Emergency nurses at Stanford Hospital are choosing to sleep in vans between shifts. These nurses need to be on call and within a 30-minute drive of the hospital, but many can't afford to live nearby.

“I personally know at least 15 people sleeping in their vehicles," said TJ Carella, an emergency nurse. "But there are definitely more than that."

The cities surrounding Stanford Hospital are some of the most expensive in the state. Average home prices are over $3 million.

"No, absolutely not," Carella said, when asked if he could afford that.

He lives in Pleasanton, which is about an hour away. When he needs to be on-call, he sleeps in a retrofitted Sprinter van that has a bed, mini-fridge, a solar-powered generator and a composting toilet.

"I tried to make it as homey as possible," he said. "But it does feel weird. I have a master's degree. I work hard, but this is the reality."

Stanford does offer spare rooms for nurses, but Carella says it is not always guaranteed. He says sleeping in a van became the only reliable way he could do his job.

"We get woken up out of nowhere, and we half to be here in 30 minutes," he said. "We are often texting each other, trying to figure out where to park. Some of us have been ticketed a few times."

His union is currently negotiating a new contract with the hospital. Not only are they asking for an increase in wages, they want a change to their schedule so nurses like Carella can better plan when he is on call.

“We do have nurses who fly in from out of state, work their straight days and fly home," said Colleen Borges, the president of CRONA, Stanford's nurses' union. "It is virtually impossible for a new nurse to purchase a new home here in the Bay Area.”

In a statement, Stanford Medicine said:

“We deeply value our nurses and are committed to reaching an agreement on a contract that recognizes their vital contributions to our health care system.”

They also mentioned Stanford has a nurse retention rate that exceeds national standards. However, Carella says that retention rate won't last.

“In order for us to keep doing what we need to do, then there are some things that need to change," he said.

By Danielle Kaye

Jan. 27, 2025

Workers at a Whole Foods Market in Philadelphia voted on Monday to become the first unionized store in Amazon’s grocery chain, opening a new front in the e-commerce giant’s efforts to fend off labor organizing in multiple segments of its business.

Employees at the sprawling Whole Foods store, in the city’s Spring Garden neighborhood, voted 130 to 100 in favor of organizing with the United Food and Commercial Workers union, the National Labor Relations Board said.

Store employees said they hoped a union could help negotiate higher wages, above the current starting rate of $16 an hour, and better benefits. Some longtime employees, who have been with Whole Foods since well before Amazon bought the chain in 2017, said reductions in benefits and cuts in staffing levels when Amazon took over, among other changes, had been sources of frustration.

But those leading the union campaign hinted at a broader goal: to inspire a wave of organizing across the chain’s more than 500 grocery stores, adding to union drives among warehouse workers and delivery drivers that Amazon is already combating.

“I expect others to follow, and that will increase the leverage that we have at the bargaining table,” said Ben Lovett, an employee at the Philadelphia store who has led the organizing. “We’ve shown them that it’s possible to organize at Amazon.”

“This fight is far from over,” Wendell Young IV, president of U.F.C.W. Local 1776, which represents food and retail workers in Pennsylvania, said in a statement, “but today’s victory is an important step forward.”

Whole Foods said in a statement that the company was “disappointed” by the election result, but that it offered competitive compensation and benefits for employees and that it was “committed to maintaining a positive working environment” at the Philadelphia store.

The successful bid to form a union comes against a backdrop of what several workers have described as a campaign of intimidation from Whole Foods. They pointed to ramped-up monitoring of employees and anti-union messaging in the store since workers went public with their organizing efforts in the fall.

In unfair labor practice charges filed with the labor board earlier this month, U.F.C.W. Local 1776 accused Whole Foods of firing an employee at the Philadelphia store in retaliation for supporting the union drive. The union also accused the chain of excluding the store’s employees from receiving a raise that had been given this month to all of its other workers in the Philadelphia area.

Whole Foods said it had complied with all legal requirements when communicating with employees about unions. The company denied allegations of retaliation, arguing that it could not legally change wages during the election process and that it had delayed a raise until after the election to avoid the appearance of trying to influence votes.

“A union is not needed at Whole Foods Market,” the company said in a statement ahead of the election, adding that it recognized employees’ right to “make an informed decision.”

The company, which has five days to challenge the election outcome before the result will be certified, will have to bargain with the union for a contract covering the store’s unionized workers, the N.L.R.B. said in statement announcing the result.

But winning a union vote doesn’t ensure that contract talks will progress. Amazon warehouse workers who unionized nearly three years still do not have a contract.

In 2022, workers on Staten Island voted to form Amazon’s first union in the United States; it is now affiliated with the International Brotherhood of Teamsters. Amazon has challenged the election outcome in court, and has refused to recognize or bargain with the union. Delivery drivers, who work for third-party package delivery companies serving Amazon, have also mounted campaigns with the Teamsters.

Last week, Amazon said it was closing all of its warehouse and logistics operations in Quebec, the Canadian province where unions had gained a foothold among some Amazon workers, and would lay off 1,700 employees.

The union push in Amazon’s grocery business resembles, in certain ways, union organizing at Starbucks that has spread to more than 500 stores in the United States since 2021, said Brishen Rogers, a labor law professor at Georgetown University.

In grocery stores and coffee shops, employees work side by side, day after day, in conditions that are often conducive to getting to know one another and forming networks of solidarity, he said. Those dynamics do not always exist in warehouses, where workers tend to be under constant surveillance.

“I would not be shocked,” Mr. Rogers said, “if it had a snowball effect across different Whole Foods locations, much like Starbucks.”

Ed Dupree, who works at the Whole Foods store in Philadelphia and has been involved in the union campaign there, said he was in touch with workers at other locations across the country who were interested in unionizing. At least 10 other Whole Foods stores have started to organize, he said.

The new political landscape in Washington may pose hurdles for the Philadelphia workers as they try to negotiate a contract, or for other stores that might file for union elections. After the Biden administration’s embrace of unions, President Trump is expected to appoint a new N.L.R.B. general counsel whose approach could make it harder for organizing campaigns to succeed.

Employers typically exploit weaknesses in federal labor law to avoid reaching a first contract with newly unionized employees, said Kate Andrias, a professor of labor and employment law at Columbia University. Legal barriers to organizing and bargaining exist regardless of the government’s stance on labor, though companies might feel more emboldened to intimidate workers under President Trump, she said.

“We’re likely to see the law become less favorable to workers during the Trump administration,” Ms. Andrias said. But, she added, “even in periods when there have been hostile labor boards in the past, workers have been successful in organizing unions.”