The contract for 6,000 nurses at Stanford Health Care and Lucile Packard Children’s Hospital in northern California is set to expire on March 31. The hospital’s nursing union, the Committee for the Recognition of Nursing Achievement (CRONA) has been in negotiations since mid-January, with nurses demanding an end to understaffing. They are also calling for higher wages 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. 

In this fight, Stanford nurses are up against not only the hospital administration but the Trump administration, as well as a union leadership prepared to suppress any serious struggle, as was made clear by CRONA’s betrayal of the nurses in their powerful 2022 strike. This raises the urgent need for nurses to rebuild their rank-and-file committee from 2022 and organize their power from below.

The attack on public health, science and healthcare is a major part of the Trump administration’s attacks on the working class as a whole. Stanford University professor Dr. Jay Bhattacharya has been nominated to head Trump’s National Institutes of Health (NIH) and was recently confirmed by the Senate.

Bhattacharya’s appointment is a sign that Trump and the ruling class as a whole plan to eliminate the few remaining aspects of public health that have endured through five years of the ongoing COVID-19 pandemic. He is notorious for his co-authorship of the Great Barrington Declaration which promoted the anti-scientific “herd immunity” policy in opposition to quarantines and lockdowns.

In addition, Bhattacharya’s career has focused on the economics of healthcare, namely how to maximize profits in medicine and run healthcare in as lean a manner as possible, no matter the repercussions for the population.

Through its employment of Bhattacharya within its medical school, Stanford played a key role in legitimizing an anti-science public health policy, which has claimed countless lives. Stanford is not just an academic institution but also a major business entity, with a $37.6 billion endowment—nearly equivalent to automaker Ford’s market value.

In the current climate, “liberal” universities across the country like Columbia University in New York City—which recently imposed a regime of censorship on its campus, targeting students who protest the US-backed genocide in Gaza—are yielding to Trump’s demands without even a pretense of opposition. Given Stanford’s ties to the tech industry and figures like Elon Musk, it is likely that the university will eventually follow suit.

The promotion of Bhattacharya and other quacks like Dr. Mehmet Oz and RFK Jr. is connected to the Trump administration’s broader attack on democratic rights. In the past two weeks, Trump has been seizing and detaining individuals such as Mahmoud Khalil for exercising their First Amendment rights by participating in pro-Palestinian protests.

Lessons of 2022

Three years ago, Stanford and Packard nurses demonstrated their willingness to fight in their week long, open-ended strike. However, the union called off the strike late on a Friday evening and pushed nurses to vote on a sell-out contract that they had not even seen. Opposition nurses responded by forming a rank-and-file committee, demanding that the full TA be released and holding an emergency meeting to campaign for a No Vote and demand a return to the picket lines.

The proposed contract included wage increases that did not keep pace with inflation and only vague pronouncements of a new staffing committee, and pledges to better adjust staffing based on acuity. The contract also included a no-strike clause, banning nurses not only from striking but also specifically from participating in sympathy strikes, ensuring that nurses scab on their coworkers.

Just months after the contract was ratified, a new and worse staffing grid was quietly announced which called for fewer nurses on the floor. This occurred at the same time as nurses were experiencing the “tripledemic” surge of flu, RSV and COVID-19, which filled the Emergency Department past capacity and necessitated hallway beds on the units. 

While nurses struggled under these conditions, members of the union bureaucracy gave themselves large pay raises. According to publicly available LM-2 forms, 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 increased her salary by 47 percent from $139,568 in 2021 to $205,835 in 2023. 

The CRONA bureaucracy also joined large local “union councils,” the South Bay Labor Council and the San Mateo Labor Council. The South Bay Labor Council is affiliated with the AFL-CIO and both councils are essentially lobbying groups and political campaign groups set up to support and endorse Democratic Party candidates.

This affiliation makes clear CRONA’s support of the Democratic Party, which is operating as an enabler for Trump’s plans for dictatorship. Two weeks ago, Democrats provided the necessary votes to prevent a government shut down, giving Trump a blank check to push through an austerity spending bill with hundreds of billions in cuts to Medicare, Medicaid, food stamps and other social programs.

Yet, amidst this unprecedented attack on the working class, CRONA insists that nurses ignore the political crisis and confine their struggle to purely “contract” questions. Under pressure from rank-and-file nurses, CRONA did add one political point to their contract, in the form of a meek appeal for Stanford to approve of “contract language” that would “respect nurses’ right not to assist in immigration enforcement.” They then make the absolute minimal demand of placing a “workflow graphic” on the walls of nursing units that explains how nurses can respond to ICE. 

CRONA has no intention of waging a real fight to defend immigrant patients and workers, a fight that would cut against its interests and the interests of the entire trade union apparatus as a defender of the two party system. 

The struggle unfolding at Stanford Health Care and Lucile Packard Children’s Hospital is a struggle against the entire for-profit healthcare system and the dismantling of public health in the interests of Wall Street.

Because of this, nurses can and must find support from workers across the United States and the world, making their struggle part of a broader movement against dictatorship and in defense of science and democratic rights. This requires that workers organize themselves independently, through the establishment of rank-and-file committees independent of Trump’s collaborators in the Democratic Party and the union bureaucracy.