(Editor's Note: At this time, a few hours after the nurses and other health
professionals at Rhode Island Hospital voted overwhelmingly to strike at 7:00
AM, Eastern Daylight Time, the Hospital invoked a provision in the contract
allowing for interest arbitration on the last offer by each side in order to
avert a strike, according to late-breaking news. This is really a surprise
move, since reportedly scabs were already hired. Stay tuned. All relevant web
sites for this struggle, and similar struggles elsewhere, are linked to the
Web site of the Massachusetts Nurses Association <http://www.massnurses.com>.
These bulletins and other articles of interest to health care, nursing and
labor activists are now being archived, in html [with links], on a web page
entitled 'Sandy's Links,' <http://users.rcn.com/wbumpus/sandy>. A future
bulletin will offer a synopsis and evaluation of the recently concluded ANA
Convention 2000. -- Sandy Eaton, RN)

MASSACHUSETTS NEWS:

Worcester Nurse and MNA Member's Testimony
Before Nursing Commission Hearing: June 15, 2000

by Kathlyn M. Logan, RN

Good afternoon,

My name is Kathlyn Logan and I am a nurse in the central Massachusetts area.
I have been in the nursing field for over twenty-five years with experiences
in medical surgical, cardiology, home care, and intravenous therapy
specialties. I am a member of the Mass. Nurses Association and chair of my
hospital's staffing advisory committee. I am here today, to tell you that in
this past decade, nursing at the bedside has become an almost impossible
accomplishment.

The current atmosphere of inpatient acute care has reached a level of
increased stress, inadequate staffing, increased levels of acuity, and
unacceptable scheduling patterns. Today a nurse can not go into work, knowing
that she/he will go home at the end of his or her designated shift. Today a
nurse can not go into work knowing that he or she will be able to deliver the
best care that the patients deserve. Today a nurse can not go into work
without the fear of working with an unsafe nurse-to-patient ratio. Today, a
nurse finds it almost impossible to take an uninterrupted meal break or to
receive any incidental time off.

The focus of the patient's comfort needs has been put aside for increased
technology, increased responsibility and an overwhelming patient load.
Nursing is not about bedside care anymore; nursing has become the catalyst
for the patient's revolving door. We need to find a balance.

Increased mandatory overtime, which is forcing a nurse to work extra hours
beyond their scheduled shifts, is purely a symptom of not having enough
staffing. Studies have shown those understaffed and exhausted nurses
contribute to increase medication errors, complications, infections, and
other poor patient outcomes. In addition to patient safety concerns, nurses
have valid concerns about the impact of mandatory overtime on their family
life, and on their social lives. Most of our nurses are mothers with young
children with childcare concerns. Many times, these mothers have been put in
a position to choose between patient abandonment and their children.

Recently I heard a physician speak on a radio talk show about sleep
deprivation. She was speaking about the affects of day light savings time and
what the loss of one hour can do to the body's biorhythm. Imagine, she was
speaking about one hour. What about two, three, four, and sometimes as much
as eight hours of sleep a nurse is deprived of when she/he is forced to stay
beyond their working shift? I know, because I have done it. When you return
to work on the following shift you drink so much coffee, you shake. When you
walk, you stagger. When you speak, you sometimes slur. When an emergent
situation comes up, your ability to respond and process data quickly is
affected. You are in a state that resembles drunkenness. When you leave, you
pray to God you make it home safely without causing any harm to yourself or
others on the highway.

Nurses today are forced to overextend themselves both physically and
emotionally in an atmosphere that demands astute, sharp assessment skills and
increased physical stamina. Regulations have been put on truck drivers for
the amount of times that they can safely be on the road. As nurses, we
administer high doses of cardiac medications, narcotics, and chemotherapy. We
monitor heart rhythms; we set up and administer intravenous infusion pumps.
All of this, plus more, done incorrectly can have a lethal ending.

In today's current healthcare, the average age of a nurse is mid-forties.
Schools of nursing have dramatically decreased enrollment. The plate will
soon be empty. If we are not in a crisis now, we soon will be. The silent
layoff has taken its toll. The current trend of inadequate working
conditions, that produce over-worked, over-exhausted nurses and unsatisfied
patient care delivery must come to an end. Without legislation that
regulates the amount of time a nurse can safely work, without legislation
that regulates the amount of patients that a nurse can safely administer care
to, eventually, there will no longer be a nurse at the bedside.

