Recently retired Big Island RN checking in. If you see nurses in front of a hospital protesting staffing ratios and working conditions, find another hospital. Same advice to my fellow nurses, find a place that shares your commitment to patient care that pays enough. The younger me went through a strike to change things for the better for everyone, it didn't change much. What did change was finding places to work that took safe staff/patient ratios seriously as a matter of company culture. Care at Kapiolanil will not get better without a change in administrative attitudes or administrative staff.
I don’t believe there are any hospitals on Oahu with a perfect nurse/patient ratio. This is especially true post Covid with many nurses no longer doing bedside care or left the profession altogether.
@@FIRED13 I worked short term contracts at various places to find a good fit, tough if you are just getting started in your career but pretty easy once you are decade in. Contacts in nurse specialty organizations have really helped also.
Mahalo for sharing your perspective. Like I mentioned, it's going to take some time to heal these relationships, especially if this continues through October.
Thank you for the video and perspective. I do not live locally, so cannot comment on the specifics in Hawaii. However, as an RN of 45 years, I hope I can shed some light on the topic of nurse/patient ratios. Historically, many hospitals have high nurse/patient ratios- which is a cost savings for the hospital, but a potentially life-threatening situation for the patients. If nurses are required to carry a high patient load (let's say over 5 to 6 patients per shift depending on patient acuity), the patient will not receive the attention that may be critical to their health. Hospital patient acuity is high these days. The "sickest of the sick" are the only patients admitted to the hospital. Not like the "old days"! This is due to the high cost of hospitalization. Nurses literally run from patient to patient, task to task during their 8 to 12 hour shift. They are responsible for assessments, medication, wound care, communications with physicians, and many other important requirements. The pressure and requirements for patient care is immense. Remember, it is the nurse who is responsible for the recovery of the patient. The doctor may write orders, but it is the nurse who is constantly assessing the patient for health status changes day to day. It is a job that requires education, excellent skills and with lots of responsibility. I hope that helps.
Unfortunately the hospital’s primary responsibility is consistently increasing profits for shareholders. The “medical industry” is not health care anymore.
I get the nurse to patient ratio but you can't have it both ways. Less patients = Less work but they want that and more $$$. How do they expect that to work out from a business standpoint? The money has to come from somewhere. They also keep talking about the 12 hours shifts but they are only working 3 days! They aren't the only ones working 12 hr shifts and I doubt the other people working 12 hr shifts only have 3 day work weeks (doctors). Add on to that the talk about full family paid insurance from the company and now its getting ridiculous. I also find it funny how they hold up signs showing how much the CEO makes. Well I'm sorry to say nurses but none of them have a clue what it takes to be a CEO of a large company. You are always working. 7 days a week any hour of the day. While you might not see them at the work location, they are always working. People would never understand what it takes until they are in that position but unfortunately the union like to spin the idea to their members that management doesn't work and they just sit back and get paid $$$. That is so far from the truth.
@@LoveVanillaRose Since you seem to be making the same comment over and over, what is the solution? Pay them more, plus bring more nurses to the point where the hospital makes no money. You know what happens when the hospital makes no money? They close and then everyone doesn't have a job. Not sure how you think a hospital operates without making a profit.
@@808lublabs4 The solution: take a page out of Ayn Rand's _Atlas Shrugged:_ escape to Vegas and become a blackjack, poker, roulette, craps dealer. Then they can afford a family home and a good standard of living.
@@808lublabs4 not everyone works 3 days a week for 12 hour shifts. There are a lot of nurses like me who work 5 days a week with being on call during the after hours and weekends. But even with this junker schedule we still wouldn’t go back to the 3 12 hr shifts if it means going back to bedside. Because no amount of money is worth being a bedside nurse nowadays. You should try it and find out.
My mother recently passed away and spent a lot of time in and out of the hospital for the last years of her life. It was incredibly clear that the staff and nurses were kind, compassionate, hardworking, dedicated people. But it was also clear that they could not give my mother the level of care they or we would have felt appropriate. This was out of the nurses and fellow workers control. They were not staffed in a manner sufficient for the care they wanted to give their patients. This was not the fault of the staff. The staff cannot pay out of their pocket for outside help. How easy it is for so many Americans to expect nurses and hospital staff to gird their loins and give the care expected as if the staff are angels who can live off mana from heaven. Take away the pay issues, hospital staff cannot sustain a life of stress and exhaustion, this shortens the amount of years someone will continue to be a hospital worker. It’s also easy to demonize workers who need more in order to save lives and/or improve the quality of our lives to the standards westerners have from their hospitals. Why when our life saving workers need more to do their job is the work Marxism even in the same conversation (just sayin). Food for thought…..
The issue here isn’t as simple as it may seem. Ratios vary according to the acuity of the patient. A critically-ill, unstable patient who requires constant adjustments should be a 1:1 ratio. If they are critically ill but fairly stable it’s a 2:1 ratio. Not critically ill but requiring a lot of hands-on (babies in the nursery, for instance) 3-4:1, and regular , uncomplicated pediatric patients can usually safely be 5:1 unless they are getting chemo or blood transfusions for example. So the question of ratios doesn’t have a simple answer. My guidelines above come from my many years of personal experience as a pediatric/NICU/PICU nurse and former Kapi’olani employee. Safe patient ratios are a hill most nurses are willing to die on because we know (and studies back this up) that it is critical to patient safety.
As a former patient, I agree to there being a nurse to patient ratio. One nurse can only do so much until things are missed and the patient suffers. Or worse yet, dies. Hospital bills are incredibly high. Can't the hospital afford more nurses? Long waits at ER. Waiting for care once admitted. From a business standpoint the hospital should want patients to be helped and satisfied with their care. That way they will tell others how the hospital helped them. Nobody wants to be in a hospital but being in a hospital with too few nurses or nurses aides is hard on the patient as well as the nurse.
I've been a patient and had family in the hospital more times than I care to follow up on. The patient/nurse ratio might is mentioned but is the ratio standard for all departments? It's a statement that isn't clarified by the nurse's unions as wards and patients vary. I've sat with my family member who was incapacitated in bed, but I could hear non-stop hollering from a patient constantly, while my family member suffered and waited for a long time, buzzing for their nurse or aide. Some can't even call because they are so wired up, medicated, monitored that they weren't even conscious. A daytime shift versus a night shift might be more active as PT/OT, visitors, doctors come in more on one versus the other. When the data is provided to the public by the union & management, citing the ratio makes a difference. Saying the ratio is off, it is like saying one size fits all, is vague, depending on the weight, height, age of the wearer. If the union wants longer work hours, so they have more time off while asking for higher pay, why would the management add more workers when the union wanted longer hours and higher pay? Reducing staffing seems like a budgetary solution that management needed for the higher wages. I've worked long shifts during physical labor, and I know how much my body can take physically and mentally, and if the old 8 hours a day, was a threshold for work that I got 1 hr lunch and 2 breaks of 15 minutes by Federal standards, what is a three-day work week putting in? I got paid 8 hours but worked only 6.5 hours of actual work. If the nurses are putting in a 12-hour day, is that an hour lunch and 3 breaks of 15 minutes? That would be 10 hours and 15 minutes per workday.
I understand all of the points you make from an HR standpoint. I want to speak from a patient standpoint as my husband was a patient at Queens when they struck. It was dramatic as the hospital nurses all left the hospital by the back doors and contract nurses came in the front door or vice versa. It’s stunningly silent in the hospital as change started a new nurses introduced to us. Omg the nurse we had counted on to help him survive leukemia was gone…what next. Fortunately the traveling nurse was excellent and gave good care. But it was scary for the patients…and it was not spur of the moment…it was a well planned out event. I’m sending support for the patients and nurses.
Mahalo for sharing your experience and what it was like at Queen's. It's a good point that often the patients are the ones most directly impacted by all that is going on.
Based on the interviews I saw on TV news, the nurses said it wasn't about the pay but about nurse/patient ratios. So the nurses are asking for the hospital to hire more nurses to reduce this ratio. We already know that Hawaii has a shortage of nurses so the union is negotiating for something the hospital can not fulfill. It is difficult to recruiting mainland nurses because of the high cost of living here in Hawaii. This is the same for other professions like teachers, doctors, police, etc. My question is what has the nurse's union tried to do to increase the number of nurses in Hawaii? Is the union helping solve the problem that their members are facing with the nurse/patient ratio? Are they encouraging high school students to go into nursing? Are they providing scholarships or loans for nursing students? Is the union trying to solve the problem or is striking their solution?
Recruit nurses from the Philippines, as is the case with many hospitals nationwide --- and internationally. They don't mind sharing an accommodation with many others to cut costs.
To answer the question about not having enough nurses in Hawaii, that is not true. There are 4 nursing programs on Oahu, one each on Maui and Big Island. The hospitals need to have a solid new grad program to set the nurses up for success.
@@user-l4y7r04wy6ivnurses that work in the USA must pass the nursing licensure exam. There are many Filipino RN’s working as nurse aide as a result of not passing nursing board exam.
That's a great point you bring up. I'd hope that the nurses union puts resources to recruiting prospective nurses and encouraging them to enter the field. I believe there are some public high schools that have nursing program pipelines through UH. Not sure how much union involvement there is.
