Why my fellow nurses and I are ready to strike at Stanford Hospital

Jennifer E. Engen

In January, Michael Odell, a fellow critical care nurse at Stanford Health Care, died after abruptly walking out of his shift at work. Although the investigation is ongoing, all signs point to suicide.

Michael was suffering quietly — something many health care workers understand all too well. As a critical care nurse in the first decade of my career, I’m feeling very uncertain about the future of my profession.

The pressure, exhaustion and trauma of working within a broken system that fails to support the pandemic’s “heroes” is driving tens of thousands of nurses to reconsider our decisions to go into nursing — myself included. In California alone, there is already an estimated shortfall of 40,000 nurses.

At the core of nurses’ uncertainty about our futures is our working conditions, and whether we will have the requisite resources and support we need to take care of ourselves, and in turn, our patients.

At the hospital where I work — Stanford, as well as at our sister hospital, Packard Children’s — 41% nurses report they are considering leaving within the next few years. This would be a tremendous loss. It is our expertise that has landed both Stanford and Packard a Magnet distinction for excellence in nursing practice. Rather than working to keep experienced nurses and recruit new ones by meaningfully improving working conditions, administrators’ approach has been to demand more of the core nursing staff and pay a premium for expensive contract “travel nurses” to try to fill the gaps.

During multiple waves of the pandemic, my unit saw critically ill COVID-19 patients every day for months at a time. We were chronically under-resourced and like many nurses, I worked shifts of 12 to 16 hours, often back-to-back, and sometimes going weeks without even a full 24-hour break.

Some of this I accepted as a natural outcome of working through a global pandemic. But while my world and the world around me was turning upside down, I needed support from my employer to address the mental health impacts of facing so much illness and death. When I sought counseling through the hospitals’ program, I was told I had to wait six to eight weeks before I could even schedule a first appointment. If I needed immediate support, I was directed to go to the emergency department or call a crisis hotline.

Michael’s memory is top of mind when nurses ask Stanford and Packard for greater mental health support, more sustainable schedules and fixes for our understaffing. We need structural solutions to the conditions of overwork and exhaustion that are burning us out and straining us mentally and physically, especially in critical care units like mine.

More than half of the nurses in my unit are travel nurses — registered nurses who work in short-term roles in hospitals, clinics, and other health care settings. While I have the utmost respect for them — I myself was a “traveler” for a time — it’s not uncommon for travel nurses without the requisite intensive care unit experience to be hired to fill staffing gaps. That means that my colleagues and I have to orient new travel nurses while simultaneously caring for patients. Once they become integral members of the team after a couple months on the job, many leave, only to be replaced by new travelers. Then, the cycle begins anew.

It didn’t always used to be like this. A fellow critical nurse, Bonnie Balfour, has been at the hospital for almost 50 years. She talks about how travel nurses were brought in to fill in parental leaves or surgery recovery or other long absences here and there. They were not a long-term solution. However, what she’s seen recently at the hospitals is a startling increase in travelers, to fill in where the hospitals have been unable to recruit and retain core staff.

Nurses at Stanford and Packard have a long-term, sustainable solution: competitive wages and benefits that would incentivize nurses to take staff positions and stay at the hospitals. Across ICU and non-ICU units alike, nurses support additional pay for critical care nurses because when ICU units are not properly staffed, all nurses and units are impacted.

Staffing must be dependable to meet the intense needs of patients who come to our hospitals. Working at level-one trauma centers, we care for patients who need more than what the law’s minimums might require. While Stanford claims there is no short staffing problem, I am receiving as many four to six texts per day to come in for overtime, as are countless others.

Nurses are the backbone of the hospitals, and we are simply asking for the resources we know the hospitals have to support us and our commitment to delivering excellent patient care. Travel nurses are generally paid substantially more than staff nurses, including here at Stanford. We also know that the hospitals’ joint operating surplus increased by $676 million from 2020 to 2021, according to Stanford’s annual report. Stanford, which prides itself on being an health care leader, could put forward real solutions and invest in its nurses. It is choosing not to.

That’s why I’m ready to go on strike Monday alongside up to 4,500 of my nurse colleagues in order to secure a better future of our profession and our patients.

The issues affecting nurses at Stanford Health Care are not unique. But that’s not a reason to accept the status quo. Applauding nurses as “heroes” is not enough. We need our employers to listen to our solutions for improvements in safety, health and well-being and career sustainability. The future of our profession — and the quality of our country’s medical care — depends on it.

Brittaney West is an intensive-care unit nurse at Stanford Health Care.


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