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Hospital readies
for RN walkout

St. Francis cancels major
surgeries and stops taking
patients at its Liliha facility


By Tim Ruel
truel@starbulletin.com

Faced with an ailing financial condition and the prospect of a nurses strike that could begin Monday, the St. Francis Medical Center in Liliha has stopped admitting patients, is canceling in-patient surgeries and will move all patients into one of its two wings on Sunday, the hospital said.

St. Francis, one of the state's largest hospitals, asked Emergency Medical Services yesterday to reroute ambulances to other Oahu hospitals, though its Liliha emergency room will remain open. Emergency surgeries will be done in order of urgency. Outpatient surgeries will be suspended Saturday, though other outpatient services will be available.

Most of St. Francis' 10 kidney facilities statewide will stay open, though one of two facilities will be closed on Maui and one of two will be closed on Kauai. St. Francis provides dialysis services to approximately 1,000 people in the isles. Most caregivers for dialysis patients will not take part in a strike.

Services at St. Francis West, a main trauma center for Leeward Oahu, will not be affected by the cutbacks, since its nurses are not part of recent contract talks, said Maggie Jarrett, spokeswoman for St. Francis.

Last week, St. Francis Hospice also began limiting its referrals.

Claudine Tomasa, negotiator for St. Francis nurses, said last night that although they recognize the hospital's financial situation, they believe the cutbacks are a tactic to force a settlement.

"They're trying to play on the public's sympathy," Tomasa said.

Other Oahu hospitals are not making such drastic cutbacks to their services in the event of a strike, largely because they are planning to bring in replacement nurses from the mainland. A big concern for the hospitals, however, is how patient access will be affected if picket lines go up, said Dr. Virginia Pressler, vice president of Kapiolani Medical Center. Kapiolani has notified city and state officials about the potential for traffic congestion at the hospital, particularly at the Punahou Street offramp of H-1 freeway.

Nurses at St. Francis, Kaiser Foundation Hospital, Kapiolani Medical Center and Kuakini Medical Center have issued notices that a mass strike could begin early Monday morning if contract talks do not reach a resolution. Nurses at Queen's Medical Center have set an early Tuesday deadline for a strike, though contract talks are scheduled for tomorrow and Saturday. About 2,500 nurses at all five hospitals could be involved in a strike.

Talks between St. Francis and the nurses broke off Monday, with the nurses union rejecting the hospital's final contract offer. No further pre-strike talks with St. Francis were scheduled as of last night.

Gov.-elect Linda Lingle, whose inauguration could coincide with the beginning of a strike, said yesterday she plans to talk with nurses and management to offer a broader perspective of how the negotiations affect everyone in Hawaii.

"Sometimes having someone from the outside come in and flush out issues can be helpful, and whether it's this strike or any other, I think a governor's role is to make sure that the community continues to have the services that it needs, but especially the emergency services," Lingle said.

"Nurses are such a key part of the medical system ... that I definitely see myself as the kind of governor who would reach out to both sides and try to appeal to them from a community perspective to get these issues resolved."

The hospitals, along with the Healthcare Association of Hawaii, held a news conference yesterday to warn the public about the potential impact of a strike on hospital services.

"The union has not moved much off of their original demand," said Chris Pablo, spokesman for Kaiser.

Kaiser, which is flying in more than 200 nurses to work in the event of a strike, plans to decide tomorrow whether to cancel elective surgeries at its hospital next week to make room for urgent cases. Most other services at the hospital will remain available.

All 10 Kaiser clinics on Oahu will stay open, though some services are being canceled, including after-hours advice, allergy testing and nurse practitioner appointments.

Kapiolani Medical Center, which is also bringing in 200 nurses from the mainland, intends to offer full services on Monday but will need to review its abilities on a daily basis, said Pressler, a former human resources official of the state Health Department.

Kapiolani, which is part of the same company as Straub and Wilcox Memorial hospitals, will draw employees from other hospitals as necessary, Pressler said.

The overall cost of a strike, for Kapiolani alone, is estimated in the millions of dollars per week, said Pressler.

Kapiolani nurses voted last night to reject management's final contract offer, according to the nurses union, the Hawaii Nurses Association. Further talks are scheduled for Friday.

Queen's Medical Center, the state's largest hospital, intends to keep all of its services operating by using temporary nurses flown in from the mainland, said Gail Tiwanak, vice president of marketing and communications.

St. Francis cannot afford to fly in mainland nurses, Jarrett said.

St. Francis, which does 80 percent of its work on Medicare and Medicaid patients, has been hit hard by federal cuts to hospital reimbursements, Jarrett said.

St. Francis Healthcare System has made several cuts in operations to save its bottom line. The system has said it lost more than $5 million in the year that ended June 2001. It fired 150 people in April 2001.

The hospital blames the high cost of unfunded medical care. Earlier this month, the pro-hospital Healthcare Association released an Ernst & Young report that said local hospitals and nursing homes have shouldered more than half a billion dollars in unfunded costs since 1998. The hospitals blame the 1997 federal Balanced Budget Act for reducing reimbursements for Medicare and Medicaid work. The report was disclosed shortly before the nurses union began issuing strike notices.

Hawaii nurses are seeking similar professional advances achieved by nurses in California, where hospitals have minimum standards for nurse staffing.

A major issue is retiree benefits, with the average age of a registered nurse in Hawaii now at 48.7 years.