@@elainesalvador8011 Yes, there are nursing programs in the state but still there are not enough nurses. This is not unique to Hawaii. According to the Hawaii State Center for Nursing | 2023 Workforce Supply Statewide Report, the current state of the RN workforce is considerably improved as compared to 2021, the U.S. Health Resources and Services Administration (HRSA) projects that in 2024, Hawai‘i will have about 70% of the RNs it needs to meet healthcare demand. According to the US Bureau of Labor Statistics Hawaii ranks 39th in the RN to State population ratio and is below the national average ratio. Hawaii Department of Labor and Industrial Relations reports a shortage of RNs in Hawaii. Hawaii Healthcare Workforce Initiative 2022 Report indicates 3,873 open non-physician healthcare position of which 999 were unfilled RN positions.
In the state of Victoria, Australia, our "legal" nurse-to-patient ratio is 1:4. In more acute wards (eg hematology etc) it could be 1:2-3. And in ICU, it's 1:1. What we have in Victoria, and even in the other states of Australia, there is only one unified union in each state. Being unified within a state is stronger.
I have family members and friends in the medical field, I hear the frustrations. I see the exhaustion, and stress of their patient load. It’s hurts me to see them like that after a 12 sometimes 16 hour shift knowing a persons life is literally in their hands. Making sure there no med errors is stressful as is! Let alone and god forbid a code. This just one of the many reasons why I feel nurses deserve what they are asking for.
Unfortunately the hospital’s primary responsibility is consistently increasing profits for shareholders. The “medical industry” is not health care anymore.
I, as well echo the comment from Sharon. I am a 25 year veteran as a nurse in the health care profession. I am also an Adjunct Professor of a school of nursing here in California. I also have a RN license for Hawaii. Us RN's fought long and hard for Ratios that are now Law here and we take great pride in safe patient care that we provide, and our patients appreciate it. Those of us that have sought out post graduate education spent $30 to $100k doing so. Our patients gain from this acquired knowledge. We also are required to pay the cost back, and more often than not, without any assistance from the institution that employs us. So yes, we would like to be compensated adequately to pay off our loans and put food on our families table. Currently Southern California cost of living is close to those in Hawaii. So we feel your pain. Compenate where compensation is due. This polarizing issue has, and always will be, reflective in the angst of the players.
Mahalo for putting up these video perspectives 🤙🏾I worked under a Union at the hotels, I have one bachelors degree from UH Manoa from TIM School, but im also in the military and im currently deployed, at this point, im not too confident with how things are and i have to do what i feel is best for my family...
Thanks for bringing up this difficult topic. I’m no expert in this area but I do know there is a nursing shortage nationwide which directly impacts nurse:patient ratios. The pandemic further complicated matters, increasing burnout in our nurses causing many nurses to leave the labor market. The impasse at Kapiolani is just the starting point, the other hospitals are going to go through their negotiations after this contract is settled. It is understandable that the Union that represents the Kapiolani nurses is taking tactical positions that will affect negotiations with other hospitals. There are shortages of not only nurses but CNAs in other areas such as long term care that affect the care of our elderly. I hope that we can support all the parties at play until they find a solution. I think longer term, the healthcare industry is going to have to work with the government to address the shortage of workers in healthcare, especially as our population ages. It’s really a tough situation but I hope we can have Aloha for one another and especially the parties involved.
There will never be a reconciliation between the administration and the nurses. Nurses and hospital administration don’t get along in general. It’s not like hospital administrators actually come onto the floor to see what goes on. You’d probably never catch the ceo of HPH walking the floors of kapiolani. This is also just the beginning. The vast majority of bedside nurses across the United States are burnt out. The young nurses aren’t going to stay in the profession and eventually the baby boomers will all retire. When that happens good luck to us all.
I'd hope that that hospital culture you are describing starts to change for the better. As Hawaii's aging population grows, we'll need our health care system to be strong.
Oh even here in Tahiti it happens lot one day it's the hospital the other day it's the airline company😂😂that was interesting to hear your point of view and observations✨✨I wonder if our Pacific islands cousins are encountering the same issue✨✨that was a cool video thanks for sharing
It's hard to recover, there maybe residual resentment. Love how you think about how to rebuild the trust if they go back to work. Also how some nurses might jump ship to another hospital.❤
Mahalo for the comment. I think the aftermath of this situation is going to be tough if things don't get resolved soon. So I hope they can work on building trust in the long-term.
In these situations, nobody wins. Lost wages are gone, people loose faith in the systems. Lock outs are like covid, the longer it last, the more everyone looses. Thank you for sharing your thoughts.
Join a Union, Or Form a Union, Get fairly compensated. Simple. We are seeing massive profits in companies that pay some of the lowest salaries. Give these folks as much support as possible
This conflict between the Nurses and the Kapiolani Administration its a sign of a toxic work environment. Hospital administrations first duty is their financial bottom line. They staff the nurses for a "low patient census" not the average or high. When there are more patients are admitted, nurses are told to "temporarily" take more patients then they can safely handle. Nurse will do their best and administration will hope no patient suffers or dies. When things go okay the hospital administration makes this the norm. When the nurses are continually understaffed it becomes a "patient safety issue". Nurses worry about their patients and their nursing license and administration worry about money. The nurses are the touch point of patient care in the hospital. When they are unhappy, overworked, underpaid and unappreciated then moral goes down. They are not being treated as professional but as just employees. Nurses are rightfully unwilling to do extra for a job they resent. It is a downward spiral; a toxic environment. The hospital reputation goes down. Less patients. Less money for Administration. The Hospital administration cuts more corners. The administration will give extra lunch or employee classes on how to be happy at work. But the real source of the problem has not been fixed. The administration has burnt out their nurses. It will take top down changes to stop this downward spiral.
Mahalo for the comment. I do think that after this situation, it will take time to heal those relationships. And maybe it will never truly be healed, but I hope that for the sake of the patients, the work environment can improve.
@@HelloFromHawaii I was the Medical Director at different Hospitals of several NICUs during my career 40 year career. The primary issue is the leadership’s toxic management style. I’ve seen this many times. The hospital will “never” improve until Kapiolani Board of Directors brings in a whole new Administration and nursing administration. The beside nurses are not the problem. The Administration needs to respect value and treat their nurses as professionals. The administration has forgotten that the are nurses are the heart of the Hospital. Administration go into a cycle of burn out nurses continually replacing them. The Administration may win this battle but it cannot win the War. Administration is completely out of touch and has created an adversarial and deep seated resentment that can only be fixed by replacing them. The Administrators no longer truly consider “patient safety” as their primary tenet. It’s all talk. The local population must support the nurses 100%. As an aside, Find out how much the administrators makes before you judge the nurses.
Hey Chris, I’m part of the union. There was a federal mediator in multiple bargaining sessions, which unfortunately did not help with finding common ground.
You are correct that nurses are focusing on wanting set staffing ratios. Nurses at Kapi’olani have told me they are getting double the amount of patients they should be given. NICU should be 1-2 per nurse. They have been getting 4 at times. This is very unsafe and should not be allowed. This is unfortunately becoming a common occurrence. At my hospital, we would sometimes be given an additional 1-2 patients (so a total of 5 or 6) on a step down unit, which should be 3-4. This on top of charge nurse duties and helping new graduate nurses. And nurses are asked too often to stay 4 hours extra (16 total hours) because we are short. It’s too much. I’ve left bedside full time. I’m now doing it part time because of the mental toll it took on me. It’s sad because I love taking care of patients. But it’s not safe anymore. It’s expected to be short and work extra. And if something goes wrong, then it’s always the nurses to blame. Seldom is it the unsafe working conditions that are taken into account.
Dont know what to say or what the solutions is, except everyone loses in these situations - the companies, the workers (both striking and non-striking) , and of course, the patients. Prayers go out to my Hawaiian friends that all parties settle sooner rather than later, and as fairly as possible.
Watching this 1 week later while watching nurses getting arrested on Hawaii News now. Bra, that escalated pretty quickly. But to be honest $137K for a 36hrs a week shift is very nice, if you want to get paid that well you must work that fast and well too. If fast paced job is not your thing you should consider working somewhere else, like in a senior health center, paid around $80K but is way more mellow. I know Hawaii is expensive, but you have to be realistic with your life style too.
I was an HNA union rep and I agree it requires diplomacy on both sides. The lockout is the epitome of a very hostile ,back stabbing g work environment at HPH
Thank you for the video! This is a complicated situation. You brought up a Great point. When push comes to shove, will the Union be there to defend when people drop off/ leave? At the same time, Unions are needed to protect Workers from unfair practices
Nurses striking is a very common thing over here on the mainland so it isn't too far out of the ordinary. Nurse to patient ratios are a problem in every state as well as not enough nurses to fill the void. The problem with Hawaii is that it is super expensive to live and the wages aren't up to the standards as what a nurse (let's say) in California with a similar cost of living makes. Nurses in Cali can easily make 200K per year (especially in the Bay area). There are many nurses willing to work in Hawaii but it is very hard to come out ahead. I know this is a problem for most people on Hawaii though.. The locals need to welcome us as well. There are a lot of locals not welcoming outsiders to the islands, even if it is to help. My husband and I are RNs and have been to Hawaii twice to work as travel RNs and that is our experience. Also, they may get more temp workers if they raise the rates for temp workers. Temp workers make significantly less than the staff workers, but they still get people to come over to the islands because it's "Hawaii"
You’re missing the point and so are the other “experts” posting here. It has nothing to do with the money. The nurses at kapiolani are pediatric nurses and yes it makes a difference. I see others in the comment section saying hire anyone… trust me, you don’t want just anyone. Our first born was at kapiolani and we had complications and had to go to the NICU. Guess what, we had two nurses who were traveling nurses and they messed up big time and almost resulted in tragedy. They kept saying oh we never saw this machine at our hospital, oh I don’t know how to do this, I don’t know why the bleeding won’t stop, etc. We had to call our doctor to come in and DEMAND the proper care. It was the most frightening experience of our lives. We ended up having our 2nd one at queens and they were so much better staffed.
