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A long-running labor dispute between the officials who run Stanford's medical facilities and the nurses who staff them boiled over this week when hospital officials announced they would impose terms of their latest offer on the nurses.

"Everyone should understand that this is a declaration of war by the hospitals against (the Committee of Recognition of Nurses Achievement) and the nurses, and a blatant attempt to try and force us to accept a bad contract," union president Lorie Johnson wrote in a letter to union members. The union represents 2,700 registered nurses at Stanford Hospital and Clinics and Lucile Packard Children's Hospital.

Meanwhile, hospital officials said the terms are fair and will help improve patient care.

"We firmly believe that these provisions reflect the high regard we have for our nursing staff and our commitment to nursing excellence," Dale Spartz, vice president of human resources for Stanford Hospital and Clinics, said in a prepared statement. "We look forward to a time when we can reach contracts with CRONA."

In December, the union's leadership reached a tentative agreement with hospital administrators, but union members shot it down. The agreement included a 4 percent pay bump as well as a new career advancement system.

The union has argued that the new career advancement system would make it difficult for some nurses to get promoted and lead to the demotion of others.

Rather than evaluating nurses on their bedside skills, the new system would require nurses to meet certification and education requirements in order to keep or get top-level nursing positions, according to the union. Over the course of labor talks, which eventually involved a federal mediator, hospital officials argued it was time to modernize the promotion system and that most hospitals around the country use the new system.

Lucile Packard Children's Hospital spokeswoman Sarah Staley said other terms being imposed will bring paid time off in line with what other hospital employees received. Sick and bereavement leave benefits will be extended, too.

"All of those were part of the tentative agreement reached between the leadership of CRONA and the hospital," Staley said.

Union attorney Peter Nussbaum, however, said the hospitals are holding some other terms over the nurses' heads in an effort to get them to ratify the contract.

"They're using it as a club to get the nurses to accept the contract that they voted down already," he said.

Johnson, who could not be reached for comment Tuesday, said in her letter, "Not everything we are planning on doing will be made public for obvious reasons."