Nurses at Kapiolani Medical Center for Women &Children said they will take a strike authorization vote beginning Thursday after nearly five months of trying to negotiate a new contract with the hospital.

The nurses said Tuesday with a settlement close at hand that management of Kapiolani Medical Center “has surprisingly stopped short of a fair agreement” in trying to ensure a safe and fair work environment. They said in a statement that they “have lost confidence in the hospital’s management.”

Kapiolani Medical Center has been demanding its nurses pay a higher percentage of their health care premiums and be satisfied with zero to below-average wage increases, according to Daniel Ross, president of the Hawaii Nurses’ Association OPEIU (Office and Professional Employees International Union) Local 50, which represents Ka­piolani Medical Center’s 725 nurses.

“The nurses have been generously giving their all in the spirit of cooperation and lokahi to support the community during this challenging time, but there has not been any appreciation by the hospital,” he said. “They have continued to show grave disrespect for the nurses and their contributions to patient care throughout our negotiations.”

Kapiolani Medical Center CEO Martha Smith refuted the characterization portrayed by Ross.

“Kapiolani Medical Center for Women &Children remains committed to reaching a timely agreement on a contract that is fair and addresses our nurses’ concerns,” Smith said. “Our nurses are important to us and we’re pleased to be able to continue to provide generous and competitive benefits during these challenging economic times.”

Smith said the hospital’s registered nurses are paid on average $124,000 ($168,480 with benefits), and its recent settlement offer includes wage increases totaling 5% over the three-year contract in addition to paid time off enhancements and the continued payment of 100% of health care costs for nurses with single coverage, among many other benefits.

“We’re disappointed that the Hawai‘i Nurses Association (HNA) indicated to us that it would not present our offer to the nurses and our nurses were not given the opportunity to formally review or vote on this offer,” Smith said.

She said that management has bargained “in good faith” with HNA and that it looks forward to its next meeting with the union and a federal mediator Jan. 13.

“We truly hope we can avoid a strike,” Smith said. “However, should the union choose to go that route, we have made the necessary preparations and have contingency plans in place for qualified temporary staffing to ensure there is no impact on patient care or services at Kapiolani.”

Ross said the medical center’s management has refused to budge on issues that are critically important to patient and employee safety and instead is demanding financial concessions from the nurses.

HNA, which represents 4,000 nurses in Hawaii’s major health care providers throughout the state, said other issues not addressed in the management’s “last, best, final offer” are nurses having to intermingle with both COVID-19 and non-COVID-19 patients during their same shift; and nurses being required to reuse N95 masks, even though Hawaii Pacific Health, the parent of Kapiolani Medical Center, is the only hospital system that reuses N95 masks instead of discarding them after a single use.

Smith said that after listening to the nurses’ concerns, the hospital has agreed to reduce the number of times N95 masks are sanitized and reissued to three times even though its existing process follows both Centers for Disease Control and Prevention and manufacturer guidelines.

“We’re confident that our PPE (personal protective equipment) practices are effective, as we have not had any employees at Kapiolani test positive for COVID-19 due to an exposure from a patient when our PPE procedures are followed,” she said.

The COVID-19 vaccine has been administered to more than 1,050 Kapiolani front-line workers since receiving its initial shipment in mid-December, Smith added.

“We also have been fortunate in that Kapiolani’s COVID-19 case numbers have remained low throughout the pandemic,” she said. “Those patients who have been identified with COVID-19 are very different from COVID-19 patients at other hospitals in that they are typically asymptomatic and released after only a couple of days. Despite the consistently low case count, our PPE procedures direct staff to wear the appropriate PPE for all patients regardless of their status.”

Ross said it’s unfortunate for current patients at the hospital and others in the community that the nurses are preparing to authorize a strike.

”At a time when every bed in the intensive care unit and every ventilator patient requires the professionalism of nurses, Kapiolani Medical Center has continued to dismiss our concerns and have not provided any viable way for us to move forward,” he said. “This will severely impact health care capacity in our state.”