They keep saying, "It has nothing to do with the money." So if this true, then are the nurses willing to prove that "it's not about the money?" Are they willing to take a pay cut if the hospital agrees to improve staffing and nurse-to-patient ratio? I highly doubt they would be willing to take a pay cut, and if they're not, then IT IS about the money, right??
Mahalo for sharing. Sorry to hear about what happened in the NICU. Like I mentioned, we had a great experience at Kaiser, but I know how stressful it can be with a newborn.
@@user-sg8kq7ii3yNot right in my opinion. Here’s my point of view, if your hospital pays considerably less than other hospitals - potential new staff are attracted to the other hospitals (and we can’t really blame them, think about student loans and years of living poor through school, or debt for other reasons). Or say the other hospitals reward experience more. This results in potential or experienced staff going elsewhere, thus safe staffing becomes not possible. Pay has to be equitable for experienced and adequate staffing.
Pilau on the Kapiolani Hospital management! Shame on you guys! You guys don't care about your patients. I can't believe that the nurses gotta strike just to take care of your patients with enough care. Like the nurses were saying, it's not about the pay, but to ensure that there's enough nurses to take care of the patients.
I can't stress how bad an idea it is to upset your nursing staff. The hospital might see them as replaceable but that couldn't be farther from the truth. A veteran nurse is the most valuable asset on the team. Making those veterans think about leaving will lead to a HUGE drop in the quality of care. If the public doesn't stand with the nurses and force the hospitals to support their frontline workers I'm afraid we the public will reap what we sow.
Unfortunately the hospital’s primary responsibility is consistently increasing profits for shareholders. The “medical industry” is not in the business of quality health care anymore.
I agree that the nursing staff is the backbone of a hospital, at least based on our experience in the maternity ward at Kaiser. So many great nurses who helped us. (Doctors were great too 😄)
If Kapiolani = parent and Nurse's Union = teen, it's important to recognize that a parent can be wrong. There's a reason so many people go to therapy for childhood trauma, and "hurt people hurt people." So if the people of the island really insist it's about $ despite having clearly recognized it's about work conditions, then get ready to suffer as a patient if you don't side with the nurses. Advocating for better work conditions is advocating for better patient care simultaneously.
Unfortunately the hospital’s primary responsibility is consistently increasing profits for shareholders. The “medical industry” is not health care anymore.
@@LoveVanillaRose I know that, and increasingly more Americans are realizing that fact as well. Hence the importance of unions, as jaded as some may be in Hawaii due to the islands' special brand of politics. In this case particularly, I would definitely side with the nurses when they're saying "work conditions!" Which new mother wants her newborn, possibly a preemie, given subpar care by an overworked nurse, in the name of shareholder value add? These past two years have been the Return of Solidarity, and it would be sad if people don't lend their support and pressure Kapiolani.
@@HelloFromHawaii It's also my reality and struggle as a parent to a pubescent child, argh! Still worth it to try and get it right! And when we don't, to try and make it right!
Hospital doing a lockout b/c they don’t want to be strung along w/nurses doing 1 day strikes here & there. Union leaders should have told members: once you walk off your job, employers can respond with a lockout & use replacement workers. And you don’t get back your job until the hospital relents or the union negotiates at the bargaining table.
I think the nurses knew about the lockout and knew what they were getting into. Not sure if they believed the admin would go through with it, but they did. So I hope the negotiations continue.
When lingle was in office teacher strike was terrible 4 day weeks and furloughs. I worked for the Honolulu advertiser and our union didn’t do much but take our money so I know how it was being laidoff
In today's Hospitals the RNs & LPNs spend most of their time charting. Most of the patient care actually done under the nurses direction by the PCAs & aides who spend the most time with the patients. A patient rarely sees a nurse (RN), except for giving them medication, IV care or a dressing change.
Let’s help the public to understand this. Nurses want better rn/patient ratio which means needing to hire more nurses. At the same time nurses want pay raises. So that means nurses want everything at the end. How does that help hospitals when their revenues are dictated by pbm, Medicaid and medicare. Seems like nursing greed.
It's a tough situation. And I think that's why they may need outside counsel to help. If the hospital is putting its foot down, the union will have the pressure to act.
Maybe there needs to be more help but not necessarily RN, but helpers - IDK but health care also needs to be affordable- surely there’s a wow-win solution.
I retired a couple of years ago and politics are always at play from within the Union and hospitals. Most of the work is from direct patient care. Hospitals should hire more aides to take care of patient's physical needs such as taking them to the bathroom and cleaning them up from being incontinent then the RNs can do their paperwork and documentations. This will alleviate patient load. Unfortunately HNA doesn't have funds to help nurses when on a strike unlike Local 5. I haven't heard an Ombudsman in play which is usually brought in a stalemate situation. HNA tooks a gamble thinking Kap will fold but found out they lost with their stragety. Kap is like any other business and are geared to profitability. Hope they get this resolved. BTW nurses from agencies are very capable of taking care of patients and most of them have extensive experience in taking care of women/children.
Mahalo for sharing. Bringing in an Ombudsman would be an interesting move. Not sure they could use Hawaii's Ombudsman, but maybe the Gov could loan him for this situation.
Kapiolani management will change their way of managing once they get sued by patient families. But they can't say that they weren't warned by the nurses. Then the onus is on the management team.
Here is an off-topic question for you. Thousands of native Hawaiians have keft Hawaii and found easier lives elsewhere. They have been replaced by even more people from the Mainland. Will Hawaii still be Hawaii without Hawaiians? Eventually, Hawaii will evolve to another resort like any other . The hokey hula dances and inauthentic luaus might continue but inly as a historic remnant of the indigenous people and culture.
It’s not quite that simple. Ratios vary according to the acuity of the patient. A critically-ill, unstable patient who requires constant adjustments should be a 1:1 ratio. If they are critically ill but fairly stable it’s a 2:1 ratio. Not critically ill but requiring a lot of hands-on (babies in the nursery, for instance) 3-4:1, and regular , uncomplicated pediatric patients can usually safely be 5:1 unless they are getting chemo or blood transfusions for example. So the question of ratios doesn’t have a simple answer. My guidelines above come from my many years of personal experience as a pediatric/NICU/PICU nurse and former Kapi’olani employee. Safe patient ratios are a hill most nurses are willing to die on because we know (and studies back this up) that it is critical to patient safety.
Ain’t nobody getting 160k/year. You gotta meet a lot of criteria to get that kinda pay. Probably gotta be a permanent night shift charge nurse that is on top of the clinical ladder
Is this really about the money or is it nursing/patient ratio. Having worked in the medical field, patient care is and should be the primary purpose. Sadly health care has become more of a business vs health care.
I think it shows how little they care about their patients if they treat their staff that way. If I own a medical facility I want the best and I will pay to keep the best. If they want budget workers they are going to be providing budget care. Shame on the management. They only care about one thing: money.
I think it's more complicated than just caring for patients. Health care in the US is a business, so there's financial aspects to it. While I may not agree with how things are run, I understand that that's how the industry is played in this country. Other counties may have it different.
Hawaiian nurses are paid more than every other state except California at an avg of $110,000 annually, my wife is nurse in Alaska and have a house on big island and she works there when we arent in Alaska, Hawaii nurses are just being babies, if you cant make it on $100k + then you need financial education
The nurse-to-patient ratio shouldn't be an issue. As a retired police officer, patrol in particular, the officer to public ratio is 100+ times higher than nurses. In my days, we had a good contract with pay but the working conditions still sucked...but we dealt with it. I understand the nurse's concerns, but you have to look at it both ways. Management has responsibility, not only to nurses, but also the public in need of medical attention. Hospitals are in dire need of more nurse, whether be NP, RN or LPNs, but they are hard to find.
Good point- nurses are hard to find. Many are retiring or switching to other professions due to the working conditions. Why is it hard to find replacements? The same reason nurses are leaving...
Mahalo for the comment. Great point at looking at it from management's perspective. I've been trying to do that as I've watched this situation unfold. Not an easy situation for either side.
Reading what you just wrote….”working conditions still sucked…but we DEALT with it.” You don’t have to deal with it. That’s the whole point. You have a voice! That’s the problem people say I just have to “deal with it.” Until you get replaced with someone cheaper when you get injured, burned out when your overstaffed etc.