-------------------------------------------

RHODE ISLAND NEWS:

Nurses pushed to the edge

Providence Journal Editorial

June 22, 2000

Rhode Island Hospital, operating millions of dollars in the red, is running
low on nurses. That approach is not working as well as hospital management
must have hoped. Nurses are complaining that they are routinely being forced
to work overtime after full, demanding and exhausting days on the job. Such
extra shifts used to be mandatory only under emergency conditions or when
unforeseen problems arose, they say; now, those shifts are covering "known
holes" in the schedule.

As a result, nurses say, their children are sometimes going unattended and
their family plans are in disarray. The nurses say their tension and
exhaustion are affecting the quality of their service to patients. "Your kids
are home alone and you haven't slept in 24 hours and they tell you, 'Deal
with it,' " said nurse Kate Pinheiro. Furthermore, nurses find themselves
working in areas that are not their specialty.

The problem has become so severe that nurses are threatening to go on strike
over it. This week, 1,700 nurses and other professionals at southeastern New
England's largest hospital sent management a 10-day strike notice. They want
their new contract to include an escape hatch from mandatory overtimes for
nurses who feel mentally or physically unable to work. Needless to say, a
walkout by the RIH nurses would not be good for the patients of the region.

The nurses have a valid point. The quality of nursing is a crucial factor in
the overall quality of care patients receive -- more now than ever, with
nurses taking over many tasks that doctors used to perform. A hospital that
is systematically understaffed in this area is putting patient care at risk
and seriously undermining the morale of the nursing staff. The situation must
be especially galling for nurses who know that some former executives of
Lifespan, which owns and operates Rhode Island Hospital, have departed with
lavish golden parachutes, most outrageously former president William Kreykes,
who retired with $3 million as the hospital spiraled into the red!

Of course, it should also be noted that some of the problems at RIH are being
seen around the country, as hospitals struggle with spiraling costs and lower
payments as a result of Medicare cuts and managed care Nurses tend to be
dedicated, hard-working and caring. Patients matter to them. For the sake of
RIH's patients, present and future, we urge Lifespan to find a way to hire
more nurses and cut back on mandatory overtime. If this means the rest of us
will have to pay more to cover the hospital costs, so be it. But then perhaps
some of the costs could be covered by reducing some of those gigantic golden
parachutes. Perhaps Lifespan's public-spirited board could look into the
possibility.

Copyright © 2000 The Providence Journal Company

--------------------------

White House Weighs In

Union workers from Rhode Island Hospital rally outside Lifespan headquarters.

by FELICE J. FREYER and JENNIFER LEVITZ, Providence Journal

June 23, 2000

PROVIDENCE -- Atty. Gen. Sheldon Whitehouse has taken sides in a labor
dispute at Rhode Island Hospital, saying that he "is nearly 100 percent
sympathetic" to nurses in their battle to do away with mandatory overtime.

In a strongly worded letter to Rhode Island Hospital President and Chief
Executive Officer Joseph F. Amaral, Whitehouse wrote, "if it were my
hospital, and I had as excellent a staff as you do, I wouldn't put up with
treating them this way. I do not know why you do."

The unusual letter from Whitehouse came as about 400 nurses and other
health-care workers in the Rhode Island Hospital United Nurses & Allied
Professionals union rallied outside Lifespan headquarters yesterday. The
letter is especially significant because the attorney general is currently
reviewing a proposal by Lifespan, Rhode Island Hospital's parent company, to
swallow up Care New England, another hospital group.

Asked about Whitehouse's role in the labor dispute, William Fischer,
Whitehouse's chief of staff, said: "As a public official who is concerned
about quality of care in this state and who is in the process of reviewing
the largest hospital merger I'm quite confident the state will ever see, he's
certainly an interested party and I think it's appropriate for him to voice
his opinion."

Amaral said last night that the attorney general is "entitled to his
opinion."

