in leadership positions, mentoring new staff). Some of the latter options are limited, primarily by the fact that there few opportunities available, certainly not enough for hundreds of nurses. I am a veteran, near 30 year RN, masters prepared, excellent bedside clinician who has been clinical faculty for senior nursing students in the past, who will, at the end of this proposed 3 year contract, most likely not have sufficient points in this program for promotion, and so will be demoted from a Staff Nurse IV to a Clinical Nurse II which as I said, is one step up from a new grad.
2. Stanford says our PTO bank is as high or higher than comparable bay area hospitals. Our PTO bank is a combined sick leave and vacation bank, where as many other local hospitals separate these hours. With the added plan to reduce our medical leave (for disability such as pregnancy) the Stanford/Packard RNs will be forced to deplete their PTO (which includes all vacation time) before then having to pay COBRA rates just to have medical insurance while on leave. Where CRONA nurses have to take a short notice PTO day of 8 to 12 hours depending on the shift worked, in order to handle an emergency...managers can merely flex their time to accommodate an outside of work issue and do not have to dip into their vacation/sick time for such events. Managers can work with physical limitations (weight lifting reductions, extremities in casts, etc.) whereas most CRONA nurses have to remain on leave until back to full health. Lastly, nurses are forced to take time off during periods of low unit census, while managers may continue to work. These are reasons why the PTO issue is so important, and why our PTO bank legitimately should be higher, rather than the same as that currently given to management.
3. Yes it is all about money. This is a bad economy for everyone. Limiting our opportunities for promotion will save the hospital money. Limiting our PTO will save the hospital money. Limiting our medical benefits will save the hospital money, and force RNs to sacrifice vacation time in order to have medical benefits for themselves and their families. We work in a very stressful environment, we have families, we need a little vacation time!
Stanford is planning to build a new hospital, and I assume needs money on the books to secure the necessary loans. They are trying to get that money by shifting it from the very people who provide the excellent care that a truly exceptional hospital strives to have. Do you want a nice building? Or do you want nurses who can care for you?
4. The average age of nurses nationwide is climbing. In 3 years time when this current contract as it is offered ends, I suspect there will be significant numbers of nurses retiring rather than facing the humiliation of demotion. New nurses will not want to accept positions with an institution that values tasks and points over quality bedide nursing. What will Stanford do then?
5. Lastly, personally, I am willing to accept less of a salary increase over the 3 year contract so that money could be used toward PTO and medical benefits instead. The professional development program needs additional adjustments to be made more fair and attainable.
I fervently wish both CRONA and Stanford/Packard would either return to the bargaining table with serious interest in adjusting the current offer to accommodate such changes, or to engage in arbitration. We need this to be ended.

The largest nurse strike in history is about to happen. All possible replacements will be there. The nurses should act now! The hospitals would be up a creek without a paddle!

The impasse could be ended immediately by the nurses agreeing to management's proposal. They don't want to, which is fine, but it is a choice they make to try get what they want, just as going on strike would be.

While I am sure nursing is hard work, like many other jobs, the market sets the wages, benefits, etc. This is a test of the market. The test is stressful on all concerned, but it does seem like a lot of money is at stake (some of it tied to professional development ratings and PTO). The bad luck for the nurses is that the contract ended during a weak labor market - if it had ended during a strong labor market, the shoe would be on the other foot.

Jerry is correct, a multi-hospital union in Minnesota is taking a strike vote today. The proposed strike is a one-day action, though the hospitals are saying that they may not allow the nurses back the next day. Also, my understanding is that the Stanford nurses are obliged to give a 10 day advance notice of a strike, though I guess they could try to coordinate timing with the Minnesota nurses to strain the supply of replacement workers. Of course, if they coordinate actions and then one group reaches an agreement, the other group is in a weaker position than before. High stake poker!

A Noun Ea Mus---I love your comments! They are so right on!

Of course we don't want to strike---but we can if we need too, I am certainly ready if the situation requires it. Nurses are smart---we have a plan "B" for ourselves in case of strikes--you have to when you work in a union environment. But the reason I don't want to strike is because I would miss caring for my wonderful patients!!! It would harm the community. Recently they had a very large strike in Pennsylvania and had a good outcome--they can do it, so can we--IF we need to. We are doing everything in our power to prevent a strike---

What is Stanford/LPCH doing????????

Thank you for all those posting who understand the negotiations and support us!
We are doing our best to serve our community and prevent a strike. We want to negotiate....but we can strike if we have to. Since 90 percent of the nurses already voted no on this contract how can we get them to vote yes?