As a Manager at Hilton Hawaiian Village we will soon have the second strike sometime this week. I was telling our team and HR that Hilton should also do a LOCKOUT! I always say the union has an entitled approach and they bully a lot, it’s sad that employees spit on the company they work for! 😔
you guys can really handle one lockout and just hire random people outside to handle your guys operations? I'm asking this Respectfully as someone who get one bachelor degree from TIM/UH Manoa, I never got into management as I decided to go another career field but one lockout not gonna work for the hotels...
People deserve a living wage! I’m a new doctor here in Hawaii from the mainland and I can feel the extremely high cost of living here. I can only imagine how people making less are feeling!
Like I mentioned, I think other employers are watching this. Has a hotel ever done a lockout in the past here? Hope the situation at Hilton gets resolved. My dad has a conference at the Hilton next week 😄
The news isn't even covering the lockout part. What does that say about the media? The unions already have their own attorneys, they are not going to go outside to retain extremely high costing law firms. They thought the hospital was bluffing, and they got called. To end the lockout, the union should just say no raise, but they want the working conditions improved. $160,000 a year is a hell of a lot of money for Hawaii, and working 3 twelve hour shift isn't that bad.
Not all RN's are the same. The traveling nurses may or may not be good in the area they are placed in. A nurse who has worked primarily with pediatrics is unfamiliar with adult medication and dosages. Patients can be harmed because of this.
The nurse union overplayed their hand. The contract on the table would make them the highest paid nurses in the state, at 133k to 166k per year for working only three days a week. Nurses could easily pick up another one or two days and increase their income DRASTICALLY. Hawaii Pacific Health isnt a great company ( I personally think they are horrid) but the nurses are greedy AF too and honestly, they should all be fired and let HPH hire new nurses who are willing and able to do the job.
It seems like a good wage schedule. To me, if the priority is patient ratios and not pay, negotiations could focus more on finding a balance with better ratios and less pay.
@@HelloFromHawaii Non negotiable. If contracts start talking about patient ratios than it opens up all other health care centers in the state to have those included. If the nurses truly care about patients; than the hospital can word it into something like "minimum staffing levels" rather than call it patient ratios; and cut pay by 25% and hire more nurses.
My mom was a rn for 40 years and my sister is a NP. 150k for 3 days with those ratios are fair. One or two days over time per week, that's 200k plus benefits. All they have to do is hire mainlander RNs. More costs from RNs means higher hospital costs. If it's about the ratios, reduce pay 25k a year and hire more Rns. Problem solved. Bi weekly schedule. 3 days in, 4 days out. 4 days in, 3 days out. Graveyard shifts should get paid 12.5k more per year. Cut the bottom 20% of performers and trouble makers and get new Rns in. Give over time to the hard workers that don't complain. That is what I would do. Entitlement is a disease.
@77mkg Understood. I'm a real estate appraiser. Fees dropped by 40%. Deal with it. We have been overwhelmed numerous times in boom cycles. Deal with it. We worked 7 days a week, week after week before. Don't complain. 150k plus benefits is great.
@fookbia8875 that's not the point they're trying to make. They'd rather have more staff than more money so they can give the care to patients. It's not always about money.
If the sticking point the nurse to patient ratio then the nurses union should disclose to the public what the ratio they want ands what Kapiolani offered and take a pay cut to help meet that ratio because it means you need to hire more staff and if you raise the pay rate and just have 3 days of work then you need it balance it out. Most people in Hawaii don’t get the joys of only 3 days work for 130-160k a year. Didn’t the news say before that most of Hawaii is average couple making 90k??? That’s an average couple and not a single person and that’s working 5 days or more per week.
It’s not quite that simple. Ratios vary according to the acuity of the patient. A critically-ill, unstable patient who requires constant adjustments should be a 1:1 ratio. If they are critically ill but fairly stable it’s a 2:1 ratio. Not critically ill but requiring a lot of hands-on (babies in the nursery, for instance) 3-4:1, and regular , uncomplicated pediatric patients can usually safely be 5:1 unless they are getting chemo or blood transfusions for example. So the question of ratios doesn’t have a simple answer. My guidelines above come from my many years of personal experience as a pediatric/NICU/PICU nurse and former Kapi’olani employee. Safe patient ratios are a hill most nurses are willing to die on because we know (and studies back this up) that it is critical to patient safety.
@@FreshEclecticism if the union is going to argue for ratios then there needs to be some line to be drawn. You can always go with hypothetical situations. But you still need to put a number down to work with. If not you keep moving the goal post. No one likes on call scheduling. If it’s a contract negotiations you are dealing with numbers that are written and signed by lawyers and management. The public deserves to know what are these goal posts that the management and unions claim. Right now the public is pissed off at the unions because nurses are being offered salaries that majority of Hawaii don’t have. But that is only from the management side are saying that. All we heard from the news report is that the union said it’s not about pay. But the public doesn’t have the information on what does that mean and how it’s spelled out.
@@FreshEclecticism the union needs to disclose the information on what the demands are if they want to gain more traction from the public. The hospital was smart to throw out the information on pay and 3 days work. That really will drive a wedge in public perception. So the unions needs to do information educational. Those union leaders get paid nice paychecks so they need to work their assess off to get the nurses back their jobs.
@@oregonducI agree with you. By the way, nursing wages on the island are substantially lower than on the mainland, although the cost of living is substantially higher. This is why there is such a terrible nursing shortage in Hawai’i and it will continue until wages catch up to mainland wages or better. I definitely didn’t move here to get rich-I took a big pay cut and my expenses nearly doubled. I had to make some major lifestyle adjustments (I don’t make nearly what the Kapi’olani nurses do). But I’m here to serve the people of Hawai’i nonetheless and enjoy all the island has to offer…at least what parts of it I can afford.
Unions, public good/welfare, reliability and management are finicky points. If the strikers are a private owner, the public may/may not notice the strike due to lack of impact on the public's everyday life. When the sugar & pineapple workers wanted better wages/working conditions, the plantation owners broke up the strikes with violence, sometimes resulting in injury & death. When unions, returning WWII veterans, Democrats taking majority of State & Federal elected positions, it touched on government/private management of wages but also working conditions. The Longshore union strike in the 70's impacted the island wide economy, whereas a strike of Safeway, private business, and teachers are selective impact on the public, so they last longer. Back when the Air Traffic Controllers went on strike, the Federal government under Reagan, made it a point to terminate those striking Controllers unions. When the HPD, FD, UPW, State, if they strike, it's not for just one day, as it will impact longer than one day. It's major when the majority of the public is impacted. Working conditions, such as ratio of workers impacts safety of workers, and clients. If the management sees that too thin a staff impacts client's safety/stability, business operations and manpower, they might reflect on the numbers, which is a long term/statistical proof of impact. Lawsuits on failing patient care, shortages due to sick/annual/emergency leave reflect those number, ratings by consumers/patient on quality of care. Striking for one day is something that a manager/supervisor damages their perspective of the workers, like a tantrum from a infant, bad that day/forgotten the next. How would the coworker who didn't strike view the one who did? It increased their workload for that person, whether management, contract nurse or nonunion staff, then it's expected to be the same as before. When the next time for performance award/recognition/promotion/increase comes along, will the manager remember that action? I remember when coworkers deciding to unionize thought they could get a pension plan and take all the profit sharing that the company gave them (which at the time was 3x what they put in). They thought they could get their cake & eat it too. They unionized, but right after that everyone in that group of workers, union or not, had their profit-sharing assets frozen until they left the company, or the company decided which was several years. Like the ATC strikers being terminated, When the management says somethings, it's something to consider the impact, which in the long run, who will lose out and how many are willing to accept the consequences.
Mahalo for sharing some great historical examples of labor strikes in the past. And great point about the scale of a particular group's impact and how it relates to the length of the strike. 🤙
Some things should never have been privatized, healthcare is one of them. Once you make them based off of profitability there is no reason to keep anyone healthy. Back before it all became privatized we came up with public funded research and we got some amazing cures, now all we seem to get is chronic illnesses and some to me seem to be made up just to cash in. I do believe that if it was publicly run that we would have better outcomes for everyone. No bankruptcies because they charge to much staff appropriate for the patient size and no more doctors having to fit into the confines of the private health or should l say illness industry mandates. I hope the people in Hawaii. Stand w8th the nurse for better quality for the times you have to go to a healthcare institute.
Huh? Doctors in socialized medicine are overall competent but do not have an incentive to do more than the basics. Do you know how many Canadians cross the border for medical care? The Canadian government pays for that care also.
Interesting that you would pick canada instead of Sweden, Denmark, Norway or Finland. Canada has a unique system that is broken up into 13 provinces and even though they are all funded by the government they do not offer the same services in each province. I don't know why that is but some places take better care of you then others. I am not sure, but if it is anything like the states l am sure plenty of that could be the color of your skin. Universal Healthcare is not universally the same across the world. Some are much better then others but maybe we should pick one that doesn't work just so we can pretend the system the states has is working perfectly. I have had to deal with our system four 24 years and there are wait periods and denials all the time. I can't get the best service because l am not wealthy. We pay at least 3 times what people pay in some countries in Europe and they can see any doctor they want because they don't have a network of doctors that the insurance companies force on people living in the states. I think there is a better way and medicare for all could be a start. What good is a helathcare system if you can't access it. Sicko was a good watch.
