A strike may be brewing at Rady Children’s Hospital in San Diego after nurses rejected a three-year contract that administration says would have increased the average salary by about 22 percent over the next three years.

Nurses and technical employees represented by United Nurses of Children’s Hospital — an affiliate of the International Brotherhood of Teamsters Local 1699 — voted Tuesday to strike after finding the brokered contract not generous enough.

Katie Langenstrass, UNOCH’s president and a medical and surgical nurse at Rady Children’s, said Wednesday that 91 percent of the bargaining unit’s roughly 1,600 members participated in the vote with 95 percent who voted authorizing a strike at the governing board’s discretion.

While contract negotiations can still continue, labor leadership says the 10-day strike notice required before health care workers may walk off their jobs is likely to arrive soon.

“Although there aren’t exact dates right now, we do feel like things are moving pretty quickly,” Langenstrass said.

Management and workers are making opposite statements about the fairness of the proposed three-year contract brokered during collective bargaining, but rejected by the union rank and file. The deal, both sides seem to agree, would give nurses 8 percent raises in its first year and 4 percent increases in its second and third years. Additional increases to extra pay, such as for working at night, training new workers or acting in a supervisory role, would push the total increase, hospital officials said, to an average of about 22 percent over three years.

The increases would come on the heels of the union’s previous three-year pact, which expired in June. That agreement increased base pay 11.5 percent from 2021 through 2023.

Today, said Chris Abe, the hospital’s vice president of operations, the average Rady nurse makes about $70 per hour working three twelve-hour shifts per week. That equates to about $131,000 per year and would increase to roughly $153,000 per year in base salary under the deal that the union rejected.

“And those numbers do not include any shift differentials,” Abe said. “The average nurse makes anywhere from $6,000 to $7,000 per year on differentials of various kinds.

“We pay well at market, and this new contract would actually bring us higher.”

But Langenstrass said the union’s own wage research shows a different picture.

“The bulk of our membership is 21 percent to 28 percent below market value, and that’s just when we look at wages,” she said. “Once we add in things like health care, pensions and other benefits, we find ourselves even further behind.”

She said that unlike those who work at local adult-serving health care organizations, Rady workers do not receive discounted health care coverage to be seen at the organizations where they work.

“At a lot of our competitors, Kaiser, Scripps, UCSD, their nurses are getting low-cost or no-cost health care,” Langenstrass said. “We have a member who works in the hospital, and her family rate is $1,000 (per month) just for health care.”

Financial filings show that Rady’s operations have generated roughly a $75 million profit in the first nine months of fiscal 2024, which ended in June. That compares to an operating profit of about $147 million during the same nine-month period in fiscal 2023, though hospital administration said that the number was inflated by certain government “provider impact” payments being recognized in a single year.

Rady is currently embarked on the largest expansion in its history, and is beginning construction on a seven-story medical tower and a double-sized emergency department, a project estimated to cost between $1.2 billion and $1.4 billion.