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The Jan. 23 burglary of a Lucile Packard Children's Hospital nurse's car while she slept in it has become a lightning rod for nurses who allege hospital managers are not providing the safe sleeping quarters required by their union contract.

The on-call nurses, who work late at night, said they are sleeping in their cars between assignments. Though some said they have asked for a bed in the hospital, they haven't been given one or they were reprimanded when seeking a spot on their own.

The hospital insists it is in compliance with the contract, and a room is given to any nurse who requests one. But there is a huge discrepancy between the hospital's and the nurses' claims, in what appears to be a breakdown in communication.

Since at least 1998, Packard Hospital's contract has required that on-call nurses who request a sleeping room be provided one.

The contract states that a patient-care manager or supervisor must "identify a location to sleep for those nurses on restricted or unrestricted on-call who have worked a minimum of 16 consecutive hours or who have less than eight hours before their next scheduled shift begins."

Four sleeping locations were designated in a 1998 agreement but are subject to change: patient rooms, the post-anesthesia care unit isolation room, the perinatal diagnostic center and at the Packard Children's Day Hospital.

But a number of nurses said they were never told about the contract provision. One nurse who has worked in the obstetrics unit for two decades said getting a sleeping space has rarely been supported.

"When people ask, the managers say, 'We'll see what we can do.' We're the last resort. Nurses are supposed to make do because that's what nurses always do," she said.

A hospital spokesperson emphasized that nurses need to request a space. The location may change, but a patient room at the day hospital is most frequently used. The hospital does not track the usage of accommodations, spokesperson Kelly Frank said in an email.

"We've been able to comply with all nurse requests for sleep space," she said.

Transport nurses in the obstetrics and gynecology unit disagreed and said they are left to sleep in their cars, which creates unsafe situations.

Lorie Johnson, president of the Committee for Recognition of Nursing Achievement (CRONA) union, said that the hospital should provide a permanent, designated sleeping space.

"On-call happens every night, every day of the year. CRONA and the nurses have long asked that a location for sleeping be pre-designated. Here, if the location would have been identified to begin with, there would have been no need for the nurse to make a specific request," she said in an email.

New hospital construction has exacerbated the problem, nurses said. Nurses must now either park farther away and walk or wait in the dark for a shuttle, they said. A rash of auto burglaries has them worried.

The victim of the Jan. 23 burglary is an on-call nurse who is assigned to ride with patients on helicopters. She sleeps between transport assignments. The nurses are required to be near or in the hospital during their shifts and to be reachable by phone.

The nurse said she lives about an hour away, so she sleeps in her SUV on days when she comes off transport work at 3 a.m. and is scheduled to work on the hospital floor at 7 a.m. Other nurses who live out of the area said they do the same.

On the night of the burglary, the nurse was parked in a lot across from the hospital at 770 Welch Road, where Packard has a clinic. She parked in a spot that was illuminated and was closest to the hospital, she said.

She awoke to the sound of breaking glass at about 3:40 a.m. A man with a gun in his hand grabbed her purse from the front-seat center console, snatched a bookbag and rifled through the glove compartment before jumping into a getaway car driven by another person, she said. A Palo Alto police report did not mention a gun, Lt. Zach Perron, said.

In a statement to the Palo Alto Weekly last week, hospital spokesperson Robert Dicks said:

"The nurse involved did not request of a patient care manager or supervisor an in-hospital sleep space. Space would have been available had it been requested. ... The nurse involved in this incident chose to rest in an area that is not controlled by the medical center," Dicks said in an email.

Johnson said nurses who work the night shift have parked in the clinic lots for years.

"The hospital has never said anything or done anything to inform nurses that these areas are not controlled by the hospital or notified nurses that they should not assume that they could safely park in those areas," she said.

The nurse whose car was burglarized said she wasn't told she could request a bed or that the area had experienced an increase in crime. Had she known, she would not have slept in her car.

Other nurses, who spoke on the condition of anonymity, supported her claims.

"If there is a room, it is the best kept secret in town," one nurse said.

"I have not heard one transport nurse in my unit say that they knew of or made use of this contract provision. ... While there may be contract language regarding on-call sleep room or space, the stark reality is these provisions are on paper only," she said.

In an email last week Johnson stated that CRONA is "concerned that hospital managers and supervisors may not be complying with their obligation under the contract to provide sleep locations for on-call nurses."

The hospital and CRONA dispute whether the hospital has done enough to ensure the safety of staff members as they've walked to and from their cars.

"Hospital leadership clearly communicated to CRONA information on safe walking paths and parking areas controlled by the medical center. ... Additional lighting is being placed along the safe walking paths of travel we have recommended to CRONA and in parking areas controlled by the medical center," Dicks said.

A security detail patrols the parking lots and offers door-to-door escort between the medical center and parking areas, he said.

But nurses said the door-to-door service has not been consistent, and Johnson confirmed that while the union has requested additional security personnel, "We were told they have five open positions and qualified applicants are limited."

CRONA and the hospital held a meeting on Tuesday to specifically discuss the matter. The hospital and union are also currently in contract negotiations, a union attorney said.

One Packard nurse was circumspect about the problem, saying: "While it may be true that the hospital is not responsible for our safety on public streets or adjacent private property, it is most important to look at the systems and practices the hospital has implemented that put the nurses in harm's way while traveling to and from work and while on call."

Stanford Hospital and Clinics' contract has the same provision. Hospital spokesman James Larkin said all on-call nurses are provided access to a sleeping room upon request. Sleeping accommodations for on-call nursing staff varies by unit. In some areas there is a dedicated room for nurses while in others, a vacant patient room is provided.

Information about rest options is disseminated "through a variety of channels, including their supervisors, training materials, colleagues and their union," he said in an email.

Stanford employs approximately 220 on-call nurses in a variety of units, he said.

The hospital "participates in regular and ongoing communications directly with our nurses and with their union representatives regarding a wide variety of topics, including their rights and responsibilities and factors related to their personal safety and security," he said.

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