@@briangarnier5714I do not live in Europe. I live in Michigan just across from Windsor. Henry Ford Health has a section of its website specifically for Canadians. There is a huge parking lot down the street from the main campus of Henry Ford that is always filled with cars with Canadian tags.
@@briangarnier5714 Thanks to Justin, Canada has become inundated and overwhelmed by Punjabis, et al, to the point where both locals and immigrants are fleeing the sinking ship.
Hawaii needs to leave the tourist city in the past and focus on hawaii first. Seriously,we should charge the tourism industry a massive tax and concentrate on hawaii
If you don’t like your job, go get a better one. Employees really have no right to tell an employer how to run their business, including how to pay or treat employees. You don’t like it… LEAVE!
Same here! What’s wild to me is that the audience only sees one side of this, the news nor people in favor of the union see the details to this bargaining/negotiating. I saw how pro union the media was without learning what was the fight about. Our housekeepers are making $28-$33 an hour and make even more when they choose to work overtime if the opportunity is there! The problem is they want $40+ an hour, there’s no way corporate will pay housekeepers more than managers etc. Unions fail to accept or realize that money is also going to maintaining buildings, paying for many other costs that are clearly blind to employees. Every business is entitled to their profit/portion. There is greed in most of these unions! Like you mentioned “go work somewhere else if you feel you’re not getting paid what you want.”
@@bentleyfonsworth9604 Sounds like someone who has never held a management position. If it’s so easy, anyone could do it. Hourly workers have no idea what it takes to be responsible for more than themselves. When you’re responsible for 100s or even 1000s of people under you, you wouldn’t think that management is expendable.
Sure, they can leave, but I do think employees should provide feedback, whether it's about working conditions or pay, from time to time. And yes, one can always leave.
Doctors make a lot more than that, doctors in Hawaii make about 20k a month. Also don’t believe what management tells you about wages, they always try to spin things to make it about pay to get the public on their side.
In the late 80’s in Honolulu, Kaiser Permanente employees were on strike for 6 months. I worked there after the strike, and asked the ladies who were on strike if it was worth it. They all replied it was not worth it. The Kaiser workers were part of the Local 5, the same union as the hotel people.
Hello hawaii , it's Kapi'olani not kapalani. 👑Queen Kapi'olani 🌺🤍. You are what locals call a Transplant local. Back in my days it was FOB. Fresh off the boat. 😂
Those replacement nurses you called "temporary workers" are SCABS. That's the part you forgot in this. The labor movement has advanced, in part, because SCABS were deterred, blocked, beaten up, threatened from replacing striking workers. Generally, there was solidarity with the labor movement. YOU DON'T CROSS PICKET LINES. Not as a customer, not as a "temporary worker." The names of those scabs should be taken down and broadcast. Shame them. The hospital's lockout is powerless without scabs.
@@HelloFromHawaii [I'm just now seeing this question]. Why does the patient care burden fall to the employees, the workers? Why not hospital management/owners? The point of any strike is to cause deprivation and inconvenience: that's because all workers have to leverage is our LABOR. Using scabs undercuts our leverage. We would have gained nothing without that leverage. The nurses aren't asking for the overthrow of capitalism. Their demands are reasonable, as anyone living in this state knows. They demand fairer contracts and better nurse/patient ratios - that's patient care.
Thae fact that Management can bring in nurses from where ever to take the place of the striking nurses defeats the purpose of a strike. Don't understand how Managment is allowed to do this. Makes no sense to me.
I’ll explain. They hired temporary work force because they need someone to take care of their patients in the hospital. Since 600 nurses are on the sidewalks striking and not working who will take care of the patients in the hospital? …. The temporary workforce. They didn’t want to do that but since negotiations didn’t go well, the nurses striked. Hence the temporary workforce was then trained and hired. They also got locked out because it was already explained to the nurses that if you don’t accept the generous offer they cant come back to work. Hope that helps you to understand.
Wow, did this situation take a few unexpected turns in recent days. Hope things get resolved soon.
Recently retired Big Island RN checking in. If you see nurses in front of a hospital protesting staffing ratios and working conditions, find another hospital. Same advice to my fellow nurses, find a place that shares your commitment to patient care that pays enough. The younger me went through a strike to change things for the better for everyone, it didn't change much. What did change was finding places to work that took safe staff/patient ratios seriously as a matter of company culture. Care at Kapiolanil will not get better without a change in administrative attitudes or administrative staff.
How do nurses find those hospitals committed to things that positively affect patient care such as staff-to-patient ratios ?
I don’t believe there are any hospitals on Oahu with a perfect nurse/patient ratio. This is especially true post Covid with many nurses no longer doing bedside care or left the profession altogether.
@@FIRED13 I worked short term contracts at various places to find a good fit, tough if you are just getting started in your career but pretty easy once you are decade in. Contacts in nurse specialty organizations have really helped also.
Mahalo for sharing your perspective. Like I mentioned, it's going to take some time to heal these relationships, especially if this continues through October.
Thank you for the video and perspective. I do not live locally, so cannot comment on the specifics in Hawaii. However, as an RN of 45 years, I hope I can shed some light on the topic of nurse/patient ratios. Historically, many hospitals have high nurse/patient ratios- which is a cost savings for the hospital, but a potentially life-threatening situation for the patients. If nurses are required to carry a high patient load (let's say over 5 to 6 patients per shift depending on patient acuity), the patient will not receive the attention that may be critical to their health. Hospital patient acuity is high these days. The "sickest of the sick" are the only patients admitted to the hospital. Not like the "old days"! This is due to the high cost of hospitalization. Nurses literally run from patient to patient, task to task during their 8 to 12 hour shift. They are responsible for assessments, medication, wound care, communications with physicians, and many other important requirements. The pressure and requirements for patient care is immense. Remember, it is the nurse who is responsible for the recovery of the patient. The doctor may write orders, but it is the nurse who is constantly assessing the patient for health status changes day to day. It is a job that requires education, excellent skills and with lots of responsibility. I hope that helps.
Unfortunately the hospital’s primary responsibility is consistently increasing profits for shareholders. The “medical industry” is not health care anymore.
I get the nurse to patient ratio but you can't have it both ways. Less patients = Less work but they want that and more $$$. How do they expect that to work out from a business standpoint? The money has to come from somewhere. They also keep talking about the 12 hours shifts but they are only working 3 days! They aren't the only ones working 12 hr shifts and I doubt the other people working 12 hr shifts only have 3 day work weeks (doctors). Add on to that the talk about full family paid insurance from the company and now its getting ridiculous. I also find it funny how they hold up signs showing how much the CEO makes. Well I'm sorry to say nurses but none of them have a clue what it takes to be a CEO of a large company. You are always working. 7 days a week any hour of the day. While you might not see them at the work location, they are always working. People would never understand what it takes until they are in that position but unfortunately the union like to spin the idea to their members that management doesn't work and they just sit back and get paid $$$. That is so far from the truth.
@@LoveVanillaRose Since you seem to be making the same comment over and over, what is the solution? Pay them more, plus bring more nurses to the point where the hospital makes no money. You know what happens when the hospital makes no money? They close and then everyone doesn't have a job. Not sure how you think a hospital operates without making a profit.
@@808lublabs4 The solution: take a page out of Ayn Rand's _Atlas Shrugged:_ escape to Vegas and become a blackjack, poker, roulette, craps dealer. Then they can afford a family home and a good standard of living.
@@808lublabs4 not everyone works 3 days a week for 12 hour shifts. There are a lot of nurses like me who work 5 days a week with being on call during the after hours and weekends. But even with this junker schedule we still wouldn’t go back to the 3 12 hr shifts if it means going back to bedside. Because no amount of money is worth being a bedside nurse nowadays. You should try it and find out.
My mother recently passed away and spent a lot of time in and out of the hospital for the last years of her life. It was incredibly clear that the staff and nurses were kind, compassionate, hardworking, dedicated people. But it was also clear that they could not give my mother the level of care they or we would have felt appropriate. This was out of the nurses and fellow workers control. They were not staffed in a manner sufficient for the care they wanted to give their patients. This was not the fault of the staff. The staff cannot pay out of their pocket for outside help.
How easy it is for so many Americans to expect nurses and hospital staff to gird their loins and give the care expected as if the staff are angels who can live off mana from heaven.
Take away the pay issues, hospital staff cannot sustain a life of stress and exhaustion, this shortens the amount of years someone will continue to be a hospital worker.
It’s also easy to demonize workers who need more in order to save lives and/or improve the quality of our lives to the standards westerners have from their hospitals.
Why when our life saving workers need more to do their job is the work Marxism even in the same conversation (just sayin).
Food for thought…..
Mahalo for sharing. Yes, the staff is incredible, even under tough working conditions. It's a systemic issue beyond just pay and ratios.
If only nurses are allowed to comment it’s gonna really jam up Mr Hawaii’s channel. Comments are what helps a channel to grow, good or bad.
😆 The comments are great. I try my best to respond if I can. At the very least, I'll see them all. The good and the bad. 🤙
The issue here isn’t as simple as it may seem. Ratios vary according to the acuity of the patient.
