Mediator to
join talks with
nurses, Queen’s

The hospital is recruiting RNs
in the event a strike begins
on Christmas Eve

The sticking points

By Christine Donnelly
Star-Bulletin

A federal mediator will try to jump-start contract negotiations between the Queen's Medical Center and 800 registered nurses who plan to strike Christmas Eve over proposed staff changes their union claims threaten patient safety.

Hospital officials deny the Hawaii Nurses Association claim, and insist that their proposals keep patient care the top priority while aiming to improve staff efficiency. They decried the union's demand for fixed nurse-patient ratios, saying staffing should be dictated by a unit's day-to-day needs. Wage increases are a secondary issue.

Despite the differences, both sides said they would work hard toward a settlement.

A Queen's spokeswoman, Karen Winpenny, said nonbinding federal mediation the union had requested would begin Monday. In the meantime, Queen's is recruiting hundreds of replacement workers from the mainland in the event of a strike.

Talks at four other Honolulu hospitals, meanwhile, are in various stages as each hospital negotiates separately with the union to replace contracts that expired Nov. 30. The five hospitals employ a total of 2,500 unionized nurses.

Kuakini Medical Center: Talks including a federal mediator lasted all day yesterday and into the night. The next mediation session is scheduled for Tuesday.

St. Francis Medical Center: Negotiations resume today after several days off.

Kaiser Permanente: 600 registered nurses will vote tomorrow on a tentative pact supported by union leaders that reportedly raises pay 8 percent over three years. Union and hospital officials declined to release specifics of the deal, reached Sunday, until after the vote, but Nancy McGuckin, executive director of the Hawaii Nurses Association, did say it met union concerns about health coverage upon retirement, wage increases and job cuts.

Kapiolani Medical Center for Women and Children: Federal mediation resumes Friday.

Nurses at Kuakini, St. Francis and Kapiolani also have authorized strike votes, but unlike at Queen's, have not issued the required 10-day notice for a strike.

Union nurses at Queen's will vote between now and Christmas Eve on whether to walk out that night.

McGuckin said the staffing issue had been festering for three or four years industrywide as the number of registered nurses has fallen and their workloads increased, including adding mandatory overtime and on-call shifts.

"And then what they say is that we've still got to cut costs, so we're going to replace some of the RNs at the bedside and replace them with technicians, so now the patients get even less care," said McGuckin. "And what we're saying now with this strike notice is 'your nurses can't work this hard, you're putting your patients in danger.' "

But Barbara Mathews, Queen's manager of medicine and behavioral health services, a member of the hospital's strike planning team and a registered nurse herself, said Queen's has and always will have enough RNs to ensure "the best patient care."

She said the staff redesign that the nurse's union so opposes is actually good for patients because it would allow registered nurses to focus more on patients and less on clerical tasks, errands and other jobs that could be done by lower-level staff.

"We believe staffing decisions should be dictated by individual needs, not on a fixed ratio. We truly believe (the redesign) will make patient care better," she said.

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The sticking points on
both sides of the table

By Star-Bulletin staff

According to a statement from the Queen's Medical Center, before the Hawaii Nurses Association issued its notice to strike, the hospital offered and the union rejected a proposal that would have:

Agreed in concept to the union's proposed "Nursing Advisory and Staffing Council" comprised of an equal number of hospital and bargaining unit representatives.

Submitted plans for a staff work/role redesign to the council for review and revisions.

Agreed that no registered nurses affected by the redesign be laid off, but would allow retraining and reassignment to other jobs in the hospital.

Increased wages 50 cents an hour, or about 1.8 percent a year for three years. That amounts to a 5.4 percent increase, compared with Kaiser's reported settlement of 8 percent, according to the Queen's statement.

The union, meanwhile, wants an end to what it sees as continuing cost-cutting moves aimed at replacing highly trained registered nurses with unlicensed and lower-paid staff.

It demanded a fixed ratio of nurses to patients, with the ratios varying by unit. For example, the request was one nurse for every one or two patients in the intensive care unit; one nurse to one or two patients in the recovery unit, and one nurse to every three or four patients in the "step-down" unit where patients go after they have improved enough to leave the intensive care unit, said Nancy McGuckin, executive director of the Hawaii Nurses Association.

"All...these ratios are the standard of care across the country, they're not extraordinary demands," she said.

Hospital officials said that they don't like the inflexibility of such ratios and that staffing decisions should be made by management, not mandated in the contract.