The CEO said that while "mandatory overtime is something nobody likes . . . I
personally don't like it, nurses don't like it, nobody likes it . . . " that
at times it's necessary in order to protect patients. Hospital management is
working toward resolving the need for it, but can't eliminate "the ability to
have it happen," he said.

Is Amaral concerned that Whitehouse, who has influence over the possible
merger, is not on the side of hospital management in the labor dispute?

"That certainly is a question that one would consider . . . I think they're
two separate issues," Amaral said. "Right now, my attention is focused on
Rhode Island Hospital, the employees of Rhode Island Hospital, and patients.
I'm not thinking about Care New England."

In his letter, Whitehouse wrote that "Even taxi drivers are limited to a
12-hour shift under Rhode Island law. . . .

"Please take me seriously when I urge you to resolve your differences with
the staff in your hospitals who provide immediate patient care, and minimize
this practice. It is not just nurses who are up in arms about this."

Whitehouse wrote: "I have been repeatedly told by doctors who work in your
hospitals of the difficulties that it creates, and the senior management of
Lifespan in the merger process has acknowledged that mandatory successive
shifts for people delivering sensitive patient care is no way to run a
hospital."

Mandatory overtime, the practice of requiring nurses to stay at work after
their shift has ended, is a key issue in the dispute. The union wants to end
mandatory overtime altogether, while the hospital argues that it is necessary
to ensure patient care when staff members call in sick, or if there is a
sudden influx of patients.

UNAP, which represents 1,700 nurses, respiratory therapists, mental-health
workers, technologists and other professional employees, on Tuesday notified
the hospital that it intended to strike if there is no contract settlement by
July 1, and Amaral sent Whitehouse a copy of that notification. Whitehouse's
letter was in response.

The hospital has offered to restrict mandatory overtime to 12 times a year
and never more than twice over 30 days.

Hospital administrators have drafted a contingency plan, should a strike
happen, and yesterday delivered it to the Department of Health, Amaral said
last night.

With 3,600 of the 5,000 workers in the two labor unions, the state's largest
hospital could end up with fewer than half its employees on the job if the
threatened strike occurs.

The union members met at 2 p.m. yesterday, holding whistles, signs, and
wearing "Restore the Pride" buttons on their matching T-shirts. They rallied
in front of the Coro Center, the Point Street headquarters of Lifespan, and
called for Amaral, the CEO, to come out and talk to them. He did not.

Asked last night about his no-show at the rally, Amaral said: "We were
working."

At the rally, representatives from the offices of U.S. Representatives
Patrick J. Kennedy and Robert A. Weygand, told the union that the two elected
officials are behind the workers.

"Requiring medical professionals to work overtime is dangerous to their
patients and unfair to these highly trained professionals," Weygand said in a
statement. "Tired or distracted health-care workers can make mistakes that
can cost lives."

The unions that represent workers at Women & Infants Hospital, and St.
Vincent Hospital at Worcester Medical Center, in Worcester, Mass., also spoke
in support. St. Vincent's was recently successful in adding to their contract
a provision that allows workers to refuse mandatory overtime if they are
mentally or physically exhausted, Linda McDonald, president of the Rhode
Island Hospital union, said.

The International Brotherhood of Teamsters, which represents 1,900 technical,
clerical, housekeeping and other workers at Rhode Island Hospital, met
yesterday to discuss the possible strike. Jeremiah O'Conner, a teamsters'
leader, would not disclose their plans.

At about 5 p.m., the ralliers marched a half-mile or so to Rhode Island
Hospital. Many rush-hour commuters honked their horns, or gave the thumbs-up
sign.

Maureen O'Berg, a pediatric critical care nurse at the hospital, said the
support is comforting. She said that while mandatory overtime is difficult,
going on strike would be the toughest bump in her 24-year career.

"Just to walk away . . . " she said as she marched.

She described the night of Hurricane Floyd as a description of the passion
she feels for her job. She and many nurses worked long past their shift. She
cared for two children with tracheotomies, although at one point, she
couldn't see them because the lights were out.

"No technology in the world can replace my eyes, my ears, and what I can do
with my head . . . not to mention my heart," she said.

Respiratory therapists Mike Martin and David Nelson carried a tall cut-out
figure. They had painted on it a suit with Monopoly money spilling from the
pockets. The prop signified "wasteful spending," they said.