A critically-ill, unstable patient who requires constant adjustments should be a 1:1 ratio. If they are critically ill but fairly stable it’s a 2:1 ratio. Not critically ill but requiring a lot of hands-on (babies in the nursery, for instance) 3-4:1, and regular , uncomplicated pediatric patients can usually safely be 5:1 unless they are getting chemo or blood transfusions for example.
So the question of ratios doesn’t have a simple answer. My guidelines above come from my many years of personal experience as a pediatric/NICU/PICU nurse and former Kapi’olani employee. Safe patient ratios are a hill most nurses are willing to die on because we know (and studies back this up) that it is critical to patient safety.
As a former patient, I agree to there being a nurse to patient ratio. One nurse can only do so much until things are missed and the patient suffers. Or worse yet, dies.
Hospital bills are incredibly high. Can't the hospital afford more nurses? Long waits at ER. Waiting for care once admitted.
From a business standpoint the hospital should want patients to be helped and satisfied with their care. That way they will tell others how the hospital helped them. Nobody wants to be in a hospital but being in a hospital with too few nurses or nurses aides is hard on the patient as well as the nurse.
I've been a patient and had family in the hospital more times than I care to follow up on. The patient/nurse ratio might is mentioned but is the ratio standard for all departments? It's a statement that isn't clarified by the nurse's unions as wards and patients vary. I've sat with my family member who was incapacitated in bed, but I could hear non-stop hollering from a patient constantly, while my family member suffered and waited for a long time, buzzing for their nurse or aide. Some can't even call because they are so wired up, medicated, monitored that they weren't even conscious. A daytime shift versus a night shift might be more active as PT/OT, visitors, doctors come in more on one versus the other. When the data is provided to the public by the union & management, citing the ratio makes a difference. Saying the ratio is off, it is like saying one size fits all, is vague, depending on the weight, height, age of the wearer. If the union wants longer work hours, so they have more time off while asking for higher pay, why would the management add more workers when the union wanted longer hours and higher pay? Reducing staffing seems like a budgetary solution that management needed for the higher wages. I've worked long shifts during physical labor, and I know how much my body can take physically and mentally, and if the old 8 hours a day, was a threshold for work that I got 1 hr lunch and 2 breaks of 15 minutes by Federal standards, what is a three-day work week putting in? I got paid 8 hours but worked only 6.5 hours of actual work. If the nurses are putting in a 12-hour day, is that an hour lunch and 3 breaks of 15 minutes? That would be 10 hours and 15 minutes per workday.
Maybe the hospital will need to hire more nurses. Perhaps that's something that can be negotiated in the future.
I understand all of the points you make from an HR standpoint. I want to speak from a patient standpoint as my husband was a patient at Queens when they struck. It was dramatic as the hospital nurses all left the hospital by the back doors and contract nurses came in the front door or vice versa. It’s stunningly silent in the hospital as change started a new nurses introduced to us. Omg the nurse we had counted on to help him survive leukemia was gone…what next. Fortunately the traveling nurse was excellent and gave good care. But it was scary for the patients…and it was not spur of the moment…it was a well planned out event. I’m sending support for the patients and nurses.
Mahalo for sharing your experience and what it was like at Queen's. It's a good point that often the patients are the ones most directly impacted by all that is going on.
Based on the interviews I saw on TV news, the nurses said it wasn't about the pay but about nurse/patient ratios. So the nurses are asking for the hospital to hire more nurses to reduce this ratio. We already know that Hawaii has a shortage of nurses so the union is negotiating for something the hospital can not fulfill. It is difficult to recruiting mainland nurses because of the high cost of living here in Hawaii. This is the same for other professions like teachers, doctors, police, etc. My question is what has the nurse's union tried to do to increase the number of nurses in Hawaii? Is the union helping solve the problem that their members are facing with the nurse/patient ratio? Are they encouraging high school students to go into nursing? Are they providing scholarships or loans for nursing students? Is the union trying to solve the problem or is striking their solution?
Recruit nurses from the Philippines, as is the case with many hospitals nationwide --- and internationally. They don't mind sharing an accommodation with many others to cut costs.
To answer the question about not having enough nurses in Hawaii, that is not true. There are 4 nursing programs on Oahu, one each on Maui and Big Island. The hospitals need to have a solid new grad program to set the nurses up for success.
@@user-l4y7r04wy6ivnurses that work in the USA must pass the nursing licensure exam. There are many Filipino RN’s working as nurse aide as a result of not passing nursing board exam.
That's a great point you bring up. I'd hope that the nurses union puts resources to recruiting prospective nurses and encouraging them to enter the field. I believe there are some public high schools that have nursing program pipelines through UH. Not sure how much union involvement there is.
@@elainesalvador8011 Yes, there are nursing programs in the state but still there are not enough nurses. This is not unique to Hawaii.
According to the Hawaii State Center for Nursing | 2023 Workforce Supply Statewide Report, the current state of the RN workforce is considerably improved as compared to 2021, the U.S. Health Resources and Services Administration (HRSA) projects that in 2024, Hawai‘i will have about 70% of the RNs it needs to meet healthcare demand.
According to the US Bureau of Labor Statistics Hawaii ranks 39th in the RN to State population ratio and is below the national average ratio.
Hawaii Department of Labor and Industrial Relations reports a shortage of RNs in Hawaii.
Hawaii Healthcare Workforce Initiative 2022 Report indicates 3,873 open non-physician healthcare position of which 999 were unfilled RN positions.
In the state of Victoria, Australia, our "legal" nurse-to-patient ratio is 1:4. In more acute wards (eg hematology etc) it could be 1:2-3. And in ICU, it's 1:1.
What we have in Victoria, and even in the other states of Australia, there is only one unified union in each state. Being unified within a state is stronger.
Perhaps it might take legislation to codify our state's patient ratio.
I have family members and friends in the medical field, I hear the frustrations. I see the exhaustion, and stress of their patient load. It’s hurts me to see them like that after a 12 sometimes 16 hour shift knowing a persons life is literally in their hands.
Making sure there no med errors is stressful as is! Let alone and god forbid a code.
This just one of the many reasons why I feel nurses deserve what they are asking for.
Unfortunately the hospital’s primary responsibility is consistently increasing profits for shareholders. The “medical industry” is not health care anymore.
Mahalo for sharing. I can't imagine the exhaustion they must experience, even if they are working 3 days a week with 4 days off.
I, as well echo the comment from Sharon. I am a 25 year veteran as a nurse in the health care profession. I am also an Adjunct Professor of a school of nursing here in California. I also have a RN license for Hawaii. Us RN's fought long and hard for Ratios that are now Law here and we take great pride in safe patient care that we provide, and our patients appreciate it. Those of us that have sought out post graduate education spent $30 to $100k doing so. Our patients gain from this acquired knowledge. We also are required to pay the cost back, and more often than not, without any assistance from the institution that employs us. So yes, we would like to be compensated adequately to pay off our loans and put food on our families table. Currently Southern California cost of living is close to those in Hawaii. So we feel your pain. Compenate where compensation is due. This polarizing issue has, and always will be, reflective in the angst of the players.
Mahalo for putting up these video perspectives 🤙🏾I worked under a Union at the hotels, I have one bachelors degree from UH Manoa from TIM School, but im also in the military and im currently deployed, at this point, im not too confident with how things are and i have to do what i feel is best for my family...
Mahalo for sharing and serving. I heard good things about the TIM school at UH. Something you want to pursue after serving in the military?
Thanks for bringing up this difficult topic. I’m no expert in this area but I do know there is a nursing shortage nationwide which directly impacts nurse:patient ratios. The pandemic further complicated matters, increasing burnout in our nurses causing many nurses to leave the labor market. The impasse at Kapiolani is just the starting point, the other hospitals are going to go through their negotiations after this contract is settled. It is understandable that the Union that represents the Kapiolani nurses is taking tactical positions that will affect negotiations with other hospitals. There are shortages of not only nurses but CNAs in other areas such as long term care that affect the care of our elderly. I hope that we can support all the parties at play until they find a solution. I think longer term, the healthcare industry is going to have to work with the government to address the shortage of workers in healthcare, especially as our population ages. It’s really a tough situation but I hope we can have Aloha for one another and especially the parties involved.
There will never be a reconciliation between the administration and the nurses. Nurses and hospital administration don’t get along in general. It’s not like hospital administrators actually come onto the floor to see what goes on. You’d probably never catch the ceo of HPH walking the floors of kapiolani.
This is also just the beginning. The vast majority of bedside nurses across the United States are burnt out. The young nurses aren’t going to stay in the profession and eventually the baby boomers will all retire. When that happens good luck to us all.
I'd hope that that hospital culture you are describing starts to change for the better. As Hawaii's aging population grows, we'll need our health care system to be strong.
Oh even here in Tahiti it happens lot one day it's the hospital the other day it's the airline company😂😂that was interesting to hear your point of view and observations✨✨I wonder if our Pacific islands cousins are encountering the same issue✨✨that was a cool video thanks for sharing
Mahalo for sharing that it's happening in Tahiti as well. I suppose that's just labor relations in all places.
It's hard to recover, there maybe residual resentment. Love how you think about how to rebuild the trust if they go back to work. Also how some nurses might jump ship to another hospital.❤
Mahalo for the comment. I think the aftermath of this situation is going to be tough if things don't get resolved soon. So I hope they can work on building trust in the long-term.
