Union nurses at The Queen’s Health System on Oahu are threatening a strike as negotiations hit a sticking point over nurse-to-patient ratios — the subject of tense disagreement at Kapi‘olani Medical Center last year. Nurses at Wilcox Medical Center on Kauai are considering similar action.

Nurses at Queen’s — about 2,000 of them — and Wilcox, with 159 nurses, say they’re frustrated with differences in positions between the front-line care providers and administrations in ongoing negotiations. Kapi‘olani reached an agreement with nurses in October, but only after lengthy negotiations, two strikes and an administration lock-out.