Nurses at Straub Medical Center are preparing to picket the Honolulu hospital next week after rejecting a best-and-final contract offer Friday from the health care provider.

About 420 unionized Straub nurses are represented by the Hawaii Nurses Association, and 96% of the roughly 400 members who voted Friday rejected the offer that was produced with the help of a federal mediator after a 3-year-old contract expired Nov. 1.

The union provided Straub, an affiliate of Hawaii Pacific Health, with a 10-day notice to stage informational picketing on Nov. 22 but is hopeful that bargaining can resume before then and lead to an agreement that makes picketing unnecessary, according to Daniel Ross, president of the Hawaii Nurses Association, OPEIU Local 50.

Ross said the vote was resounding and conveyed a strong view from Straub nurses that their concerns over working conditions, including pay, are not being addressed.

Travis Clegg, Straub’s chief operating officer, said in a statement that collective bargaining meetings with union representatives have been productive and resulted in over 20 tentative agreements being reached on issues including safety and staffing.

“We greatly respect and value our nurses at Straub Medical Center,” Clegg said in a statement. “We offered a proposal to HNA that would make Straub nurses among the highest paid nurses in the state. We stand by our offer and are open to continuing discussions.”

Patrick Switzer, a Straub nurse on the bargaining team, said disagreement still exists over major issues that include wages in light of the cost of living being pumped up by high inflation, meal and rest break management, on-call compensation and staffing levels of experienced nurses.

Switzer said the job has gotten a lot harder since the coronavirus pandemic took hold locally in early 2020, with more patients now, adding to stress on nurses.

“The staff feels frustrated and are burned out,” he said. “It’s gotten really chaotic.”

Straub nurses held an informational picket about three years ago after the prior contract expired. At that time a major sticking point was Straub’s attendance policy, which nurses said was punitive and motivated staff to come into work when sick.

Hawaii Pacific Health is the nonprofit parent company of Straub as well as Kapiolani Medical Center for Women &Children and Pali Momi Medical Center on Oahu and Wilcox Health on Kauai.