In these situations, nobody wins. Lost wages are gone, people loose faith in the systems. Lock outs are like covid, the longer it last, the more everyone looses. Thank you for sharing your thoughts.
Mahalo for sharing 🤙
Join a Union,
Or Form a Union,
Get fairly compensated. Simple.
We are seeing massive profits in companies that pay some of the lowest salaries.
Give these folks as much support as possible
Yikes, good luck gang 🤙 i wish the best for you all.
🤙
This conflict between the Nurses and the Kapiolani Administration its a sign of a toxic work environment. Hospital administrations first duty is their financial bottom line. They staff the nurses for a "low patient census" not the average or high. When there are more patients are admitted, nurses are told to "temporarily" take more patients then they can safely handle. Nurse will do their best and administration will hope no patient suffers or dies. When things go okay the hospital administration makes this the norm. When the nurses are continually understaffed it becomes a "patient safety issue". Nurses worry about their patients and their nursing license and administration worry about money. The nurses are the touch point of patient care in the hospital. When they are unhappy, overworked, underpaid and unappreciated then moral goes down. They are not being treated as professional but as just employees. Nurses are rightfully unwilling to do extra for a job they resent. It is a downward spiral; a toxic environment. The hospital reputation goes down. Less patients. Less money for Administration. The Hospital administration cuts more corners. The administration will give extra lunch or employee classes on how to be happy at work. But the real source of the problem has not been fixed. The administration has burnt out their nurses. It will take top down changes to stop this downward spiral.
Mahalo for the comment. I do think that after this situation, it will take time to heal those relationships. And maybe it will never truly be healed, but I hope that for the sake of the patients, the work environment can improve.
@@HelloFromHawaii I was the Medical Director at different Hospitals of several NICUs during my career 40 year career. The primary issue is the leadership’s toxic management style. I’ve seen this many times. The hospital will “never” improve until Kapiolani Board of Directors brings in a whole new Administration and nursing administration. The beside nurses are not the problem. The Administration needs to respect value and treat their nurses as professionals. The administration has forgotten that the are nurses are the heart of the Hospital. Administration go into a cycle of burn out nurses continually replacing them. The Administration may win this battle but it cannot win the War. Administration is completely out of touch and has created an adversarial and deep seated resentment that can only be fixed by replacing them. The Administrators no longer truly consider “patient safety” as their primary tenet. It’s all talk. The local population must support the nurses 100%. As an aside, Find out how much the administrators makes before you judge the nurses.
Pretty insightful thought.
Mahalo 🤙
Hey Chris, I’m part of the union. There was a federal mediator in multiple bargaining sessions, which unfortunately did not help with finding common ground.
You are correct that nurses are focusing on wanting set staffing ratios. Nurses at Kapi’olani have told me they are getting double the amount of patients they should be given. NICU should be 1-2 per nurse. They have been getting 4 at times. This is very unsafe and should not be allowed. This is unfortunately becoming a common occurrence.
At my hospital, we would sometimes be given an additional 1-2 patients (so a total of 5 or 6) on a step down unit, which should be 3-4. This on top of charge nurse duties and helping new graduate nurses. And nurses are asked too often to stay 4 hours extra (16 total hours) because we are short. It’s too much.
I’ve left bedside full time. I’m now doing it part time because of the mental toll it took on me. It’s sad because I love taking care of patients. But it’s not safe anymore. It’s expected to be short and work extra. And if something goes wrong, then it’s always the nurses to blame. Seldom is it the unsafe working conditions that are taken into account.
Mahalo for sharing. Glad to hear that there was a federal mediator. I hope that working conditions improve with whatever the outcome is.
Dont know what to say or what the solutions is, except everyone loses in these situations - the companies, the workers (both striking and non-striking) , and of course, the patients.
Prayers go out to my Hawaiian friends that all parties settle sooner rather than later, and as fairly as possible.
🤙
Watching this 1 week later while watching nurses getting arrested on Hawaii News now. Bra, that escalated pretty quickly.
But to be honest $137K for a 36hrs a week shift is very nice, if you want to get paid that well you must work that fast and well too. If fast paced job is not your thing you should consider working somewhere else, like in a senior health center, paid around $80K but is way more mellow. I know Hawaii is expensive, but you have to be realistic with your life style too.
I was an HNA union rep and I agree it requires diplomacy on both sides. The lockout is the epitome of a very hostile ,back stabbing g work environment at HPH
Thank you for the video! This is a complicated situation. You brought up a Great point. When push comes to shove, will the Union be there to defend when people drop off/ leave? At the same time, Unions are needed to protect Workers from unfair practices
It's a tough situation. In the end, I hope that the work environment improves and that resentment can left outside so it doesn't affect the patients.
My heart is broken for the babies who are left without the seasoned nurses who are familiar with their needs.
Nurses striking is a very common thing over here on the mainland so it isn't too far out of the ordinary. Nurse to patient ratios are a problem in every state as well as not enough nurses to fill the void. The problem with Hawaii is that it is super expensive to live and the wages aren't up to the standards as what a nurse (let's say) in California with a similar cost of living makes. Nurses in Cali can easily make 200K per year (especially in the Bay area). There are many nurses willing to work in Hawaii but it is very hard to come out ahead. I know this is a problem for most people on Hawaii though.. The locals need to welcome us as well. There are a lot of locals not welcoming outsiders to the islands, even if it is to help. My husband and I are RNs and have been to Hawaii twice to work as travel RNs and that is our experience. Also, they may get more temp workers if they raise the rates for temp workers. Temp workers make significantly less than the staff workers, but they still get people to come over to the islands because it's "Hawaii"
You’re missing the point and so are the other “experts” posting here. It has nothing to do with the money. The nurses at kapiolani are pediatric nurses and yes it makes a difference. I see others in the comment section saying hire anyone… trust me, you don’t want just anyone. Our first born was at kapiolani and we had complications and had to go to the NICU. Guess what, we had two nurses who were traveling nurses and they messed up big time and almost resulted in tragedy. They kept saying oh we never saw this machine at our hospital, oh I don’t know how to do this, I don’t know why the bleeding won’t stop, etc. We had to call our doctor to come in and DEMAND the proper care. It was the most frightening experience of our lives. We ended up having our 2nd one at queens and they were so much better staffed.
They keep saying, "It has nothing to do with the money." So if this true, then are the nurses willing to prove that "it's not about the money?" Are they willing to take a pay cut if the hospital agrees to improve staffing and nurse-to-patient ratio? I highly doubt they would be willing to take a pay cut, and if they're not, then IT IS about the money, right??
Mahalo for sharing. Sorry to hear about what happened in the NICU. Like I mentioned, we had a great experience at Kaiser, but I know how stressful it can be with a newborn.
Anecdotal evidence is anecdotal.
@@user-sg8kq7ii3yNot right in my opinion. Here’s my point of view, if your hospital pays considerably less than other hospitals - potential new staff are attracted to the other hospitals (and we can’t really blame them, think about student loans and years of living poor through school, or debt for other reasons). Or say the other hospitals reward experience more. This results in potential or experienced staff going elsewhere, thus safe staffing becomes not possible. Pay has to be equitable for experienced and adequate staffing.
Pilau on the Kapiolani Hospital management! Shame on you guys! You guys don't care about your patients. I can't believe that the nurses gotta strike just to take care of your patients with enough care. Like the nurses were saying, it's not about the pay, but to ensure that there's enough nurses to take care of the patients.
OMG..I used to work with Rosalee (Rose) at Kapiolani. Fantastic nurse.
🤙
I can't stress how bad an idea it is to upset your nursing staff. The hospital might see them as replaceable but that couldn't be farther from the truth. A veteran nurse is the most valuable asset on the team. Making those veterans think about leaving will lead to a HUGE drop in the quality of care. If the public doesn't stand with the nurses and force the hospitals to support their frontline workers I'm afraid we the public will reap what we sow.
Unfortunately the hospital’s primary responsibility is consistently increasing profits for shareholders. The “medical industry” is not in the business of quality health care anymore.
I agree that the nursing staff is the backbone of a hospital, at least based on our experience in the maternity ward at Kaiser. So many great nurses who helped us. (Doctors were great too 😄)
If Kapiolani = parent and Nurse's Union = teen, it's important to recognize that a parent can be wrong. There's a reason so many people go to therapy for childhood trauma, and "hurt people hurt people." So if the people of the island really insist it's about $ despite having clearly recognized it's about work conditions, then get ready to suffer as a patient if you don't side with the nurses. Advocating for better work conditions is advocating for better patient care simultaneously.
Unfortunately the hospital’s primary responsibility is consistently increasing profits for shareholders. The “medical industry” is not health care anymore.
@@LoveVanillaRose I know that, and increasingly more Americans are realizing that fact as well. Hence the importance of unions, as jaded as some may be in Hawaii due to the islands' special brand of politics. In this case particularly, I would definitely side with the nurses when they're saying "work conditions!" Which new mother wants her newborn, possibly a preemie, given subpar care by an overworked nurse, in the name of shareholder value add? These past two years have been the Return of Solidarity, and it would be sad if people don't lend their support and pressure Kapiolani.
