UPDATE: 5 p.m.

Kapi‘olani Medical Center for Women & Children today brought in several hundred temporary nurses to fill nursing jobs after unionized nurses walked off the job and hit the picket line this morning to start a weeklong strike.

“I am happy to share that our patients are well taken care of. We are fully staffed, and we no disruption in care. Our emergency department is open receiving ambulances and the care is provided for our community,” Gidget Ruscetta, Kapi‘olani’s chief operating officer, said during a news conference this afternoon at the hospital. “This morning for the last couple of hours we’ve already had 35 people in our emergency room and we’ve also received ambulances at that time. Our (operating rooms) are open so our operating rooms already done two emergency surgeries. We are very comfortable, very confident that this workforce is in place for the duration of the strike and we are well taken care of.”

Ruscetta said the critical care areas, all clinical services, the parking garage and cafeteria remain open. “All of our services are running,” she said.

However, outside the hospital, disruptions were evident.

Along the sidewalks, anywhere from 100 to 350 unionized nurses at the peak were picketing waving signs with various messages , including “Safe nurses, safe patients,” “Patient safety first,” and “Called heroes treated like zeros.” A paper mache nurse and giant rat, which nurses said represented the company, also were among the picketers.

Rosalee Agas-Yuu, HNA president and critical care flight nurse since 1993, said, “I love this hospital. It’s hard to strike. However, we want staffing ratios (that set a maximum number of patients a nurse can care for during a work shift) codified into the contract.”

Agas-Yuu said over the last three years, especially after COVID, staffing shortages have resulted in mandatory overtime, which is not good for nurses or their patients.

“In the time of a crucial period, they’ll do (the overtime). But day and night in and out it’s too much,” she said.

Unionized nurses at Kapi‘olani walked off the job and hit the picket line this morning to start the weeklong strike after their union and hospital management failed to come to a contract agreement.

Officials with the Hawaii Nurses’ Association, which represents about 600 nurses at Kapi‘olani, say the strike will last from 7 a.m. today through 6:59 a.m. Jan. 28.

“We just want people to come out and help support us,” Paulette Vasu, HNA treasurer and a labor and delivery nurse at Kapi‘olani, told the Honolulu Star-Advertiser Saturday. “The more people that come and support us, the better it’s going to be, and it’ll show management how loved we are, at least by the community. And hopefully, they’ll get the message that we are irreplaceable.”

Contract negotiations have been ongoing since September. Nurses contend they are stuck over the union’s demand for staffing ratios that set a maximum number of patients a nurse can care for during a work shift.

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On Jan. 10 and 11, Kapi‘olani presented what it said was its “last, best and final offer,” which included across-the-board raises and longevity pay but, according to HNA, did not address the staffing ratio concern. Hospital management says it offered staffing guidelines that strongly aligned with most of HNA’s proposals.

“We have offered staffing guidelines, which are different from the hard ratios that the union has proposed, and the difference is flexibility,” Gidget Ruscetta, Kapi‘olani’s chief operating officer, told the Star-Advertiser. “We strongly believe that we need the guidelines in place to allow us the flexibility to bring additional nurses in to provide the care that we need for our patients.”

Further negotiations are scheduled for Jan. 31 and Feb. 1. Ruscetta said that hospital management proposed these dates over a week ago, and that the union didn’t respond and agree to the dates until Friday.

“At this date, we are focused on providing patient care and providing uninterrupted quality care during the strike,” Ruscetta said. “We are hopeful that when we go back to the table on the 31st and Feb. 1, we will work towards an agreement so that we can continue to provide services as we always have.”

More than 90% of the unionized nurses at Kapi‘olani voted to authorize the strike on Jan. 5, and the union notified hospital management of the strike Jan. 10. The nurses have worked without a contract since Dec. 1.

Nurses plan to be present on the strike line from 7 a.m. to 8:30 p.m. today and 6 a.m. to 8:30 p.m. Monday through Saturday.

Star-Advertiser reporters Allison Schaefers and Kacie Yamamoto contributed to this report.