Unionized nurses at Kapi‘olani Medical Center for Women &Children will begin a weeklong strike this morning after failed contract negotiations with hospital management, who reassured the community that hospital operations will go uninterrupted.

The Hawaii Nurses’ Association, which represents approximately 600 nurses at Kapi‘olani, will lead the strike, which is set to last from 7 a.m. today through 6:59 a.m. Jan. 28. Nurses will be present on the strike line from 7 a.m. to 8:30 p.m. today and 6 a.m. to 8:30 p.m. Monday through Saturday.

“We just want people to come out and help support us,” Paulette Vasu, HNA treasurer and a labor and delivery nurse at Kapi‘olani, said in an interview with the Honolulu Star-Advertiser. “The more people that come and support us, the better it’s going to be, and it’ll show management how loved we are, at least by the community. And hopefully, they’ll get the message that we are irreplaceable.”

The strike comes after months of failed contract negotiations since mid- September, primarily over the union’s demand for staffing ratios that set a maximum number of patients a nurse can care for during a work shift.

Since the beginning of the COVID-19 pandemic, nurses say they have been overwhelmed with the number of patients they care for, resulting in burnout and nurses moving to work elsewhere or retiring. Hospital management has said that fixed staffing ratios negatively impact the facility’s flexibility and capacity to care for patients.

An overwhelming majority of unionized nurses at Kapi‘olani voted to authorize a strike Jan. 5, and the union notified hospital management of the strike Jan. 10 after the two sides failed to reach an agreement on contract negotiations. The nurses have worked without a contract since Dec. 1.

During the most recent negotiation meetings on Jan. 10 and 11, Kapi‘olani presented what it said was its “last, best and final offer,” which included across-the-board raises and longevity pay but, according to HNA, did not address the staffing ratio concern. Hospital management responded that it offered staffing guidelines that strongly aligned with most of HNA’s proposals.

“We have offered staffing guidelines, which are different from the hard ratios that the union has proposed, and the difference is flexibility,” Gidget Ruscetta, Kapi‘olani’s chief operating officer, said in an interview with the Honolulu Star-Advertiser. “We strongly believe that we need the guidelines in place to allow us the flexibility to bring additional nurses in to provide the care that we need for our patients.”

Further negotiations are scheduled for Jan. 31 and Feb. 1. Ruscetta said that hospital management proposed these dates over a week ago, and that the union didn’t respond and agree to the dates until Friday.

“At this date, we are focused on providing patient care and providing uninterrupted quality care during the strike,” Ruscetta said. “We are hopeful that when we go back to the table on the 31st and Feb. 1, we will work towards an agreement so that we can continue to provide services as we always have.”

“We just want the management to bargain with us. They’re not bargaining in good faith. It’s their way or the highway, and that’s not bargaining,” Vasu said. “Hopefully, they’ll come back in a more agreeable mood and we can actually get a contract.”

The hospital will remain fully open to provide patient care throughout the strike, and has secured a temporary workforce of several hundred “experienced nurses licensed in Hawaii who specialize in women’s and children’s care” to ensure that operations of the facility go uninterrupted during the strike.

“These are nurses that come from across the mainland, and they have experience and have worked at some of our top children’s hospitals across the nation,” Ruscetta said. “I am completely confident in their skill sets, their abilities, and know that we will provide excellent care for this community and it’ll be uninterrupted.”

As the strike begins this week, Ruscetta said that Kapi‘olani’s focus remains on patient care.

“The nursing union made a decision to strike. Our focus is patient care. It always has been and it always will be,” Ruscetta said. “We are the resource and the only full-service women’s and children’s hospital for Hawaii and the Pacific basin. We must be here for our community. That is a commitment we made, and we will not lose sight of that. We will provide that care throughout this nursing strike and beyond.”

But for HNA, the strike is the association’s “last resort.”

“The nurses didn’t want to strike. This is not what we want to do,” Vasu said. “We felt this was it. They’re not listening to us, and hopefully this will wake them up.”