Santa Clara County nurses, clad in cobalt blue shirts bearing their union logo, gathered in front of Valley Medical Center on Tuesday morning, brandishing cowbells and signs as they commenced the first day of a three-day strike. The nurses, part of the Registered Nurses Professional Association, initiated their inaugural strike due to a deadlock in negotiations with the county over wage increases and working conditions.

“We just want competitive wages so we feel respected,” remarked Jennifer Hughes, a registered nurse at Valley Medical Center for the past 11 years. “We just want to feel safe and want our patients to be safe.”

Representing over 3,750 nurses in the Santa Clara Valley Healthcare system, California’s second-largest county-owned health and hospital system with one million patient visits annually, the association is picketing this week at the system’s three main hospitals: Valley Medical Center and O’Connor Hospital in San Jose, and St. Louise Regional Hospital in Gilroy.

Alyssa Dulong, who has been with Valley Medical Center for 11 years and the county for 29 years, voiced concerns about the county’s proposed changes in determining patient acuity. The severity of a patient’s illness determines the level of focused care they receive.

“If we have to take care of more patients that are sicker and should have more of our attention, that’s not safe for them and that’s not safe for us,” Dulong stated.

The nurses have been without a contract since October and are requesting a 15% wage increase through October 2025, amounting to 5% annually and retroactive to the contract’s expiration date. The most recent proposal, rejected by the union, was formulated by a third-party mediator in late March. It offered a 13% raise for nurses between now and October 2026, with increases of 3% at ratification, 4% in October 2024, another 4% in October 2025, and 2% in October 2026.

Due to the large number of nurses on strike, the county has had to spend over $20 million to cover the gap and bring in nearly 1,000 contract nurses to work around-the-clock shifts during the three-day strike, according to County Executive James Williams. “We have to first maintain these critical operations for the community, which is why we’re so disappointed that RNPA quickly rejected the mediator’s proposal before announcing a strike,” Williams stated during a news conference. “We were hopeful that the proposal, which we believe was a very fair offer, would have been accepted by RNPA. Unfortunately, we now have to allocate funds towards this essential coverage.”

Williams mentioned that this could potentially impact the budget for the upcoming fiscal year, especially since the county is projecting a $250 million deficit.

During the strike, all three hospitals and clinics will remain open, but county officials have stated that some elective surgeries and non-urgent appointments have been rescheduled. However, Williams mentioned that on Friday, some nurses at Valley Medical Center participated in an “illegal sickout,” which led to the temporary closure of San Jose’s only level one trauma center.

According to county officials, Valley Medical Center was unable to accept ambulances with trauma patients for 2 hours and 11 minutes on Friday after nearly all operating room nurses called in sick. During this time, a two-year-old child from Gilroy suffered a “very serious trauma injury.”

Valley Medical Center is one of two pediatric trauma centers in the county. With it being closed, the child had to be transported to Stanford by ambulance, which took 50 minutes.

The county could not provide further details but confirmed that the child survived.

In a statement to The Mercury News regarding the incident, Williams emphasized the importance of keeping Valley Medical Center’s level one trauma center operational.

“We support our employees’ right to engage in lawful union activities, including planned and properly noticed strikes,” he said. “Unlike a planned strike, sickouts are unlawful because they can jeopardize health and safety, and the county will not tolerate actions by employees that put patient care or the community at risk.”

Susie York, president of the nurses association, stated in a separate statement that “RNPA was not involved in the decision of some nurses to call in sick on Friday, or aware of it happening until after it occurred.”

“Of course, nurses can point to patient care issues that happen day after day due to understaffing and other poor management,” she added. “The county does not seem as interested in publicizing those, though.”

Concerns about the strike were already mounting among family members of patients in the Santa Clara Valley Healthcare system by Tuesday afternoon.

Tearria Ruffin and Pam Reynolds, who had flown in from out of town earlier in the week, were visiting their loved one at O’Connor Hospital with balloons in hand.

“I was just concerned with what’s going to happen or are they just discharging her fully because there’s not enough staff,” Ruffin said, reflecting on her reaction upon learning that nurses at the hospital where her mother is receiving care were striking.

Reynolds expressed concern even before the strike began, noting that her sister’s dialysis was scheduled for Monday morning but did not occur until late in the evening.

“We just hope it gets taken care of,” Reynolds said. “I understand the workers also. I feel like this must be a big enough stand to take if they did this like this, and that’s concerning.”