CRONA nurses union pushes through sellout contract at Stanford Health

Stanford Health Care located in Palo Alto, California [Photo by Wikimedia/Travis Wise / CC BY-SA 4.0]

On Sunday, April 6, the Committee for Recognition of Nursing Achievement (CRONA) union announced that Stanford Health Care (SHC) and Lucile Packard Children’s Hospital (LPCH) nurses had voted to ratify a new three-year contract. According to an instagram post by the CRONA union, 75 percent of nurses, or 4,754 nurses, voted yes to ratify the contract.

CRONA had been in negotiations since mid-January, with nurses demanding an end to understaffing, a wage increase to match the cost of living in the surrounding South Bay region, where median rent for a modest three-bedroom home is close to $5,000.

Many nurses cannot afford to live in the area where they work. On March 29, 2025, local news outlet KCRA reported on Stanford nurses forced to sleep in their vans between shifts. Meanwhile, Stanford University sits on an endowment of $37 billion.

The contract does not meet nurses’ demands. A wage increase of 12 percent over three years was agreed to, essentially a cut in wages when adjusted for inflation. Several nurses commented their dissatisfaction with the contract on CRONA’s instagram page.

One nurse pointed out that the 12 percent wage increase is less than the 15 percent wage increase over the duration of the agreement from the previous contract.

Another nurse wrote:

this seems very weak to me. 4 percent doesn’t even cover my rent increase, let alone the rest of life.

The SHC contract also did not include enforceable minimum staffing ratios. It only requires that staffing plans shall be available to the nurses on that unit in electronic form and in hard copy.

Section 33.3.2 of the agreement states:

Staffing is determined by a combination of professional judgment, acuity and staffing plans/matrices. In meeting the staffing needs of the unit or area of practice the Resource Nurse is permitted to use judgment in adjusting staffing levels …

In both cases, the language gives management substantial discretion in determining staffing levels. In addition, the contract lacks concrete mechanisms for nurses to challenge dangerous understaffing situations, offering “transparency” instead of actual control.

According to Becker’s Hospital Review, the contract includes weekend staffing provisions, which state that nurses may be scheduled to work every third weekend. Nevertheless, the full contract language reveals the critical qualifier “if staffing permits,” making any such alleged scheduling flexibility an illusion.

The contract also includes workplace violence prevention measures, including training, increased tracking and reassignment accommodations for nurses, who have been assaulted or threatened by a patient or visitor. This provision subordinates nurse safety to staffing considerations and management’s prerogative. It does nothing to address workplace violence, which is a consequence of understaffing, inadequate security measures, overcrowding and long wait times, which are the result of the for-profit healthcare system that places profits over lives.

In addition, new provisions addressing artificial intelligence (AI) in the contract states:

the use of technology should not limit a Nurse’s exercise of clinical judgment and that, while technology may affect nurses nursing duties, it is not intended to be used to eliminate the Nurse’s role in the delivery of patient care.

CRONA bureaucrats did not include any enforceable protection against the use of AI, effectively giving the green light for nurses’ duties to be affected and possibly replaced by AI technology.

The contract not only fails to address nurses’ demands for substantial pay raises to compensate for the high cost of living in the Bay Area, it also does nothing to address understaffing, workplace violence and the use of new technology. While nurses continue to struggle under these conditions, members of the union bureaucracy give themselves large pay raises.

The contract was “bargained” by union bureaucrats whose salaries and social interests are far more aligned with management than nurses. According to ProPublica, CRONA President Colleen Borges increased her salary from $204,365 in 2021 to $230,447 in 2023, a 13.7 percent raise. CRONA Treasurer Jolivette Enriquez-Leano’s salary increased from $139,568 in 2021 to $205,835 in 2023, a 47 percent raise.

The betrayal is only the latest. Nurses raised virtually the same demands—inflation-busting wages and improved staffing ratios during the 2022 strike, which was sold out by CRONA. The union hailed the contract as a “victory,” and in spite of this three years later the same critical issues persist.

This highlights the urgent need for a fightback by the working class. Nurses must organize independently to defend their interests and those of their patients. And this fight must be connected to the broader political struggle against the attacks on public health, democratic rights and the efforts by the Trump administration to set up a dictatorship in the United States.

Nurses must take matters into their own hands rather than relying on the union bureaucracy to fight for their interests, a fight that will never come. Nurses must take up the initiative to build up the Stanford Nurses Rank-and-File Committee under the broader umbrella of the International Workers Alliance of Rank-and-File Committees (IWA-RFC) and link up their struggle with other sections of workers coming into struggle and lead a nationwide counteroffensive against the attacks on the working class.