Another sign read: "Unsafe staffing. Enough said."

At the end of the march, Linda Blais, the statewide president of UNAP, folded
up a six-foot cardboard cutout and stuffed it into the back of her minivan.
It looked ratty and beaten up.

"That's us after mandatory overtime," she said.

Copyright © 2000 The Providence Journal Company

-----------------------

Nurses' union frowns at R.I. Hospital offer

The hospital's "best offer" isn't good enough, says the union, which will
vote on it tomorrow, the eve of a possible strike.

by FELICE J. FREYER, Providence Journal

June 29, 2000

PROVIDENCE -- Rhode Island Hospital officials yesterday presented the nurses'
union with a "best offer" that they said was carefully crafted to avert a
strike, but the union called it a "take-it-or-leave-it" proposal that fell
far short of addressing union concerns. The hospital's proposal includes wage
increases ranging from 13.5 percent for inexperienced new hires to a
2-percent increase plus a 2-percent lump sum payment for higher-paid
experienced workers; new restrictions on mandatory overtime and incentives to
volunteer for overtime; and an "earned time bank" in which all sick time,
holiday time and vacation time would be treated as single pool.

"We hope they will see this addresses their needs," said hospital president
Joseph F. Amaral. "We think it's a good and fair proposal."

"It's not an acceptable proposal by any means," said Rick Brooks, director of
the 1,700-member United Nurses & Allied Professionals. Brooks said that
experienced employees were not getting sufficient wage increases and that the
hospital proposed eliminating existing protections against mandatory overtime.

He said the offer pushed the union closer to a strike.

The two sides are scheduled to meet again this morning, but Brooks said
hospital officials had "indicated an unwillingness to change their
positions." Hospital officials declined to say whether they would consider
any changes in their "best offer," but Amaral described it as "a package of
things that are all interrelated."

The union's contract expires tomorrow, and members are scheduled to vote
tomorrow on whether to accept the hospital's last offer or to go on strike
Saturday morning.

Amaral said the hospital presented its best offer two days before the vote so
that union members would have time to evaluate the proposal, which he
described as complex. "You can't provide it at Thursday at midnight and have
people deciding everything at 8 o'clock in the morning," he said. "These
people deserve to have time to make their decision."

But Brooks said members would need little time to know that it would not
satisfy them. The hospital proposals, Brooks said, "are not going to change
the fundamental working conditions" and are "in many ways a step backward."
He also said the hospital's decision to "cut off negotiations" indicated an
unwillingness to reach a settlement.

The proposal includes these restrictions on mandatory overtime, a key issue
in the dispute:

No one could be required to work overtime more than eight times a year, more
than twice in one month and more than three times in any consecutive
three-month period.

No one would be required to work overtime on the shift before a holiday off,
a scheduled weekend off, or the start of a vacation.

Those who volunteer for overtime will go to the bottom of the mandatory
overtime list.

Those who volunteer to work overtime immediately before or after a scheduled
shift will get paid double time, while those who are required to work will
get paid time-and-a-half.

But Brooks said the hospital proposal would eliminate an existing requirement
that management search for volunteers before requiring overtime.
Additionally, any overtime shift of less than four hours would be exempted
from the restrictions, he said, so that theoretically a worker could be
required to work extra hours every day of the week, if each day the overtime
were less than four hours.

The hospital proposal also creates an "earned time bank" combining sick,
vacation and holiday time. Employees could "sell" their time to reduce their
copayments on benefits and could convert their time to cash under certain
circumstances.

Before starting negotiations at 10 a.m. yesterday, the representatives of the
hospital and the union met separately with Governor Almond. Spending about 45
minutes with each side, Almond said he "urged them to do their very, very
best to reach an agreement and avert a strike." Almond said he did not take
sides. "I reiterated something I'm sure they're aware of -- the seriousness
of this, this is the state's major hospital, the impact the strike would
have," he said.

Asked whether he had urged the hospital to go to binding arbitration, as the
contract permits, Almond said, "That was a subject of discussion with both
parties and I won't go any further than that."

