Hawaii Nurses Strike: After Mediator Intervention, New Contract Ratified

• A new contract has been ratified following a Hawaii nurses strike that resulted in a lockout, demonstrator arrests, and the introduction of federal mediators.
• The practitioners at Kapi’olani Medical Center for Women and Children initiated a one-day strike on Sept. 13, after which they were locked out.
• The nurses are arguing for better quality of care more so than increased wages, according to local media reports.

Following a lockout, arrests, calls for safer staffing, and the introduction of a federal mediator, nurses at a Hawaii medical center could soon be back to work.

The Honolulu Star-Advertiser reported on Wednesday afternoon that a tentative contract agreement had been reached with the help of federal mediators. The contract was ratified the following day.

Practitioners at the Kapi’olani Medical Center for Women and Children initiated a one-day strike on Sept. 13, after which they were locked out, according to Hawaii News Now. They had been working without a contract since November 2023.

Hawaii Nurses Association (HNA) President Rosalee Agas-Yuu said in a statement to the local news outlet that the 600 nurses represented by the union are “committed to doing their part to reach an agreement.”

Why Did Hawaii Nurses Strike?

Hawaii Pacific Health, which operates the medical center, stated it would provide nurses with competitive wages and a new staffing model that “follows an agreed-upon nurse-to-patient staffing matrix unique to each unit.”

“Unfortunately, after a year of negotiations, the nurses’ union continues to refuse to take our offer to its members for a ratification vote,” the health system stated. “We value our nurses and their dedication to serve the health care needs of our community, and we believe it is time to move forward so our nurses can benefit from the significant and immediate improvements our offer would provide.”

Quality of care has been a key point in the union’s argument, more so than wages, in its quest for a new three-year contract. Hawaii Public Radio (HPR) reported that nurses say they’re being assigned too many patients. They want a contract to require a ratio that “guides how many patients can be assigned to nurses at any time,” according to HPR.

Agas-Yuu shared an example of “problematic staffing” with HPR. Using the Neonatal Intensive Care Unit as an example, she said the hospital wants a NICU nurse to oversee four babies, when “three is more than enough.”

“They work with tiny ones that really don’t need much effort to move, but because they’re so small, you have to be very, very on key with everything because you don’t want to get (them) too much fluid because they’re so small, and you want to make sure that their heart rate, their blood pressure is okay,” Agas-Yuu said. “It’s just a little bit more of a challenge.”

Patient Care During Hawaii Nurses Strike

With the medical center’s nurses locked out until a contract agreement is reached, temporary travel nurses were brought in to pick up shifts. But some patients have said the quality of care isn’t the same. 

Yuzo Mochizuki, the mother of a 7-year-old boy who has a rare neurological condition, told Hawaii News Now that the temporary staff ignored her son when he was vomiting and “suffering from low oxygen.”

“In this case, the travel nurses told me they’ve been working six, seven days straight, so I think they are really tired and they are shorthanded. I think there wasn’t enough staffing to tend to everyone that needed help,” she told Hawaii News Now. 

The Agreement

With both sides of the strike unable to come to terms, Hawaii Gov. Josh Green, M.D., and Attorney General Anne Lopez suggested on Sept. 24 the use of a federal mediator.

“Our nurses are a critical piece of our health care system in Hawai‘i,” Green stated in a news release. “I encourage both parties, who I respect, to request the assistance of a federal mediator. A neutral mediator can help break through barriers and guide both sides toward a fair agreement that serves our community and allows us to care for our sickest children.”

Days later, the hospital agreed to “extend medical, dental, and vision benefits” to nurses after Sept. 30, under the following conditions:

• HNA maintains participation with the federal mediator and negotiations are ongoing and productive. 
• HNA negotiates in good faith during this process. 
• HNA does not disrupt services. This includes disruption of patient access and services, including employee, temporary worker, vendor, and visitor access. 

Negotiations continued, with an HNA Instagram post stating that an agreement, expected to be ratified on Thursday, included “the first contractually enforceable nurse-to-patient ratios in Hawaii history.” The hosptial, however, stated that staffing had been a priority “throughout these negotiations,” according to the the Star-Advertiser.

The Bottom Line

Nurses at Kapi’olani Medical Center for Women and Children in Hawaii have been without a contract since last November. The lack of an agreement between the Hawaii Nurses Assocation and the medical center’s ownership led to a one-day strike that resulted in a lockout. In the weeks since the lockout, patients have expressed concerns about the quality of care and a federal mediator was brought in to help bring a resolution to the stalemate. As of late September, the hospital agreed to extend benefits to HNA nurses if they met a series of conditions related to the negotiations. An agreement between the sides, and the HNA ratified the contract on Oct. 3.

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