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The Honolulu Advertiser

Posted on: Tuesday, December 31, 2002

Talks to resume for St. Francis, Queen's nurses

By Mike Leidemann
Advertiser Staff Writer

Nurses and management at two Honolulu hospitals will return to the bargaining table this week, trying to end their four-week-old strike.

New negotiations at The Queen's Medical Center will be held at 10 a.m. Thursday, a nurses' spokesman said. Talks at St. Francis Medical Center, the first there since the strike began Dec. 2, will be held Friday morning, a hospital spokeswoman said. No new negotiations are planned for Kuakini Medical Center, the third hospital affected by the strike.

Altogether, 1,400 O'ahu nurses at the three hospitals are on strike.

"We are pleased that this meeting is taking place and we will work hard to try and bring closure to this long, painful strike," said Caroldean Kahue, chief negotiator for the the nurses at Queen's, where two previous bargaining sessions broke off without an agreement.

The announcement of the talks at St. Francis came yesterday as the hospital administration, worried about its bottom line, said it would start increasing its revenue-producing services.

The hospital, which severely cut back patient services at the start of the strike, will start to reinstate some of them this week, hiring 30 more replacement nurses, said Terry Long, chief financial officer for St. Francis Healthcare System.

"Since it appears the strike will go on for some time, we've decided to start resuming some of the areas that were cut to a bare minimum when the strike started," Long said.

St. Francis is probably the hardest hit financially of the three hospitals.

Even before the walkout, the hospital had been struggling, losing about $650,000 in the first four months of the fiscal year beginning July 1. Losses include a reduction of almost $31 million in government reimbursements in the past five years, Long said.

"Almost 80 percent of our patients are covered by government programs such as Medicare, Medicaid or Medicaid-QUEST," he said. "Because of that we'll never be able to have a strong bottom line."

Immediately after nurses walked off the job, the hospital reduced patient loads, curtailed surgeries and new admissions and laid off more than 140 ancillary personnel, such as those in maintenance or food service.

Now there is growing fear in the local medical community that St. Francis, founded in 1927 and the state's leading provider of renal dialysis treatment and transplant operations, may not be able to financially survive a long strike.

"The longer the strike goes on, the greater the financial impact, the greater the threat to our ability to full our mission," Long admitted. "We may not be able to help all those we helped in the past."

Nurses argue that the hospital could be supported by several other profitable enterprises under the St. Francis Healthcare System umbrella. Among the other facilities and businesses operated by St. Francis are: St. Francis Medical Center-West, a home care and hospice unit, a community fund-raising foundation and a for-profit enterprise that runs clinical laboratories and a laundry service in Honolulu.

"If you look at the whole system, it's healthy," said Sue Scheider, director of collective bargaining for the Hawai'i Nurses' Association. "We think it's possible for the system to bail out the hospital."

"None of the enterprises makes a great deal of money," Long said. "We believe it's a crowning achievement if we just break even every year."

In recent years the hospital has shifted more of its patients to the St. Francis West facility, reduced some staff, moved out of rented office space and started planning to renovate the operating rooms on its Liliha campus in order to attract more physicians there — all moves to lower costs or bring in new revenues.

With the strike entering its fifth week today, St. Francis has decided that it can no longer get by on additional cutbacks alone.

"We need to start taking actions that will bring revenue back to the facilities. We want to try to use the replacement nurses to bring some of our services back to normal," Long said. "We've already started doing more transplants and open-heart surgeries and there are more things we can do."

The strike also has helped managers identify new, more efficient ways of work which may result in permanent changes, such as the sharing of some special populations with other hospitals, he said. "We may not be able to take all the special patients that we have in the past."

Scheider said the hospital still needs to address the concerns of its striking nurses or risk further losses. Without proper staffing and competitive salaries, healthcare will degenerate, leaving the hospital worse off than before, she said.