By Brian Contreras on April 19, 2018

After a barrage of accusations that Stanford’s recently-acquired ValleyCare Medical Center is a poor work environment — including allegations of worker intimidation, bribery and patient endangerment — the hospital’s nurses have taken matters into their own hands and unionized.

Wednesday night, in a secret ballot that came out to 188 in favor and 114 against, the Registered Nurses (RNs) joined the California Nurses Association/National Nurses United (CNA/NNU) union.

All full-time and regular part-time ValleyCare RNs were eligible to participate, and the process was set up, monitored and tallied by the regional director of the National Labor Relations Board (NLRB).

According to the NLRB Notice of Election, unionizing only required “a majority of the valid ballots cast.”

The Pleasanton-based ValleyCare merged into the Stanford Health Care system in 2015. Although nurses at Stanford Hospital and the Lucile Packard Children’s Hospital are already part of the Committee for Recognition of Nursing Achievement (CRONA), an independent union, their ValleyCare equivalents are not.

The ValleyCare unionization campaign was an ongoing effort and took place amid mounting concerns that the hospital was a poor environment to work in. Last week, for instance, two ValleyCare RNs and three organizers from CNA met with Stanford students at the El Centro Chicano y Latino community center to discuss the issues motivating their push to unionize.

Cenobio Hernandez ’18 advertised the event with an email stating that “RNs are often called and told not to come to work claiming they are not needed,” leaving units understaffed. He also noted that RNs are “required to work in units they are not trained for… causing patient safety concerns.”

Stanford Health Care corporate communications and media relations lead Patrick Bartosch disputed those claims in a statement to The Daily.

“As almost every other hospital in the nation, ValleyCare Hospital does have staff that are ‘on call’ to come into work in case of an unexpected increase in workload,” Bartosch wrote. “However, we make every effort to limit these circumstances. All of our staff only work in areas they are trained for and which are part of their regular scope of work.”

A Facebook post advertising the event, made by the Stanford Coalition for Planning an Equitable 2035 (SCoPE), added that violations of a 1999 California law regulating the ratio of nurses to patients also spurred the pro-union movement.

The law in question, Assembly Bill 394, mandates minimum staffing ratios for different hospital contexts, such as 1:1 in an operating room or 1:4 in an emergency room. Studies have shown that such laws improve both patient care and nurse safety.

While Wednesday’s vote marked the ValleyCare RN’s only successful unionization, it was not the first attempt of its kind.

“A couple times, [nurses have] tried to organize,” said one nurse at the Monday event, whose name has been omitted because she feared for her job security. “Once it was 15 years ago and several people got fired, so staff was really frightened to organize even though [it’s] a federally-protected law that we can.”

That law is the National Labor Relations Act, under which “employees have the right to attempt to form a union where none currently exists,” as per NLRB guidelines.

The nurse added that non-nurse staff have also tried to organize more recently, which “didn’t go over well, either.”

Some of the nurses contacted CNA in November to see if they could organize and improve working conditions around issues like “not having pay comparable to other area hospitals,” understaffing and having to hand off patients to other nurses at critical stages.

“They don’t pay us [differently] if we work Christmas Day,” added another nurse, whose name has also been omitted due to employment concerns.

Hospital administration denied their claims, however.

“ValleyCare Hospital is fully committed to offering the best working conditions for all of our employees,” Bartosch wrote. “At ValleyCare, there have been no cuts in hourly wages or to the retirement plan in recent history. Instead, select hourly wages have increased significantly and our retirement employee match program was launched this year, which in turn increases our employees’ retirement savings.”

He added, “the number of holidays, the amount of holiday pay and vacation time, as well as seniority structures have not changed in years and claims to the contrary are factually inaccurate.”

But according to the RNs, Stanford Hospital ran an “aggressive, nasty campaign” to scare nurses into not supporting unionization and even fired nurses for organizing pro-union efforts.

The nurses also said that unionizing is not just a question of improving labor conditions for the nurses themselves; it leads to better treatment for patients, too. This message aligns with a recent string of radio advertisements by the Stanford Hospital-affiliated Service Employees International Union associating the facility’s high infection rates with poor working conditions.

“Most of it’s patient advocacy,” the first nurse said, referencing studies showing that unionized hospitals outperform their non-unionized counterparts on most measures of patient outcomes.

Yet other issues also pervade the hospital environment, the two added. Workers have allegedly been told that they’ll be fired for talking about how much they earn, and the second nurse said that hospital management is aggressive and intimidating toward RNs — to the detriment of patient care.

“There’s a significant positive relationship, a significant effect, towards safe patient care when you have nurses who are able to enforce regulations,” said Omar Batanyan, a union organizer with NNU who was at the El Centro event.

Unionizing was even more important, the speakers added, because ValleyCare nurses were (until Wednesday night) unique in the Bay Area for their lack of a union.

“We’re the only hospital around, in our area, that’s not unionized,” the first nurse said. And although they’d brought their complaints to administrators as high up as the president of the hospital, there’d been “no changes; it just [got] worse.”

Efforts to unionize were complicated, however, by Stanford’s hiring of a “union-busting firm” which “harassed and intimidated and threatened” nurses into not supporting a union, said CNA’s Michele Nyberg.

The firm in question is IRI Consultants, which identifies itself as “finding opportunities amid organizational challenges to improve employee satisfaction and performance” and offers a “Union Vulnerability Assessment” to employers that suspect their workers of planning to unionize.

It is around this issue, Nyberg added, that the event attendees and other Stanford students came in.

“This firm is paid for through Stanford tuition dollars,” she said. “So you all do have a stake in what we’re talking about.”

Bartosch declined to answer questions about whether Stanford is working with IRI Consultants, whether the firm had attempted to intimidate nurses or whether tuition dollars were being used to pay them.

Monday’s two nurses described additional issues they said they and their peers have faced, such as being paid thousands of dollars in “hush money” and being fed misleading information by administrators about the dangers of unionization.

“They try to spread incorrect information,” the second nurse said, referencing slideshow presentations that nurses are repeatedly shown, which Batanyan said “nitpick” the National Labor Relations Act.

Bartosch declined to answer questions about these specific claims.

At the close of Monday’s event, the speakers circulated a letter for attendees to sign. Addressed to University President Marc Tessier-Lavigne and cc’d to Stanford Health Care — ValleyCare President Scott Gregerson and Stanford Health Care CEO and President David Entwistle, the letter criticized the University’s alleged hiring of the union-busting firm, firing of pro-union advocates, intimidation tactics and bribing of nurses.

“We firmly believe that tuition fees and public money should NOT be used to prevent anyone from exercising their legal and human right to organize,” read the letter, a Google Forms version of which was later released for public circulation.

It was in that context that the vote over whether to unionize took place. And although hopes were high going in — “I think we have a good chance of winning,” said NNU’s Dana Trentalange at the time — so were the stakes.

“If we lose,” one of the nurses remarked, “I’m being fired.”

If the results of Wednesday’s ballot are any indication, she no longer needs to worry.

Contact Brian Contreras at brianc42 ‘at’ stanford.edu.