Nurses in Hawaii Have Given Notice of Intent to Strike

It’s a new year, but nurses at Hawaii’s Kapiʻolani Medical Center are fighting the same battle that’s been waged by healthcare workers all over the country for years: safe nurse-to-patient ratios and inflation-adjusted wages. There were 27 healthcare worker-led strikes in 2023, and with no federally mandated staffing ratios passed, the trend may continue this year.

As is often the case, administrators at the Kapiʻolani Medical Center pointed to what they feel is a generous pay package in their offer. Still, the nurses pushed back, stating that guaranteed nurse ratios are the most critical part of the contract that remains unaddressed.

Paulette Vasu, a nurse at the Kapiʻolani Medical Center, told Khon2 News, “We really didn’t want to have to do it, but management’s not listening to us, and we feel this is our only recourse for patient safety. For our safety. This is what we have to do.”

This strike highlights a growing chorus of nurses and labor unions demanding that safe staffing ratios be written into law to protect patients and staff nationwide.

Rosalee Agas-Yuu, the president of the Hawaii Nurses Association, echoed the nurses’ sentiments that troubling staffing issues in the facility are their primary concern. According to nurses, the neonatal intensive care and labor and delivery units at Kapiʻolani Medical Center are routinely understaffed by four or more nurses per shift.

Nurse-to-patient ratios are determined by unit location, patient acuity, and the nurse’s skill set. For example, a nurse in the intensive care unit should have a maximum of 1-2 patients. A medical/surgical floor nurse should have at most four patients. These ratios are based on decades of research and wisdom from nurses who have spent their lives at the bedside.

Healthcare worker burnout is a huge problem that can result in patient and clinician harm if left unaddressed. It should be no surprise, then, that one of the biggest drivers of nursing burnout is an unsafe work environment due to a lack of enforced patient-to-nurse ratios.

Agas-Yuu said this intentional understaffing by the facility is unsafe for patients and contributes to nursing burnout, which has been shown to further cause harm to patients through medication errors and miscommunication and cause staff injury.

Nurses nationwide are demanding their employers do more to guarantee safe staffing. Nurses at Kapiʻolani Medical Center plan to join that chorus and strike for one week starting on January 21 at 7:00 a.m. and concluding on January 28 at 6:59 a.m.

The hospital plans to pay a premium for travel nurses to cover the striking nurses’ assignments so there will be no interruption to patient care.

This strike is a small part of a much larger labor rights movement that spans countless industries across the nation. From the automotive industry to Hollywood to healthcare — America’s workers are demanding safer working conditions and fair pay. They’ve already won concessions on the picket line and at the contract negotiation table.

The hard-fought victories that nurses scored in 2023 will likely fuel even more action from other nurses who have seen the power of collective action.

Here is a look at the most significant and most successful nursing strikes and negotiations of 2023:

The most common concerns cited in these actions include: