The Kauai Nurses’ Bitter Battle

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Wednesday - September 20, 2006

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Many causal onlookers probably consider Kauai’s Wilcox Memorial a “country” hospital. The idea of referring to it as a country hospital is a way of characterizing everyone who works there or goes there for treatment as unimportant and out of touch with the latest medical technology.

Nurses are at the forefront when it comes to medical care. When you end up in a hospital, any hospital, the people you meet immediately are the nurses - all kinds of nurses who have all kinds of skills and specialities. The people in a hospital who will nurse you back to health after a serious operation are - nurses. You will see them at least 10 times more than the doctor who operated on you. So it’s no surprise that they are like a mirror into the soul of the hospital. If it’s a well-run institution and cares for its staff and patients, it will be immediately apparent. If the emotional level of the staff and management is low, you will be able to feel it whether you are carried in, wheeled in or walk in. It’s a powerful message in understanding the meaning of territoriality.

With that in mind, I find it curious that the nurses at Kauai’s Wilcox Memorial Hospital are in their 12th week of a strike. More than 100 nurses represented by the Hawaii Nurses Association walked off the job on June 24. The stalemate over a new contract was said to be over staffing levels, with the union calling for a cap on the number of patients assigned per-nurse to ensure safety, and the hospital administration insisting that staffing is adequate.

The union says the hospital, owned by Hawaii Pacific Health, refuses to develop a patient classification system. There is no question it has many good reasons to believe patient classification is a management prerogative and none of the nurses’ business.

There is nothing wrong with management and staff disagreeing over issues; however, this strike has brought out an ugliness in management not seen in the Hawaiian Islands in many years. There are many laws governing labor relations that mandate the relationship between labor and management, and the law frowns on any “first, last, best” or “take it or leave it” offers from management.

It is not a good idea to discuss bargaining issues in the media. But one thing that can be discussed is the apparent strategy being used by those at the bargaining table. Unfortunately, this negotiation has turned into a ancient distributive confrontation. Distributive simply means “in order for you to win, I have to lose,” and there is no room for negotiation.

There has to be an attitudinal structuring for the sake of the patients on Kauai. Both parties have to participate in activities that will create an atmosphere of cooperation, trust and respect. Said another way, a degree of friendliness toward each other. What we are witnessing here is a conflict where both parties seek to destroy the other’s base. The proof is in the fact that neither side will acknowledge the legitimacy of the other. The attitudes of both sides have polarized, and management appears to have adopted a strategy with a goal of eliminating the union. That’s not good for Kauai, the nurses or patients of the hospital.

What’s even more disturbing in this conflict is that the federal government is involved. It has assigned a federal mediator to assist both sides in reaching a reasonable settlement. Sadly, the mediator’s efforts have not borne any fruit and the strike rages on.

Something else makes no sense. The politicians have taken a laissez faire approach to the labor relations problems at the hospital, which has emboldened the private sector employers to take a harder line in bargaining. At some point the governor and the legislative leaders of Kauai County are going to have to step forward and end this labor conflict and force them to bargain constructively.

It’s already tough enough finding good nurses to staff all hospitals and clinics around the state without allowing profit motives to crush the nurses’ union. It’s not necessary, and the people responsible for allowing it to happen should consider their next visit to a hospital for medical assistance. I can’t think of anything more frightening than a disgruntled nurse. After all, when doctors perform their magic, the patients are usually unconsciousness and you can’t see their frowns.