While Rhode Island Hospital negotiators were at work inside the Days Hotel in
Providence yesterday afternoon, union leaders representing health-care
workers at several other hospitals held a news conference outside, alleging
that other hospitals in the state are ill-prepared to handle the additional
patients diverted from Rhode Island Hospital.

The representatives of unions at Landmark Medical Center in Woonsocket, Our
Lady of Fatima Hospital in North Providence, Memorial Hospital of Rhode
Island in Pawtucket, Westerly Hospital, Women & Infants Hospital and Butler
Hospital said that care for patients throughout the state would be
compromised by the overflow as Rhode Island Hospital cuts back.

"This will truly be a disaster if they go on strike," said Lynn Blais,
president of the statewide United Nurses & Allied Professionals. "There's no
excuse for this to take place," said Jan Salsich, an intensive care nurse at
Westerly hospital and president of the UNAP local there. Salsich said her
friend's 18-year-old child was in fragile condition undergoing cancer
treatment at Hasbro Children's Hospital, and now had to be transferred out.
"I hate to think the 18-year-old son of my friend may lose his life but
that's entirely possible," she said.

The union also alleged that some hospitals are refusing to hire nurses from
Rhode Island Hospital who were seeking to work during the strike. Also
yesterday, 10 cardiologists who work at Rhode Island and Miriam Hospitals
wrote to Amaral saying that a strike "will plunge Rhode Island into an
unprecedented health-care crisis. . . . "

"Not only will access to care be limited," wrote Dr. Fredric V. Christian and
nine colleagues, "but there is likely to be delayed treatment which will lead
to increased suffering for patients and possibly increased mortality."

Representatives for several hospitals, however, said they were taking
measures to prepare for the additional patients.

Marie Koppa, vice president for marketing and development at Memorial
Hospital said that the hospital had asked staff to volunteer for additional
shifts if needed, and had received a good response, but had not scheduled any
additional shifts or recruited additional staff.

Mike Trainor, spokesman for Fatima, said that the hospital had added an
emergency-room doctor for the weekend, as well as additional nurses. Because
of an early-summer flu, the hospital had fewer than 10 beds available
yesterday, Trainor said, but many of those beds are expected to be freed up
before the end of the week. Fatima is also recruiting per-diem staff for the
strike, and if staff can be found, it can add as many as 20 beds. The
hospital can also cancel elective surgery to free up more beds if necessary.

Trainor said that the hospital would allow strikers to apply for per-diem
work at Fatima.

Butler Hospital, a psychiatric hospital in Providence, had about 100 patients
yesterday, and the capacity to take 20 to 25 more if necessary, said
spokesman Jim Hallan.

Landmark is opening an overflow unit with about 14 beds, said spokeswoman
Fran Driscoll, and expects to be able to handle the overflow with its regular
staff volunteering for extra shifts and with existing per-diem staff.

Copyright © 2000 The Providence Journal Company

-------------------------------

Nurses' union set for strike vote

(Governor) Almond urges final-hour talks, calls for binding arbitration

by FELICE J. FREYER, Providence Journal

June 30, 2000

PROVIDENCE -- Negotiations between Rhode Island Hospital and its nurses'
union broke off early yesterday afternoon after the union rejected the
hospital's last offer and no further proposals were put forth.

Now, hospital officials say they are lobbying employees in the hallways to
accept what President Joseph F. Amaral described as "a generous offer," while
the union prepares for a strike vote set for today in meetings at 1 p.m.,
6:15 p.m. and 8 p.m.

If the 1,700-member United Nurses & Allied Professionals votes to strike
starting tomorrow morning, the hospital can still avert the strike by
requesting binding arbitration. Under the contract, only the hospital can
call for arbitration, but if it does, the union cannot walk out.

Yesterday afternoon, Governor Almond called on both sides to stay at the
bargaining table until midnight tonight and -- if a settlement cannot be
reached by then -- to submit to binding arbitration.

"If pulling the trigger on binding arbitration is the only way to avert a
strike," Almond said in a statement, "then for the sake of all Rhode
Islanders, I urge the Rhode Island Hospital management and the leadership of
UNAP to let their differences be resolved in binding arbitration."

