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The Honolulu Advertiser

Posted on: Saturday, December 7, 2002

Dialysis patients raising concern as strike drags on

By Mike Leidemann and Mike Gordon
Advertiser Staff Writers

Kaiser nurses to vote on pact

Nurses at Kaiser Medical Center will vote today on a new contract offer, the Hawai'i Nurses Association said.

The 646 nurses at Kaiser have been offered a 21 percent pay increase over a three year contract. Experienced nurses would get additional improvements in the second and third years of the contract.

The contract also includes new staffing guidelines and some improved retirement benefits for retiring nurses.

Meanwhile, nurses at three other O'ahu medical centers — Queen's, Kuakini and St. Francis — remained on strike yesterday. No new negotiations at any of the hospitals were scheduled.

St. Francis Medical Center said yesterday it is considering hiring replacements for some striking nurses while concern mounted over the well-being of dialysis patients across O'ahu.

As nearly 1,400 nurses remained on strike at three O'ahu medical centers, the National Kidney Foundation of Hawai'i recommended that dialysis patients go on an "emergency" diet, and the mother of a seriously ill dialysis patient worried that the strike contributed to a worsening of her daughter's condition.

"St. Francis and the nurses somehow have to figure out a way to get back to serving the people who need the help," said Peggy Morgan, whose 50-year-old daughter suffered a collapse of her veins during a dialysis treatment at St. Francis this week and had to be rushed to Queen's, where she remains in serious condition under the care of replacement nurses.

Representatives of St. Francis and the Hawai'i Nurses Association were scheduled to meet last night with a federal mediator to discuss the possible return of some nurses in critical areas, including the dialysis center, said Maggie Jarrett, spokeswoman for St. Francis. The discussions will not touch on wider contract issues, she said.

Dr. Jared Sugihara, head of the Renal Institute of the Pacific at St. Francis, said Thursday that dialysis patients have had their regular treatments cut by as much as one-third, creating a situation that could turn life-threatening in the long run.

That warning was echoed yesterday by the Kidney Foundation, which said it has fielded increased calls of concern from dialysis patients since the strike began Monday.

"Medically speaking it's not optimal to reduce dialysis time," said Julie Schweitzer, chief operating officer of the foundation. "In the short-term it's OK, but now the short term is getting stretched to the maximum."

The foundation said it has advised patients since the start of the strike to go on an emergency diet, which limits the intake of items normally removed during a dialysis treatment. Among other things, the diet calls for a reduction in fluids, protein, salt and potassium. The diet is designed to keep waste products from building up in the blood.

Through talks with the nurses and in a court case, St. Francis has asked for return of at least 16 nurses to bring staffing levels in the dialysis center back to normal. A hearing on the lawsuit is set for Thursday.

Nurses have said they would return temporarily to help any critically ill patients, but have wondered why St. Francis has not pursued other alternatives, including hiring replacement nurses.

"We are looking into taking other steps to provide those essential nurses that we need," St. Francis spokeswoman Maggie Jarrett said yesterday. "We are looking at agencies on the island in the hope that there might be some additional nurses that would be available through them." As of late yesterday afternoon, no decision on hiring nurses had been made, she said.

Morgan said she could not specifically blame her daughter's collapse on the strike, but worried that it could contribute to problems for other patients as well.

"Dialysis is life and death for a lot of people," she said. "The technicians at St. Francis are tired, the supervising nurses are working 16-hour shifts and problems are bound to happen."

On Thanksgiving Day, Morgan's daughter, Margaret, suffered a "fistulary blowout" in which the veins used for dialysis treatment collapse. She was hospitalized at the time, then returned for her regular dialysis treatment on Tuesday, the second day of the strike, Morgan said.

When the veins collapsed again, Margaret began to bleed internally and had to be rushed back to Queen's, passing through a picket line in front of the emergency room entrance, she said. Margaret, whose kidney failure four years ago was brought on by lupus, is now recovering from vascular surgery, Morgan said.

Morgan was particularly upset by what she said was a militant, party-like atmosphere on the picket lines at Queen's.

"Everyone's got a right to strike. It's an American tradition, but there's got to be respect, too," she said. "My daughter might be in there dying, and they're out there screaming and waving fists."

The Kidney Foundation said about 1,500 Hawai'i residents need regular dialysis treatment. About two-thirds of them receive it through several centers run by St. Francis. The only other dialysis provider, Fresenius Medical Care, is operating at capacity and cannot accommodate any St. Francis patients, officials said.

Normally, patients spend three to five hours hooked up to a dialysis machine that cleans their blood, doing the work normally done by a healthy kidney. St. Francis said because of staff shortages it is reducing the dialysis time of some patients by up to an hour.

"We've got to find some solution soon," Schweitzer said. "Whether it's through talks or the courts, somethings got to be done. The situation is getting tense."