Negotiate.

Binding arbitration is the fair way to go. A fair impartial outside source to decide if the contract is fair????? How about that...hmmmm...sounds like a win-win situation. In the long run... Stanford forcing it's hand it will lose---badly.


Now why didn't Stanford think of binding arbitration first????

The nurses need to stay working. They can end this today. We need to have good standards in place for nurses. The pay is very good - PTO is some of the best. The standards are very old! Nurses should accept and get on with taking care of patients.

To patient....our goal here is to preserve some benefits and make the clinical ladder fair so that future nurses will want to work at Stanford. When the economy turns--which will be soon and nurses retire--which they are already doing and nurses quit and go somewhere else-which they are already doing---who will come work at Stanford?????? Nursing schools are not producing enough nurses to replace the ones that are leaving.

Of course the union wants binding arbitration.

" A typical arbitration panel is composed of three professionally trained arbitrators, one chosen by management, one chosen by the union, and one chosen by the first two. They will hear the arguments, consider the issues, and fashion a remedy, a contract. That contract almost never favors management. It almost always favors the union and for a very simple reason. Arbitrators need to work. When they work they always face the same unions on one side of the table, but different governing bodies on the other. Unions keep book on the performance of arbitrators, and they will shun or boycott arbitrators who don't favor union positions. Put bluntly, arbitrators who don't please unions don't work. Arbitrators don't have to fear governing bodies because they very seldom have to face the same one twice, and governing bodies don't keep book on them. Hence, governing bodies enter binding arbitration at a terrific disadvantage and virtually never win. "

From
Web Link

I am an LPCH employee and I like to think all employees (including nurses) provide value to the hospital. There appears to be false information out there with regards to the negotations.

Did you know that with regards to PTO, all non-nursing employees have already had their PTO banks reduced 5 months ago? I'm a young adult hoping to start a family and I was upset when they decided to reduce my PTO balance (which I didn't lose by the way - it's still getting paid out in cash)....but at the same time, I understand. The new policy still allows us to rebuild our PTO and there is now an extended sick leave account (which can be used once an employee is out 3 days due to illness or the very first day of hospitalization). I also did some checking since I plan on having children soon and it appears that during maternity leave (while we qualify for short term disability and FMLA), we do not need to pay for COBRA (even if we have no PTO left). I am still unclear about whether we would need to use all of our PTO to supplement disability, but that's where good planning comes in...I encourage the nurses to check with HR about the policy so that you are well informed.

We do have it pretty good here since many other employers in the area have all cut down the maximum allowed hours for accrual altogether. And job security in healthcare is much better than some other industries.

In order for our hospitals to continue serving our local communities, certain cost management needs to happen. There is an extreme amount of government pressure for hospitals to keep their costs down since there are many uninsured, leaving the insured to cover the costs.

With regards to the hospital expansions, this is only because LPCH and Stanford want to continue to meet the growing needs of the community (which includes Palo Alto and many other cities in the state). This is much needed and yes it does cost money...nothing is free. But with expansion usually comes an increase in the number of jobs, which should only benefit us more down the line.

I can't speak to the pay scales for nurses, but it's my understanding they are paid pretty well compared to other hospitals (even those with similar levels of care). And I think they deserve to continue to be paid well considering that they are the ones caring for our patients. But they also need to understand that we are all very lucky to be employed by top-scale hospitals who are interested in providing continuing care to the communities and don't just care about the here and now. If the hospitals were to shut down due to financial problems, I would be out of a job as will all of the nurses. That's in addition to the patients we would no longer be able to serve. I'm willing to make concessions to secure the future of my job and community. Are nurses?

The proposed clinical ladder is just plain bad business ---that is what concerns the bulk of the nurses. It will not attract new nurses to work at Stanford and it will drive current nurses away. It will not help current nurses or future nurses give better patient care. In the long run it will cost the hospital more money on future expenses to attract nurses to work at Stanford. Expensive gimmicks won't even get those nurses then.

I just looked up the current UCSF contract which is online for all to see. They have a separate bank for PTO and Sick time. The sick time bank allows them to accrue an UNLIMITED amount of sick time and leave it there in the employees sick bank.

UCSF also used a neutral fact-finder to assist with negotiations for their last contract and accepted the fact finders recommendations.

This is how negotiations should be done.

Hmm, that's two posts now claiming that the nurses are not so much concerned for themselves, so much as for future nurses or even the hospital itself.