St. Francis cancels major surgeries and stops taking patients at its Liliha facility

By Tim Ruel

truel@starbulletin.com

Faced with an ailing financial condition and the prospect of a nurses strike that could begin Monday, the St. Francis Medical Center in Liliha has stopped admitting patients, is canceling in-patient surgeries and will move all patients into one of its two wings on Sunday, the hospital said.

St. Francis, one of the state's largest hospitals, asked Emergency Medical Services yesterday to reroute ambulances to other Oahu hospitals, though its Liliha emergency room will remain open. Emergency surgeries will be done in order of urgency. Outpatient surgeries will be suspended Saturday, though other outpatient services will be available.

Most of St. Francis' 10 kidney facilities statewide will stay open, though one of two facilities will be closed on Maui and one of two will be closed on Kauai. St. Francis provides dialysis services to approximately 1,000 people in the isles. Most caregivers for dialysis patients will not take part in a strike.

Services at St. Francis West, a main trauma center for Leeward Oahu, will not be affected by the cutbacks, since its nurses are not part of recent contract talks, said Maggie Jarrett, spokeswoman for St. Francis.

Last week, St. Francis Hospice also began limiting its referrals.

Claudine Tomasa, negotiator for St. Francis nurses, said last night that although they recognize the hospital's financial situation, they believe the cutbacks are a tactic to force a settlement.

"They're trying to play on the public's sympathy," Tomasa said.

Other Oahu hospitals are not making such drastic cutbacks to their services in the event of a strike, largely because they are planning to bring in replacement nurses from the mainland. A big concern for the hospitals, however, is how patient access will be affected if picket lines go up, said Dr. Virginia Pressler, vice president of Kapiolani Medical Center. Kapiolani has notified city and state officials about the potential for traffic congestion at the hospital, particularly at the Punahou Street offramp of H-1 freeway.

Nurses at St. Francis, Kaiser Foundation Hospital, Kapiolani Medical Center and Kuakini Medical Center have issued notices that a mass strike could begin early Monday morning if contract talks do not reach a resolution. Nurses at Queen's Medical Center have set an early Tuesday deadline for a strike, though contract talks are scheduled for tomorrow and Saturday. About 2,500 nurses at all five hospitals could be involved in a strike.

Talks between St. Francis and the nurses broke off Monday, with the nurses union rejecting the hospital's final contract offer. No further pre-strike talks with St. Francis were scheduled as of last night.

Gov.-elect Linda Lingle, whose inauguration could coincide with the beginning of a strike, said yesterday she plans to talk with nurses and management to offer a broader perspective of how the negotiations affect everyone in Hawaii.

"Sometimes having someone from the outside come in and flush out issues can be helpful, and whether it's this strike or any other, I think a governor's role is to make sure that the community continues to have the services that it needs, but especially the emergency services," Lingle said.

"Nurses are such a key part of the medical system ... that I definitely see myself as the kind of governor who would reach out to both sides and try to appeal to them from a community perspective to get these issues resolved."

The hospitals, along with the Healthcare Association of Hawaii, held a news conference yesterday to warn the public about the potential impact of a strike on hospital services.

"The union has not moved much off of their original demand," said Chris Pablo, spokesman for Kaiser.

Kaiser, which is flying in more than 200 nurses to work in the event of a strike, plans to decide tomorrow whether to cancel elective surgeries at its hospital next week to make room for urgent cases. Most other services at the hospital will remain available.

All 10 Kaiser clinics on Oahu will stay open, though some services are being canceled, including after-hours advice, allergy testing and nurse practitioner appointments.

Kapiolani Medical Center, which is also bringing in 200 nurses from the mainland, intends to offer full services on Monday but will need to review its abilities on a daily basis, said Pressler, a former human resources official of the state Health Department.

Kapiolani, which is part of the same company as Straub and Wilcox Memorial hospitals, will draw employees from other hospitals as necessary, Pressler said.

The overall cost of a strike, for Kapiolani alone, is estimated in the millions of dollars per week, said Pressler.

Kapiolani nurses voted last night to reject management's final contract offer, according to the nurses union, the Hawaii Nurses Association. Further talks are scheduled for Friday.

Queen's Medical Center, the state's largest hospital, intends to keep all of its services operating by using temporary nurses flown in from the mainland, said Gail Tiwanak, vice president of marketing and communications.

St. Francis cannot afford to fly in mainland nurses, Jarrett said.

St. Francis, which does 80 percent of its work on Medicare and Medicaid patients, has been hit hard by federal cuts to hospital reimbursements, Jarrett said.

St. Francis Healthcare System has made several cuts in operations to save its bottom line. The system has said it lost more than $5 million in the year that ended June 2001. It fired 150 people in April 2001.

The hospital blames the high cost of unfunded medical care. Earlier this month, the pro-hospital Healthcare Association released an Ernst & Young report that said local hospitals and nursing homes have shouldered more than half a billion dollars in unfunded costs since 1998. The hospitals blame the 1997 federal Balanced Budget Act for reducing reimbursements for Medicare and Medicaid work. The report was disclosed shortly before the nurses union began issuing strike notices.

Hawaii nurses are seeking similar professional advances achieved by nurses in California, where hospitals have minimum standards for nurse staffing.

A major issue is retiree benefits, with the average age of a registered nurse in Hawaii now at 48.7 years.



St. Francis Healthcare System
Hawaii Nurses Association



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