St. Francis,
nurses OK a
tentative
agreement

Nurses at Queen's vote to
accept terms but talks are
continuing at Kuakini and
Kapiolani hospitals

By Lori Tighe
Star-Bulletin

The Hawaii Nurses Association and St. Francis Hospital reached a tentative settlement last night and nurses at The Queen's Medical Center voted to accept their agreement, leaving two hospitals still negotiating to prevent Christmas season nurse strikes.

"This is a landmark agreement with groundbreaking and national-trendsetting language," said Marian Marsh, RN, director and chief negotiator for the Hawaii Nurses Association, referring to the Queen's accord.

Agreements at Queen's and St. Francis are the first in the country to allow nurses to participate in staffing decisions, and to begin collecting nursing data, said Nancy McGuckin, executive director of the Hawaii Nurses Association.

"It really allows nurses to practice their profession and to address patient care and staffing issues on equal footing with the employer," McGuckin said.

St. Francis's 420 nurses will vote on their tentative agreement tomorrow. Negotiations continue at Kapiolani and Kuakini Medical centers.

The three-year agreement with Queen's includes no further reductions of registered nurses at the patient's bedside. It also adopts guidelines set by the American Nurses Association called "Principles For Nurse Staffing," which provide nurse participation in assessing patients' daily needs for care.

Collecting nursing data will also be a first for the hospitals, McGuckin said.

Hospitals have collected patient satisfaction data before, but not nursing indicators, including bed sores, medicine errors and infiltrated IVs.

Bed sores, from patients not being turned, cost hospitals an estimated $2 billion a year to treat, she said.

"By tracking them you can determine how good you're doing, where you need improvement and is nursing making a difference to the patient. We know we are, but we haven't tracked it," she said.

Queen's 800 nurses overwhelmingly ratified their new contract yesterday, with about 70 percent of the bargaining unit voting in favor.

"I think everyone at Queen's is delighted," said Queen's president and CEO Arthur Ushijima. "We're all very happy and looking forward to a nice holiday."

He said the nurses' anger and frustration during the negotiations about staffing concerns is being felt by the rest of the health-care industry.

"The mood of these negotiations reflects the mood across the country and how health care providers are feeling. We're all very highly stressed," he said.

The Balanced Budget Act reducing Medicare and Medicaid reimbursements, combined with managed care pressures, has caused hospitals to constantly seek ways to save money.

To meet the nurses' 8 percent raise over three years, Queen's Hospital will "reassess our priorities and focus on care with the biggest impact," Ushijima said.

"We've reduced our expenses fairly dramatically over the last few years and we need to look at services which don't support the main area of care," he said.

Kuakini Hospital broke off talks on a positive note at 1 a.m. yesterday morning, McGuckin said. Kapiolani Hospital meets today at 10 a.m.

Kapiolani filed a lawsuit yesterday against the state to go through a staffing agency and hire nurse strike replacements.

About 460 nurses are prepared to strike at 7 a.m. Dec. 28.

"Kapiolani stresses its primary objective is to get back to the table and resolve the issues," said Patrick Jones, the hospital's lawyer.

Current state law prohibits employers from going through a third party to hire strike replacements.

Kapiolani needs to go through a staffing agency to recruit specialized nurses in labor and delivery, Jones said.

The suit contends that federal law allows third-party employment services, which makes the state law unconstitutional.

"We think the federal law governs in this area," Jones said. "The hospital has to prepare for a strike, because its first responsibility is to patients."