It reminds me of over-paid CEO's and their crony boards explaining that they need giant bonuses and stock option packages "for the good of the shareholders." Hmmm... I don't blame them for trying to get what they can (the nurses or the CEO's), but it is hard to swallow.

I agree that it looks like management does intend to drive some of the long-tenured, high-ranked, highly-paid nurses away - that seem obvious. If the worst happens and new nurses won't come to Stanford, I suppose the hospital can always raise future pay (or adjust the clinical later) when they need to. The concerned nurses can rest easy, I think.

I am concerned about where Stanford is going to get the nurses that I will be working with. I am not a long-term Stanford nurse and I have worked in healthcare a long time--long enough to know what works and what does not.

Negotiating works--we are quite willing to give things up-just need to
have fair negotiations instead of Stanford's stubborn take or
leave stance. My unit that I work in right now is short nurses and resignations are
coming in! I do not want to compromise care by working with inadequate staffing because Stanford can't find nurses to cover shifts--it's already here!

We are not overpaid CEO's.

We save your lives, how important is that????

Some claim that the current economic downturn means by default that any nursing strike won't succeed. They point to "supply and demand". To a point this is true. And if would be relevant if it wasn't nurses working in a variety of the most specialized clinical settings. Anyone with any clinical experience knows that any attempt to retrofit the bulk of Stanford's RN's with scab traveler's could only be done by very radically curtailing the medical/surgical services usually provided. The term "hibernation" comes to mind.

So the nurses look at the profoundly professionally insulting proposal and argue against it with fervor. Some right wingers from the community then weigh in with "Supply and demand". But if the shoe were indeed on the other foot---and the nurses and their union then acted like Teamsters on steroids---the rejoinder would be "but that is so unprofessional to act that way".

If healthcare workers argue professionalism then management retorts with supply and demand. If healthcare workers then argue supply and demand (or act on it via a strike) then the hospital cries crocodile tears and whines "but that's so unprofessional".

Part of supply and demand is how organized and determined a skilled and professional workforce can stick together and hang tough.

I suspect if Stanford/LCPH pushes this to a strike that lesson will be taught again.

I am sad to hear a professional use the offensive term "scab". I am clear no manager would use that term- replacement workers/staff are a reality with a work stoppage.
The hospital is obligated to have a plan to care for patients if the present RNs chose to abandon them.

The communication from the CRONA lawayer is both offensive and only bringing partial truths to light.
CRONA has backed themseleves into a corner and the poor behavior is what the public is seeing.

Interesting thread here. I just did a quick and dirty Craigslist search in jobs for nurses in South Bay and came up with 48 current listings. I think of all professions right now in these times, nurses do hold a fairly good hand of cards. There is a high demand for skilled nurses, and with the health care legislation passing, this demand will increase.

You go, nurses! You are consistanly the ones that show the most care and nurturing when I have had the misfortune of being hospitalized.

And the term "scab" has a long and not so happy history. Strike breakers would be more kind, but when strikes happen, kind is not one of the dominating feelings. This is about someone's life, job and passion.

I consider the 50%/50% for continuing education a deal breaker for a professional, but if Stanfoo persists then get a law passed that requires employers to pay both the expense and salary during that required education - if it is off hours, pay overtime. Perhaps also, management might be required to spend some time at the highest level of direct patient care they are qualified for just to prove they know what they manage.
My old leader, John L. Lewis, got portal-to-portal pay for miners. Perhaps the Nurses need to put Rosie O'Donnell on their team.

I have been so impressed with how the CRONA attorney has handled these negotiations. We are lucky to have him.

Thank you all so much for the supportive comments. It really means alot to me and just reinforces why I became a nurse, to care for you if you need it. I love being a nurse and it is so wonderful to get support from you the community.

Don't back down Stanford Nurses!!

Stanford administration is obviously playing dirty.... & manipulating your image & your concerns to the media. Historically, hospitals have always gone after the wages & benefits of Nurses during bad economic times - & it has always been to the detriment of patients. This situation is basically the same, except that the days of big corporate healthcare are coming to an end. Come on, Stanford Nurses: take control & lead the way!

Thank you mmmmmMom!!!! Your are a great support! Means alot to us!

"I agree that it looks like management does intend to drive some of the long-tenured, high-ranked, highly-paid nurses away - that seem obvious."

