About 600 unionized nurses at the Kapiolani Medical Center for Women & Children walked off the job Sunday, demanding that Kapiolani set a firm nurse-to-patient staffing ratio they say would reduce the widespread need for extended shifts and overtime. The Hawaii Nurses Association says nurses will strike through Sunday morning.

So far, Kapiolani management has resisted the demand, presenting a “last, best and final offer” on Jan. 10 that included raises and longevity pay but did not concede on the staffing ratio issue. Kapiolani has brought in several hundred temporary nurses to staff the medical center. Meanwhile, the next bargaining session is scheduled for Jan. 31.