Hundreds of nurses at Kapiolani Medical Center for Women &Children picketed Friday morning to demonstrate their frustration over stalled negotiations for a new, three-year contract.
They rallied several hours for support in front of the hospital, wielding signs that said “Fair Contract Now!” and “Safe Staffing for Our Patients,” along with “Toot Your Support,” eliciting honks from drivers passing by.
The Hawaii Nurses’ Association, which represents more than 600 nurses at Kapiolani, said negotiations for a new contract have been underway since mid- September, with little progress. Their contract expired Thursday.
The primary issue is not over pay, but nurse-to- patient ratios affecting patient safety at Kapiolani, according to the union.
“Post-COVID, the patient workload has increased while the number of nurses has not been returned to pre-COVID numbers at the bedside,” said Daniel Ross, HNA president, in a statement. “The specialties of pediatric/neonatal and obstetric nursing are what makes Kapiolani Medical Center unique. Retaining the current nurses while finding ways to attract new recruits to Kapiolani would be a win for both sides, but most of all, a win for our community of women and children who may become patients at Kapiolani.”
Rose Agas Yuu, a critical care transport nurse and HNA’s vice president, said nurses are simply handling too many patients at one time. Many have burned out after the stress of the pandemic but are still overburdened.
Many have moved out of state to places such as California where nurse-to-patient ratios are implemented by law, she said, while others are mulling whether to stay.
Another issue on the table is mandatory overtime required of nurses, particularly in the emergency room and family birth center.
This means some nurses have had to work 16-hour work shifts, sometimes for several days in a row.
“It’s been very hard, especially the last three years,” said Yuu.
Gidget Ruscetta, Kapolani Medical Center’s chief operating officer, said management is engaging in a back-and-forth dialogue with union members and hopes to reach a new agreement soon.
“We take safety very seriously here at the medical center, and it really is a top priority,” said Ruscetta. “Running a women and children’s hospital, we have what’s called ebbing and flowing all the time. We have patients coming in, going out, babies being born 24/7. So we assess our staffing several times throughout the day.”
Staffing, she said, is based on how many patients are in-house and how ill they are. These factors help the hospital determine how many nurses are needed per shift.
“We are supporting our nurses,” she said. “We check in with them and listen to them throughout the day.”
At the same time, Kapiolani, the state’s largest specialty hospital for women and children, is making every effort to boost its staffing through active recruitment, creative workforce development training programs, and partnerships with high schools and universities.
“Throughout the country, staffing is challenging for every industry, and we’re no different,” she said.
Kapiolani is fortunate to have many experienced nurses, she said, with 60% having worked there more than 10 years.
Additionally, she said nurses are asked to volunteer for overtime before going into mandatory overtime, which is for an additional one to four hours, with significant compensation.
In January 2021, HNA said negotiations between union nurses and management reached an impasse, particularly over a substantial increase in health care insurance premiums for nurses with dependents.
The negotiations for that contract took place during the height of the pandemic, when management required nurses to reuse N95 masks up to five times, the union said, and to care for both COVID-19 and non-COVID-19 patients during their same shift.
Some nurses who tested positive for COVID-19 also had to tap into extended sick leave to isolate themselves.
Nurses that year voted to authorize a strike.
HNA said its members at Kapiolani have taken a stand for nurse-to-patient ratios, a first for Hawaii, believing it is key to reducing stress and improving recruitment and retention.
“We know for the nurses it’s going to be big lift to get these ratios,” said Yuu.
She added that the nurses are picketing because they have the patients’ best interest at heart.
“That’s the thing you hear from them, is the struggle to provide the care that they deserve,” she said. “They can feel when it’s short.”
The union filed a 10-day notification of the picket as required. Nurses picketed during their time off, prior or after their day and night shifts, she said.
Ruscetta assured patients that no services have been interrupted due to the picket. She said she continues to be inspired by the work Kapiolani’s nurses do every day.
“I remain very inspired by the work they do and that they are here every day with us working to take care of our patients,” she said. “We are committed to working through this to reach an agreement.”
The next bargaining sessions are scheduled for Dec. 14 and 21.