Amaral declined to comment on the governor's call for arbitration. But at a
press briefing earlier yesterday, he said, "I don't think arbitration is the
answer" because it would mandate a settlement rather than getting the two
sides to agree.

The arbitrator would consider both sides' last offer on each contract
provision, and for each provision would choose one or the other. As a result,
Amaral said, the hospital would have to revise its last offer because its
parts are "interdependent."

Arbitration would take, at best, six months and could last for years, Amaral
predicted. During that time, the hospital and union would be bound by the
terms of the current contract, which has allowed for the mandatory overtime
that nurses find so burdensome and which had made it difficult for the
hospital to recruit new staff.

But Amaral also said, "It's pretty clear that a strike is just the worst
thing that could happen."

Rhode Island Hospital is the state's largest hospital, the primary teaching
hospital of the Brown University School of Medicine, and the site of the
region's only trauma center and only children's hospital. A strike there
would affect health-care services throughout the state as other hospitals
scramble to care for patients that a diminished Rhode Island Hospital would
have to turn away.

The strike would also start on a holiday weekend when the state will be
teeming with merry-makers at major events such as the Tall Ships and a soccer
tournament at the University of Rhode Island; emergency rooms were already
expecting to be busy, even without a strike.

Late yesterday, the hospital presented the union with its "best offer." The
offer included restricting mandatory overtime for each employee to no more
than eight times a year, no more than twice a month, and no more than three
times in any consecutive three-month period. It also included wage increases
ranging from 2 percent to 13.5 percent, with the biggest increases
concentrated on newly hired employees with eight or fewer years of
experience.

UNAP President Linda McDonald said that even with the significant increases
the hospital has proposed for lower-paid nurses, Rhode Island Hospital's
rates would still not be competitive with other hospitals in the state.

For example, a registered nurse with five years' experience now earns $17.43
an hour at Rhode Island Hospital, and the hospital's last offer proposed
raising that rate to $20.54 on July 1. But according to data provided by the
union, a nurse with five years' experience currently makes $23.30 at Landmark
Medical Center, $22.31 at Our Lady of Fatima Hospital, $21.71 at Women &
Infants Hospital, $17.65 at Memorial Hospital of Rhode Island and $19.72 at
Westerly Hospital.

Roughly half of the hospital's nurses are not in the group that would receive
the significant increases, said Michael DeAngelis, senior vice president for
human resources. Those experienced nurses, some of whom make as much as $29
an hour, would receive a 2-percent wage increase plus a 2-percent lump sum
payment that would not raise their base pay.

UNAP's McDonald also said that the restrictions on mandatory overtime are not
sufficient, and that they are paired with the elimination of existing
protections against mandatory overtime. For example, she said, the hospital
wants to eliminate its obligation to call for volunteers before mandating
overtime and its obligation to mandate only for unforeseen circumstances.

Additionally, there are no restrictions on mandating overtime shifts that are
less than four hours long.

According to UNAP data, union employees logged a total of 189,980 hours of
overtime (not all of it mandated) in 1999 at a cost to the hospital of $6.3
million. The hospital did not dispute those numbers but noted that the
overtime represents just 8 percent of the total scheduled hours of UNAP
members.


McDonald said that the hospital's offer came as a package that had to be
accepted in its entirety, and the union could not even negotiate changes in
minor points that troubled it.


"The proposal is totally unacceptable," McDonald said. "We cannot and will
not recommend the hospital's offer to our members."

Amaral said: "I am deeply concerned about the union's inability to come to a
compromise." He said union negotiators had held fast to their demands while
the hospital had bargained in good faith.

He described the hospital's last offer as a $10-million package that was
"meant to improve their work life."

"This is a significant offer," Amaral said. "We've heard their concerns. We
think this answers it."

Amaral said that he and other administrators were walking around the hospital
speaking directly to employees to make sure they understood the offer's
provisions.

"It's not clear to me," Amaral said, "that the union leadership is
communicating to their membership and to the public accurately what we're
proposing."

McDonald disagreed. "We have been talking to the members," she said. "They
would like us to work toward a settlement. They do not feel this is a fair
settlement. I have received phone call after phone call: 'It's not fair!' "

Meanwhile, the hospital yesterday moved forward with its plans to reduce the
number of patients to 230, about half the normal level. Yesterday afternoon,
there were 265 patients in the hospital, 32 of them children.

