Nurses at Stanford and Lucile Packard Children's hospitals have overwhelmingly voted to end a weeklong strike, their union, the Committee for the Recognition of Nursing Achievement (CRONA), said on Monday. The strike was the first in 20 years by the union against the hospitals.

The nurses walked out on April 25 after a 93% approval vote that authorized CRONA to call a strike. The nurses chose to strike against the hospitals due to conditions they said were exacerbated by the COVID-19 pandemic. Intense pressure of understaffed units and constant requests for overtime were pushing as many as 45% of union members to consider leaving the hospitals soon, according to the union, which represents about 5,000 nurses.

Over the weekend, 83% of nurses voted to ratify the three-year contract, which includes safe staffing measures, across-the-board wage increases, improved access to mental health support, additional vacation time and measures to recruit and retain nurses for high acuity areas. The nurses will return to work on Tuesday morning, May 3, CRONA said.

"CRONA's new contracts represent an enormous victory for nurses at Stanford and Packard, who have been fighting tirelessly for improved work and patient care conditions. We have won improvements across all the priorities nurses identified at the beginning of our contract campaign. CRONA nurses always knew our worth. We are glad the hospitals are finally acknowledging it now after a week-long strike that demonstrated how difficult it is to get nurses with the skills and experience that Stanford and Packard nurses bring to their patient care," said Colleen Borges, president of CRONA and pediatric oncology nurse at Lucile Packard Children's Hospital.

The contract changes come amid burnout and exhaustion among nurses nationwide. Recruitment and retention of nursing talent was a core concern during negotiations, the union said. The nurses called on the hospitals to commit financially to address inadequate staffing, rising costs of living in the Bay Area and a consistent lack of rest and recovery.

The nurses will receive across-the-board wage increases that keep up with the high cost of living in the Bay Area, rising prices and competitive contract nurse rates. The pay increases will be a combined 7% base wage increase this year — initially 5%, followed by 2% — with additional raises of 5% in 2023 and 5% in 2024.

Nurses working in units that are difficult to staff and require care for the most severely ill patients, including emergency departments, intensive care units and critical care transport teams, will receive additional incentive pay. The new contracts require staffing based on patient acuity — the level of sickness and care needed — and include commitments from the hospitals that ensure nurses with high-acuity patients are able to safely take meals and rest breaks.

To reduce burnout, the nurses also demanded greater access to mental health treatment and the ability to rest and recover. The new agreement will give the nurses greater access to mental health care and funding specifically designated for mental health treatment.

The hospitals have committed to consulting with CRONA before selecting a vendor to revamp their Employee Assistance Program, which was widely criticized by many nurses for its delayed and inadequate support for nurses seeking counseling. Nurses will also be able to pre-schedule an additional week of paid vacation and the contracts confirm nurses' rights to use protected sick leave for mental health reasons.

The new contract also offers significantly increased retiree medical benefits and student loan assistance. The hospitals would also provide a new rapid response team to address workplace violence incidents and in-person training on emergency-response protocols.

The contract also maintains a no-cost medical plan for nurses and their spouse and dependents.

"I was proud to vote for this contract. It's what nurses at Stanford and Packard have been fighting for: changes that ensure we can meet our patients' needs, especially in critical care units and emergency departments, with time to rest and recover and take care of our own health. We're grateful to have the support of our patients and our community, who understood that excellent patient care is inseparable from nurses' working conditions and stood with us on the picket line," David Hernandez, a Stanford Hospital emergency room nurse, said in the union statement.

In a statement issued Monday, Stanford hospital leaders said they were "pleased" that the agreement was ratified. "After extensive discussions, we were able to reach a contract that reflects our shared priorities and enhances existing benefits supporting our nurses' health, well-being, and ongoing professional development," according to the statement. "We look forward to welcoming our union-represented nurses back tomorrow, Tuesday, May 3. We appreciate the incredible effort that our entire health care workforce put forward last week."