Stanford/LPCH has pursued a number of specialty areas, such as neonatal intensive care, pediatric oncology, pediatric cardiovascular, etc. Specialty areas need long-tenured, highly skilled nurses. For an institution that depends on its professional reputation, it makes absolutely no sense to anyone but a dumb bean-counter to drive away the highly skilled (a real accountant understands the value of good people; a dumb bean counter talks about slots and seats as if they can be filled off the street). This isn't the county hospital where the trickiest thing they do is an emergency appendectomy.

I just don't understand why Stanford is unwilling to negotiate. I hope this doesn't start to look like Harlan County, USA.

My sense is that Stanford doesn't want to compromise on the clinical rankings issue ("negotiate further") because 1) what they have now is far from what others do and from where Stanford thinks it needs to be and 2) they think conditions are such that they can win. Given that the labor environment is often favorable to nurses, they want to use this opportune time to achieve a major change.

When two sides are far apart, as it seems now, I'm not sure where "negotiation" gets you - it is a stalemate. You need to move on to other methods of conflict resolution - binding arbitration, strikes, lock-outs, etc. The stress goes up for everyone, unfortunately - but it isn't easy to achieve (or resist) major changes.

"I am sad to hear a professional use the offensive term "scab". I am clear no manager would use that term- replacement workers/staff are a reality with a work stoppage."

Really? You are "sad" that a labor union attorney (yes a professional) uses that term?

Offensive is as offensive does.

"The hospital is obligated to have a plan to care for patients if the present RNs chose to abandon them."

If the nurses strike it will not be because they CHOOSE (two O's) to abandon the patients. Rather because the hospital, in a time when many nurses know that the economy works against any major gains, is using a profoundly professionally insulting and dishonest "professional development" ruse in order to foist it's plans. I don't know if these people are profoundly stupid or psuedo brilliant in some psycho Machiavellian fashion----sticking to their "guns" (for now) as part of a strategy to bring on a strike.

I suppose I could verbally abuse my wife and throw all sorts of insults and insulting "proposals" to her. Then when she leaves I could say "but I had to bring in that bimbo to live with me because my wife abandoned my children". Hey and I find calling my new live-in a "bimbo" to be insulting!

A noun e mus. Brilliant!!! Well said Sir! I salute you!

Pray that the powers above guide us thru this.

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Anonymous, you were pushing for SEIU to strike. Now they stand to loose 75 full-time-equivalent positions, or about 8 percent of the city's workforce. You're really encouraging the nurses to do the same?

Here we go again-I trust CRONA and it's very talented attorney
to make wise choices and lead us through this with
some help from the powers above. You know I have
witnessed many patients recover miraculously in my unit after The healthcare team
had given them a poor prognosis.

What made the difference?

Prayer.

I am praying for the best outcome for all and keeping an
open mind concerning results.

Stanford has a few things to learn about he resolve of these women (and a few men) when it comes to preservation of professionalism. The Stanford plan to demote nurses is an effort to de-professionalize nurses so that all nurses with a license are basically at the same pay grade. Those who strive for excellence and have years of experience will be at the same level as those who just show up for work and punch their time card and leave promptly at the end of shift.

Why would any experienced professional in any field take a job were they had to prove to their employer each year, on their own time outside of working hours, that they were worthy of stay at the same pay grade? Stanford cannot point to ANY OTHER hospital in California that has such a requirement for their professional employees. Imagine if Stanford M.D.'s had to fulfill such requirements each year in order to avoid getting a cut in pay. When looked at objectively Stanford is just creating a scheme where it can demote experienced higher paid nurses in order to reduce expenses.

What kind of nurse to you want caring for you?

At the "new" Stanford Hospitals it will be the cheapest money can buy.

The only party that wants something new is the hospital. The nurses have agreed to some of these "new" items i.e. concessions. The hospital has been "invited" back to negotiations.They said NO. The hospital was offered a counter proposal and refused to negotiate yet again. Now they consider arbitration which was proposed by CRONA. The nurses have turned down a raise and bonus because other parts of the contract are so detrimental to us now and to future new nurses. The nurses want to work. We do not want to strike. The only party consistently speaking of a strike is the hospital. They posted want ads in the NY Times for replacement nurses BEFORE negotiations even started in January. The nick name for the hospital in the community is " The Axis of Evil". It seems well deserved and true. Where is the management team? What are they doing? Even if this gets worked out without a strike, so much damage is being done by not negotiating. They are failing. We need communication and team building not this. Like my grandma always said, "You need to listen to be heard. You need to be respectful to be respected." Come back and negotiate hospitals. You should be working with your nurses not against them. Don't force us to strike. Nobody wins. We all suffer. We all lose. Such a waste of time....