DeAngelis said that UNAP members who had received layoff notices last week
would be called back to work today. If they strike, they would not be
eligible for unemployment payments, he said.

Copyright © 2000 The Providence Journal Company

--------------------------------------

CALIFORNIA NEWS:

A Message From the Nurses at Stanford & Lucile Salter Packard Children's
Hospitals

This was not an easy decision to make. Ethical as well as financial
considerations were taken into account. Many of us are the sole financial
support for our families and striking is a real financial hardship. However,
we believed that we had to deal with the results of budgetary decisions which
have negatively affected patient care. We take this decision seriously and
want you to be aware of the following facts.

CRONA raised mandatory overtime and staffing issues two and a half months ago
but the Hospital chose not to address them until after the
CRONA Stanford/Packard Nurses went on strike. We reached agreement on these
issues after the strike began.

Yes this is now about money. CRONA accepted below cost of living increases
during our last two contracts in an effort to improve the Hospital's economic
future. Unfortunately the administrators chose to throw this money into a
merger which failed. Now we are in a poorer economic situation and again we
are being offered below cost of living wage increase.

In the midst of a major nursing shortage, we are unable to recruit enough
nurses to fill vacancies and experienced nurses are leaving everyday. It will
take a lot of money to entice people to this area as it is so expensive. Yes,
we are asking for a larger than cost of living raise because we need nurses!
It is difficult to give great care if we are not allowed enough people to do
it. Nurses will leave if they are not satisfied with the care they are able
to deliver. With fewer nurses, we are faced with more overtime and it becomes
a vicious cycle of work, more work, fatigue, and more work.

The Vice President of Human Resources stated that the hospital would rather
spend $35 million on replacement nurses than increase the nurses' economic
package. The replacement nurses are paid at an annual salary of $208,000 to
$274,000.

Most of the replacement nurses are from U.S Nursing Corps, a firm
specializing in supplying strikebreakers. In Massachusetts strike breakers
were terminated for patient abandonment and giving the wrong baby to a mother
to breast feed. The hospital said that it will continue "business as usual."
A strike of 1700 qualified experienced nurses is not "usual".

A patient, Gayle E., told us on June 21st, "They said everything would be
fine but they are running around like chickens with their heads cut off. I
had a cardiac cath done and the nurse gave me too much fluids. I had to spend
the night because of the mistake. I was so scared I had my husband spend the
night with me. I'm supposed to have open heart surgery but I won't until you
nurses are back."

CRONA recommends you do not become a Stanford patient during the strike. If
you must be hospitalized, have a family member or friend stay with you.
Question treatments and medications. Ask your nurse or doctor how long they
have been at Stanford or Packard. At the end of June most of the nurses will
have less than a month's experience at Stanford and Packard and there will be
new residents in training with no experience at Stanford and Packard.

It is unfortunate that Malinda Mitchell and Chris Dawes, the CEO's of
Stanford and Packard Hospitals, have chosen to spend millions on replacement
nurses when a fraction of that could bring the CRONA nurses back. The last
breakdown of negotiations occurred when it was stated that it did not matter
what salary proposal CRONA offered: SHC would not increase it's offer of 4%
each year even though this is below the cost of living. The nurses want this
issue resolved so they can come back and care for their patients.

--------------------------

Unions negotiating for more than 4,000 health care workers stressed by
staffing cuts, big workload

06/26 13:11, Copyright 2000, U.S. Newswire

The union representing more than 4,000 health care workers at 10 Bay Area
hospitals are vowing to hold a one-day strike July 6 if progress is not made
in upcoming contract negotiations.

Service Employees International Union Local 250, which represents licensed
vocational nurses, nursing assistants, radiology technicians, housekeepers
and other clerical and service workers, claims short-staffing and workload
increases have caused worker injuries and decreased patient care.

"Sutter Health and Catholic Healthcare West -- two multibillion-dollar health
care corporations -- have put quality patient care at risk," said SEIU Local
250 President Sal Rosselli at Catholic Healthcare West-owned St. Mary's
Medical Center in San Francisco, where the union on Friday served the 10-day
strike notice.

