Nurses’ resolve has The intensity of this year's Hawaii Nurses Association negotiations with five Honolulu hospitals and the looming possibility of a strike show high levels of dissatisfaction among local nurses.
built over time
Frustration with compensation that lags
the mainland and worries about retirement
have led to a tough negotiationBy Lyn Danninger
ldanninger@starbulletin.comThe union this week delivered strike notices to Queen's, Kaiser, Kapiolani, Kuakini and St. Francis hospitals. Bargaining continues, but a strike could begin Dec. 2.
A number of factors have been brewing for a long time, explaining why nurses now seem to be unhappy, said some familiar with the situation.
For example, professional advances in states such as California, where minimum nurse staffing ratios at hospitals have been established along with significant pay raises, are adding to nurses' resolve at the bargaining table.
One of the biggest issues for local nurses relates to retiree benefits. The average age of a registered nurse in Hawaii last year was 48.7 years, said Bee Kooker, interim dean of nursing and dental hygiene at the University of Hawaii. So it should come as no surprise that nurses are more pre-occupied with what will happen when they retire, she said.
But the aging of the nurse work force also means the state can expect to see far fewer experienced nurses in coming years, she said.
In a survey taken last year, when asked about their retirement plans, 17.4 percent of registered nurses said they would retire in 2006. A further 43.2 percent of the work force plan to retire in 2011 and by 2016, 62.5 percent indicated they would retire, Kooker said.
With an aging work force, working conditions, particularly mandatory overtime, take on an even greater significance, said Linda Beechinor, an assistant professor of nursing at Hawaii Pacific University, who was recently appointed to the national board of directors for the American Nurses Association.
"One of the things pushing nurses to retire early is working conditions. An older nurse cannot keep working 16-hour shifts. You just can't do physically do it," she said.
The effect on family life is also a big consideration, Beechinor said.
"It impacts a great deal on family life when you have to work mandatory overtime, can't get vacation and days off," she said. "If nursing eventually becomes a game for younger nurses, you lose that mentoring and experience."
Kuakini registered nurse Jeraldine Kunimura believes existing nursing shortages are exacerbated by working conditions.
"We know there are nurses out there, but why don't they want to come to work in the hospitals?" she said. "We want retention of seasoned nurses."
Kunimura, a union unit representative at her hospital, said most grievances she has heard from staff this year relate specifically to staff levels and safe patient care.
Beechinor and Kooker say nurses are aware of continuing financial problems at local hospitals, but say nurses' working conditions have gotten steadily worse as hospital budgets tightened.
"The nurses realize the source of the problem is the financing of the health care system and that the hospitals are strapped for money. But nurses can't keep absorbing the problem for the industry," Kooker said.
Kooker also pointed to recent research showing a direct correlation between staffing levels and medical errors.
The seriousness of the negotiations between nurses and the hospitals show how high the stakes have become for both sides, both Beechinor and Kooker say.
"I hope everyone realizes when they make their choices what the consequences will be. In some way or another we have to look at what would be best for Hawaii, our nurses and our health care system," Beechinor said.
Hawaii Nurses Association