The 65 nurses could walk off the job as early as Monday unless a new agreement is reached, the Hawai'i nurses association said.

The two sides were to meet at the Hawaii Employers Council and are being assisted by a federal mediator.

The nurses voted overwhelmingly to authorize a strike after rejecting management's offer earlier this month.

Nurses say a key reason they rejected management's proposal is that pay increases offered by the hospital would be negligible in light of healthcare premium increases.

The nurses said they are seeking a contract that is competitive with other area hospitals.

The nurses also are seeking to improve safety and want the contract to address patient care concerns, such as mandatory overtime and extra required shifts.

The Hawai'i Nurses' Association said the hospital management "remains mired in positions unacceptable" to the nurses.

Hospital officials did not return calls seeking comment.

Sue Scheider, chief negotiator for the nurses union in these negotiations said the nurses have questioned the hospital administration's "loyalty to the rural community."

"They have questioned the wisdom of the dramatically curtailed maintenance on the existing hospital facility while millions of dollars are being pumped into hyping the administration's much-publicized effort to build a bigger new hospital at Koa Ridge," Scheider said.

The 162-bed facility includes 103 beds in the long-term-care facility, as well as an intermediate care facility, intensive care unit and emergency room. It is the only 24-hour primary and emergency care medical facility between 'Ewa and Kahuku.