"Staffing cuts and workload increases have now reached epidemic proportions."

Virginia Stalder, a radiology technician for 18 years at St. Mary's, said
staffing levels had gotten so low her 20-person department held a one-day
strike two weeks ago. She said the walkout had gotten some attention from
management, but the issues had not been resolved.

"They're totally bottom-line oriented and not patient-oriented," she said of
her employer.

The July 6 strike, targeted at hospitals owned by Catholic Healthcare West,
or CHW, Sutter Health and two East Bay independent hospitals, could
effectively shut down those hospitals for the day.

SEIU contracts have expired in recent months at all the hospitals put on
strike notice.

Hospitals on notice

They include five operated by Sutter Health -- Alta Bates Medical Center in
Berkeley, Eden Medical Center in Castro Valley, Oakland's Summit Medical
Center, Sutter Lakeside Hospital in Lakeport and Sutter Solano Medical Center
in Vallejo. CHW owns St. Francis Memorial Hospital in San Francisco and Seton
Medical Center in Daly City in addition to St. Mary's.

Only two on the list -- Oakland's Children's Hospital and Alameda Hospital in
Alameda -- are independently owned and operated.

Rosselli said a major step toward averting the walkout could be made if the
hospitals agreed to allow the union members to serve on a committee and make
joint decisions about such issues as staffing. Other contracts points include
wages, benefits and job security.

But L. Wade Rose, CHW's vice president of policy and planning for the
company's Bay Area region, called the union's focus on patient safety a smoke
screen to hide its real agenda.

"The real issue around the bargaining table is guaranteed jobs for life,"
Rose said. "They have to create issues to justify a strike. They will cook up
most anything to justify it, in this case placing the public's health at
risk."

Rosselli said the union had not demanded a lifetime job guarantee, just a
written commitment from the hospitals to provide continuing employment if a
worker's job is eliminated.

Rosselli said other unions -- including the California Nurses Association and
the Office and Professional Employees International Union -- had agreed to
honor the strike at some of the hospitals.

Scheduled for more talks

The strike notice does not come at a time when negotiations were at an
impasse. All the hospitals are scheduled to return to the table next week,
but the notice is expected to to put an added strain on those sessions.

Melissa Ridlon, human relations director at Children's Hospital, said she'd
gotten word of the strike notice during Friday's session.

"Certainly a strike notice, when you're trying to bargain in good faith,
presents some significant issues," she said. "It increases tension and makes
it more difficult to continue negotiating."

Rosselli said the union wanted to put pressure on the negotiations, which
have been continuing since March. "We had to create a deadline, or we'll be
negotiating until Christmas," he said.

Ridlon said Friday's session had to be cut short so the hospital could bring
in a federal mediator and prepare for a strike.

"With Children's Hospital, it's absolutely critical we start planning
immediately when given a strike notice," she said. "Given the fact there is
already a strike at Lucile Packard Children's Hospital in Stanford, we are
the only the children's hospital in the area. We absolutely cannot shut down."

Nurses began picketing outside Stanford Hospital and Lucile Salter Packard
Children's Hospital in Palo Alto on June 7 after their contract expired.

Sucked into grievance

Officials from the other independent hospital, Alameda Hospital, suggested it
had been sucked into a larger grievance about corporations swallowing up
community hospitals.

Tony Corica, director of human relations for the 106-year-old hospital,
described the negotiations, scheduled to resume Thursday, as "fairly amiable."

"We've been included in with some of the larger hospitals," he said.

In a statement, Sutter Health accused Local 250 of waging a "corporate
campaign" again the company. CHW and Sutter are the sixth and ninth largest
hospital chains in the country, respectively.

Harry Joel, CHW's regional vice president for human resource, said the
hospital was scheduled to return to the bargaining table Tuesday.

Joel said the strike notice was premature. "There are so many items we
haven't even discussed," he said. "No one's even close to reaching an
agreement. We haven't talked wages at all. I don't know what they're striking
about."

CHW officials expected to start preparing for a strike July 1 by postponing
elective procedures and possibly transferring patients. The hospitals will
provide only limited emergency services.

©2000 San Francisco Examiner

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