After months of negotiations, the Hawaiʻi Nurses’ Association ratified a three-year contract for hundreds of nurses at Kapiʻolani Medical Center for Women and Children.
The union said the new contract would address the nurses’ biggest concern — what they called “unsafe” staffing conditions from having too few nurses assigned to too many patients.
But in a news conference a day after the contract was ratified, Kapiʻolani Chief Operating Officer Gidget Ruscetta wouldn’t guarantee that union nurses would get smaller patient loads, even on average.
“Because we're a 24/7 medical center and we are the only women's and children's (hospital) in the Pacific, we never know what's coming in our doors," Ruscetta said.
"And so it's very important that we never turn patients away, and we are always available. So, the number of nurses varies from shift to shift. It can vary every four hours if patients get better or they get sick,” she said.
She noted that during the year-long contract negotiation, the hospital focused on flexible staffing levels rather than fixed ratios, as staffing needs are complex and can vary based on patient requirements.
During contract talks, HNA and Kapiʻolani negotiators struggled over a staffing “matrix” that includes ideal ratios of nurses to patients.
Eventually, both sides came to an agreement on the matrix, but Ruscetta on Thursday noted that it’s not actually in the new contract and serves more as a guide.
What is included in the contract is a staffing council made up of Kapiʻolani nurses and nurse leaders that will meet monthly to go over any staffing issues. The matrix will be reviewed annually.
The council is meant to serve as an enforcement mechanism to ensure appropriate staffing levels.
HNA President Rosalee Agas-Yuu on Wednesday, when the union voted to ratify the new contract, said that it could take a while for the hospital management to improve staffing levels.
But she said the nurses are watching to make sure there’s progress.
“The nurses are very interested and very committed to make sure that safe staffing conditions are being continued or met in each unit of the hospital,” Agas-Yuu said.
She added that the union will also watch how Kapiʻolani meets its staffing needs, either through traveling nurses or new hires.