If only nurses could be real professionals instead of union workers, then we would have professional discussions about how patients are cared for, what educational levels required to provide that care and how hospitals, doctors, nurses and other staff contribute to humanity and its well-being. Nursing gave up hope of being true professionals decades ago when, due to market forces, our struggling profession decided that only 2 years of training is required to be a registered nurse. Then, in order to liberate nurses from poverty, unions were formed and the race was on. Now here we are with another wave of market forces that could price nurses out altogether and bring even more poorly educated workers to the bedside to deal with the economic challenges.

It makes me sad but the nasty talk just makes it more painful.

Jack, you are misinformed - or just using rhetoric in your post - "The Stanford plan to demote nurses is an effort to de-professionalize nurses..." is sooooooooooooo wrong - very misleading and just not true. Why would a leading hospital do this? No sense at all! And BTW, non-union employees DO have to spend a lot of time OFF THE CLOCK so-to-speak - in order to stay gainfully employed. It's called being salaried. It's called staying late and working weekends to make deadlines in order to keep your job. It's called working holidays when things are due - or things break - and guess what? I don't get extra pay - no overtime - no nothing. I can't remember the last time I worked 40 hours. Or 4 days a week? Sweet!

Mary, the process is that there are negotiations, and then the employer can put out a "last, best and final" - and then the employees get to accept or not. That's the process - and the hospital has repeatedly stated they will consider reasonable counter-proposals - and of course those are not forthcoming from CRONA. Surprise, surprise...

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"Anonymous, you were pushing for SEIU to strike. Now they stand to loose 75 full-time-equivalent positions, or about 8 percent of the city's workforce. You're really encouraging the nurses to do the same?"

I was NOT "pushing" SEIU to strike. I merely said that, if they did strike I would support it and do what I could to help. It's my understanding that SEIU has filed a grievance that the city didn't negotiate in any good faith (ala what is occurring now with Stanford/LPCH and CRONA) and why strike when an upcoming ruling may send both parties back to the table.

Further SEIU didn't strike (at least yet) and yet still they stand to lose 75 positions. Are you saying that merely my supposed encouragement for a strike, despite that it didn't occur, now caused such rancor within the city that they are now forced to layoff these workers?

It's not logical captain.

So "here we go again" can you explain the logic of your point? Is my online power such that I can cause even non-striking workers to be laid off?

And as regards Resident's point. Do you really think that if across some geographic expanse (CA or entire USA) that all nurses had to have a Bachelor's degree as a minimum entry requirement, yet still were needed 24/7/365 in areas both urban to rural, that substituting "professional discussions" instead of unionization would be a better way for nurses to optimize their wages and benefits?

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I hope the hospitals hold firm - for the same reasons we don't pay off hostage-takers. It encourages bad behavior.

Again I have to say Thank You A Noun Ea Mus. You are clearly in touch here.

Nursing shortage is nipping at our heals and the work is not easier. I for one still enjoy it and appreciate every compliment I get from my wonderful patients! Again Thank you to the community that supports us!

I truly believe we will get through this and the best outcome will prevail. It won't be easy, but when things work we hang onto them and when they don't they drift away. I have seen it many a time. Having worked in healthcare for 35 plus years in many different capacities, hospitals (union, nonunion) and states- union environments produce better working conditions and the patient ultimately reaps the benefit. Happy nurses give better care.

This is appearing more and more to be a one-sided conversation.

As an LPCH employee (non-management), I believe the nurses should accept what is on the table. The rest of us employees had a number of these same changes enforced upon us 5 months ago and we understand it will help the hospitals stay financially stable in the coming years.

To the one who mentioned about UCSF having a separate sick bank and PTO bank, that is exactly what is being proposed by Stanford and LPCH and is already in place for other employees. And any employee on paid leaves of absences can continue to receive their benefits. Not every employer offers this, so I find this to be fair.

Many other industries are laying people off. We are lucky to be employed. Yes, nurses save lives. But in order for you to continue to save lives, the hospitals need to be in financially sound shape to continue to be industry leaders and provide the outstanding care to the surrounding communities. We are still a business, and even with the best product (in this case the care that is provided by our workers including nurses), a business needs to control costs in a market when steep inflation isn't acceptable anymore, in order to continue doing business. Basic Economics.

