Hundreds of unionized health care workers, including most of the essential staff at Maui Memorial Medical Center, will hold a three-day strike starting 7 a.m. Nov. 4 in protest of unfair labor practices.

The United Nurses and Health Care Employees of Hawaii announced Thursday it had issued 10 days’ notice to Maui Health, which operates Maui Memorial in Wai­luku, Kula Hospital and Lanai Community Hospital, of the upcoming strike from Nov. 4 to 7.

UNHCEH represents about 1,000 registered nurses, pharmacists, imaging techs and other workers who voted in September to authorize a strike, prior to their contract expiring Sept. 30.

Talks with Maui Health, the nonprofit organization affiliated with Kaiser Permanente, have been ongoing since late July.

The union says it it had sought to begin bargaining earlier and that it is advocating for living wages, safer nurse-to-patient ratios and equal benefits.

“The community’s been hurting ever since COVID,” said Matt Pelc, a CT technician and UNHCEH chair, in a news release. “This year alone, because of those (Aug. 8, 2023) fires, rent has gone up on Maui about 40%. We’re losing staff left and right. Many people have moved off the island because they couldn’t afford to live here. We’re trying to make it so nurses and health care workers can afford to stay and care for our ohana.”

Maui Health, in response, said its highest priority is the health, safety and well-being of its patients and residents.

Although a strike notice does not mean there will be a strike, Maui Health said it has contingency plans in place, including a temporary workforce, and that all its hospitals, clinics and offices would remain open.

“We are disappointed that the union decided to issue a strike notice within the first 30 minutes of starting our first of three bargaining sessions scheduled for this week,” said Maui Health in a written statement. “We believe the best place to resolve our differences and reach an agreement is at the bargaining table and we remain committed to continuing to bargain in good faith to reach a mutually beneficial agreement to avoid a strike.”

“We value and respect all of our employees; they are the very heart of how we provide high-quality and compassionate care,” Maui Health continued. “Our goal remains to reach an agreement that provides our employees with market-competitive wages and benefits while ensuring we can continue to provide our community access to the high-quality health care they need and deserve.”

Maui Health said its bargaining team was eager to engage in productive discussions at scheduled sessions today and Saturday.

The union says Kaiser, which is “the gold standard for healthcare nationwide,” took over management of Maui Health in 2017, along with promises to elevate care standards, but “has not kept its promises to Maui and Lanai residents.”

Maui Health workers are covered by separate contracts from other KP health care workers in Hawaii and the rest of the U.S., the union said, and are not only getting lower wages and fewer benefits, but working under lower care standards, with high turnover and chronic staffing shortages.

Rowan Funes, an emergency room nurse, said there’s a disparity in wages between Maui Memorial and a Kaiser clinic just across the street. There’s also a disparity between wages for the same positions at Maui Memorial and Kaiser Moanalua on Oahu.

Maui Memorial is the only acute care hospital on the Valley Isle, yet staff there are paid anywhere from 10% to 30% less than at Kaiser facilities elsewhere.

“They’re almost trying to treat us as second-class citizens,” said Funes, who is also on the union’s negotiating team. “It’s disheartening. It’s just the fairness of it all.”

Funes said the union has presented well-thought-out proposals on wages and staffing ratios but that talks have resulted in minimal progress.

The counterproposals are low, he said, with wage increases at a mere $1 more per hour, as opposed to a requested $9 to $10 more per hour, and do not address the higher costs of living, particularly the skyrocketing costs of Maui housing since the 2023 wildfires.

“They’re bargaining like we’re in the 1980s,” he said.

For Maui Memorial admitting clerks, receptionists and others on the lower end of the pay scale, the union is advocating for living wages and a bump up from $20 to $22 an hour, he said, to at least $30 or more an hour.

Additionally, workers want more paid time off per year. In California the Kaiser contract includes 40 hours of paid time off per year, he said, to improve work-life balance, including a “mental health” day if needed. Maui Memorial workers want the same.

“A lot of the language we’re adding is directly from their contract,” he said.

The union is also pushing for the same nurse-to-patient ratios on Maui that Kaiser has agreed to in its contract covering registered nurses in California.

This includes a ratio of 1 nurse to 1 patient in ER trauma, 1-to-2 in critical care and 1-to-4 in the medical-­surgical unit.

While nurse managers do their best to manage ratios, Funes said, the ER can quickly become overwhelming when a trauma patient comes in requiring one-on-one care, leaving the other nurse on duty to care for seven patients.

The registered nurse turnover rate at Maui Memorial is more than three times higher than at Kaiser’s other clinics and hospitals in Hawaii, the union said, at 13.9% compared with 4.2%, which comes at a tremendous cost to the hospital.

At the same time, due to the constant turnover and shortages, nurses are getting burned out.

This cycle will only continue without better pay and improved working conditions, according to Shelly Donnelly, a psychiatric registered nurse at Maui Memorial, due to the inability to recruit and retain nurses who can afford to live on Maui.

At Maui Memorial, nurses have long been working short-staffed, she said, and studies have shown that for every patient added to a nurse’s workload, the probability of mortality increases by 7%.

“The burnout is constant,” she said. “You worry if you’re going to come to work in safe or unsafe working conditions because it’s so dynamic and changes from day to day.”

The union says the November strike is an unfair labor practice strike due to several, separate incidents.

“I think a majority of the nurses are obviously worried about patient safety while we are on strike,” said Donnelly. “I feel like we’ve been put in this position. This is what we have to do to be heard for the community and patient safety in the long run.”