To Jack and Mary,

There is a great difference between a Last, Best and Final Offer and a First, Only and Final Offer. The hospitals did not really negotiate. We nurses just want a fair deal. I truly hope that a strike is averted.

To the LPCH Employee,

Thank you for your insightful and well thought out remarks regarding "Basic Economics". Everybody agrees that the hospital needs to be in financially sound shape... and during tough economic times a tightening of the belt may be necessary..

What defines 'financial shape' is what is in question here.. I would argue that having a budget surplus of millions of dollars may be a little bit more that just scraping by as the hospitals would have us all think.. Maybe financial health is not much of a concern..

On the second point- does embarking on a new major construction project during tough economic times (the new hospital, which btw, IS needed) line up with what we would consider financial conservatism? Hmm, it the hospital is so worried about its financial health, then maybe an economic climate characterized by market instability and steep inflation is not the right time...

Alternatively, maybe this is the hospitals attempt to take advantage of their nurses, who unlike the last strike are relatively unable to go out and find other work (during these tough economic times) and shove something unfair down their throats...

Let's be clear, that whatever else may be true about the hospitals proposal, whatever their real motives are.. it will save them millions of dollars... A reasonable person should be suspicious..

As I understand it the Hospitals HAVE TO build something that will meet updated earthquake standards. In fairness they do need money to do this. In retrospect they have not earned the respect and trust of others in their past negotiations and financial decisions. Hopefully we can all work something out that is palatable to all.

The hospitals have replied and said no to binding arbitration. I read on UCSF site that for their last contract a mediator was involved. I don't think it was a binding situation but UCSF did cooperate and allowed a neutral third party to advise.

Stanford is not even open to CRONA nurses discussing anything with their CNO's or any mediator. They just want us to take an offer presented by an attorney and keep nursing out of it. Who knows the hospital better--nurses or attorneys???? With all due respect there is fine legal counsel out there, but hospitals need to have nurses involved in process as well--significantly. Stanford does not want the nurses to talk because they know that some of their higher management nurses disagree with PNDP as it is written. As my Dad always said if your gonna do something--do it right. I will not vote yes on something that I believe will not be in the best interest of anyone. It would be a nightmare to try to implement that PNDP as it stands.

CRONA is not a large greedy union. We just want to be involved in the process- not shoved aside. CRONA stands for all the nurses who really care about what happens now and in the future to working conditions and their impact on patient care.

Again, unhappy nurses give lousy care. Nurses become unhappy when they are not valued and respected for what they have contributed to a hospital. If 90% of CRONA's nurses believed this offer valued and respected them they would have voted yes.

I do not see anywhere in the offer a place that offers separate sick time that can be banked in unlimited amounts. UCSF offers this. If it is there it is not clear.

When the hospitals say "we stand behind our last best and final offer," well what the hospitals are doing is hiding/cowering behind their offer. Hospitals, what do you have to lose by actively negotiating? I'm losing respect for the Stanford administrators. It appears when we say "negotiate" the hospitals run the other way.

If the hospitals had come to the bargaining table with any desire to truly negotiate they might have asked for our help to cut back where needed and work TOGETHER with us.

They have not and it appears they never will. Their reputation and pocketbook will suffer.

Every patient deserves to have a qualified nurse care for them at the bedside. Stanford is driving away its qualified nurses with it's poor labor management practices.

Many other hospitals are currently trying this tactic and it is not working well for them.

I think everyone wants the economy to look bad so they can take advantage of other people.

The economy is not all bad for all people.

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I don't see doctors threatening a strike since reimbursements are going down the drain. Patients go to the Stanford for their renowned doctors not for the unionized nurses.

Experienced Stanford Nurses guide and teach the residents and interns in the proper way to deliver care. We prevent many, many mistakes.

I support the nurses in there decision.

All hospitals are now trying to reorganize in the the name of "Health Care Efficiency" or code name "Worker Wage Reduction".

This effects both patients and workers negatively. All Bay Area Nurse should support Standford Nurses, Period! Remember most people can not do this job even if they tried!

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It sounds to me as if Stanford is doing what many major corporations and smaller businesses are doing—using this time of financial duress to reorganize and cut costs for the future. That includes cutting salaries and pensions for the future. And for that they may need to lose a few current well paid staff. But new future staff will start at lower pay, advance in smaller steps to higher pay grades, work longer hours, and make their full retirement out of a 401K which they fund themselves.

The cynic in me says, however, that over time overhead may have to go up in order to afford the best management.