Mahalo for the comment. It's true what you said. Parents can be wrong sometimes. I'm learning that as a young parent. 😅
@@HelloFromHawaii It's also my reality and struggle as a parent to a pubescent child, argh! Still worth it to try and get it right! And when we don't, to try and make it right!
Hospital doing a lockout b/c they don’t want to be strung along w/nurses doing 1 day strikes here & there. Union leaders should have told members: once you walk off your job, employers can respond with a lockout & use replacement workers. And you don’t get back your job until the hospital relents or the union negotiates at the bargaining table.
I think the nurses knew about the lockout and knew what they were getting into. Not sure if they believed the admin would go through with it, but they did. So I hope the negotiations continue.
I don’t understand. If they just complain about the patient to nurse ratio, why are they asking for such a big pay increase ?
I'm sure they are seeking both.
When lingle was in office teacher strike was terrible 4 day weeks and furloughs. I worked for the Honolulu advertiser and our union didn’t do much but take our money so I know how it was being laidoff
If the unions 9n Hawaii are so powerful why are most wages so low. Historical I unions are strong most wages are much higher
Not all of the wages are low. There are other unions, particularly in the construction industry, that do pretty well for themselves.
In today's Hospitals the RNs & LPNs spend most of their time charting. Most of the patient care actually done under the nurses direction by the PCAs & aides who spend the most time with the patients. A patient rarely sees a nurse (RN), except for giving them medication, IV care or a dressing change.
Let’s help the public to understand this. Nurses want better rn/patient ratio which means needing to hire more nurses. At the same time nurses want pay raises. So that means nurses want everything at the end. How does that help hospitals when their revenues are dictated by pbm, Medicaid and medicare. Seems like nursing greed.
It's a tough situation. And I think that's why they may need outside counsel to help. If the hospital is putting its foot down, the union will have the pressure to act.
Maybe there needs to be more help but not necessarily RN, but helpers - IDK but health care also needs to be affordable- surely there’s a wow-win solution.
I retired a couple of years ago and politics are always at play from within the Union and hospitals. Most of the work is from direct patient care. Hospitals should hire more aides to take care of patient's physical needs such as taking them to the bathroom and cleaning them up from being incontinent then the RNs can do their paperwork and documentations. This will alleviate patient load. Unfortunately HNA doesn't have funds to help nurses when on a strike unlike Local 5. I haven't heard an Ombudsman in play which is usually brought in a stalemate situation. HNA tooks a gamble thinking Kap will fold but found out they lost with their stragety. Kap is like any other business and are geared to profitability. Hope they get this resolved. BTW nurses from agencies are very capable of taking care of patients and most of them have extensive experience in taking care of women/children.
Mahalo for sharing. Bringing in an Ombudsman would be an interesting move. Not sure they could use Hawaii's Ombudsman, but maybe the Gov could loan him for this situation.
Kapiolani management will change their way of managing once they get sued by patient families. But they can't say that they weren't warned by the nurses. Then the onus is on the management team.
Here is an off-topic question for you. Thousands of native Hawaiians have keft Hawaii and found easier lives elsewhere. They have been replaced by even more people from the Mainland. Will Hawaii still be Hawaii without Hawaiians? Eventually, Hawaii will evolve to another resort like any other . The hokey hula dances and inauthentic luaus might continue but inly as a historic remnant of the indigenous people and culture.
Does anyone have the exact details of what each side is asking for? What nurse-to-patient ratio are they asking for?
It’s not quite that simple. Ratios vary according to the acuity of the patient.
A critically-ill, unstable patient who requires constant adjustments should be a 1:1 ratio. If they are critically ill but fairly stable it’s a 2:1 ratio. Not critically ill but requiring a lot of hands-on (babies in the nursery, for instance) 3-4:1, and regular , uncomplicated pediatric patients can usually safely be 5:1 unless they are getting chemo or blood transfusions for example.
So the question of ratios doesn’t have a simple answer. My guidelines above come from my many years of personal experience as a pediatric/NICU/PICU nurse and former Kapi’olani employee. Safe patient ratios are a hill most nurses are willing to die on because we know (and studies back this up) that it is critical to patient safety.
I don't think they've made public the patient ratio offers and demands.
160k for 3 days of work? That’s 266k/year pay. Almost M.D. level pay on mainland. How much do doctors make there?
Did you read your own post? 160k a year does not equal 266k a year.
@@supreme5998 if they work 5 days a week they do.
@@Omikoshi78 its a 12 hour work day. They work at a .9 schedule of 36 hours, that’s why it’s 3 days. 5 days would be 60 hours. It’s not the same.
Ain’t nobody getting 160k/year. You gotta meet a lot of criteria to get that kinda pay. Probably gotta be a permanent night shift charge nurse that is on top of the clinical ladder
@@CH-sr1js this is also true.
I’m pro union . If there wasn’t a problem they wouldn’t have walked out .
I they show photos or describe
The situation.
So why are they causing problems only when it's contract time?
Is this really about the money or is it nursing/patient ratio. Having worked in the medical field, patient care is and should be the primary purpose. Sadly health care has become more of a business vs health care.
They say it's about the patient ratio at this point.
The irony of all this happening in the midst of the anniversary of the Hanapēpē Massacre of 1924 is wild.
They not calling the unions bluff.... they bullying the union.. they not negotiating! "It's my way only!" You started good but lost your way.
I don't know if I would call it bullying. It's part of the negotiations.
I think it shows how little they care about their patients if they treat their staff that way. If I own a medical facility I want the best and I will pay to keep the best. If they want budget workers they are going to be providing budget care. Shame on the management. They only care about one thing: money.
I think it's more complicated than just caring for patients. Health care in the US is a business, so there's financial aspects to it. While I may not agree with how things are run, I understand that that's how the industry is played in this country. Other counties may have it different.
Hawaiian nurses are paid more than every other state except California at an avg of $110,000 annually, my wife is nurse in Alaska and have a house on big island and she works there when we arent in Alaska, Hawaii nurses are just being babies, if you cant make it on $100k + then you need financial education
The nurse-to-patient ratio shouldn't be an issue. As a retired police officer, patrol in particular, the officer to public ratio is 100+ times higher than nurses. In my days, we had a good contract with pay but the working conditions still sucked...but we dealt with it. I understand the nurse's concerns, but you have to look at it both ways. Management has responsibility, not only to nurses, but also the public in need of medical attention. Hospitals are in dire need of more nurse, whether be NP, RN or LPNs, but they are hard to find.
Good point- nurses are hard to find. Many are retiring or switching to other professions due to the working conditions. Why is it hard to find replacements? The same reason nurses are leaving...
Mahalo for the comment. Great point at looking at it from management's perspective. I've been trying to do that as I've watched this situation unfold. Not an easy situation for either side.
Reading what you just wrote….”working conditions still sucked…but we DEALT with it.” You don’t have to deal with it. That’s the whole point. You have a voice! That’s the problem people say I just have to “deal with it.” Until you get replaced with someone cheaper when you get injured, burned out when your overstaffed etc.
unfair staffing and schedules, unfair wages.. I stand witht them
Its those new executives that came from the mainland that has not worked from ground up.
Well I'm not sure where the executives are from, but they may need to bring in more local middle management to smooth the waters after this one.
As a Manager at Hilton Hawaiian Village we will soon have the second strike sometime this week. I was telling our team and HR that Hilton should also do a LOCKOUT! I always say the union has an entitled approach and they bully a lot, it’s sad that employees spit on the company they work for! 😔
you guys can really handle one lockout and just hire random people outside to handle your guys operations? I'm asking this Respectfully as someone who get one bachelor degree from TIM/UH Manoa, I never got into management as I decided to go another career field but one lockout not gonna work for the hotels...
People deserve a living wage! I’m a new doctor here in Hawaii from the mainland and I can feel the extremely high cost of living here. I can only imagine how people making less are feeling!
@@paopaomedfat Living in "Paradise" has its price.
Like I mentioned, I think other employers are watching this. Has a hotel ever done a lockout in the past here? Hope the situation at Hilton gets resolved. My dad has a conference at the Hilton next week 😄
The news isn't even covering the lockout part. What does that say about the media? The unions already have their own attorneys, they are not going to go outside to retain extremely high costing law firms. They thought the hospital was bluffing, and they got called. To end the lockout, the union should just say no raise, but they want the working conditions improved. $160,000 a year is a hell of a lot of money for Hawaii, and working 3 twelve hour shift isn't that bad.
The news still talks about it, but not the extent as before. Although I've never worked 3 12-hour days, I'm sure it's exhausting.
Not all RN's are the same. The traveling nurses may or may not be good in the area they are placed in. A nurse who has worked primarily with pediatrics is unfamiliar with adult medication and dosages. Patients can be harmed because of this.
As a former travel nurse I can tell you that they will NOT place you in an area where you do not have a minimum of 2 years experience.
I'd hope that they take previous work experience into consideration before placement.
The nurse union overplayed their hand. The contract on the table would make them the highest paid nurses in the state, at 133k to 166k per year for working only three days a week. Nurses could easily pick up another one or two days and increase their income DRASTICALLY. Hawaii Pacific Health isnt a great company ( I personally think they are horrid) but the nurses are greedy AF too and honestly, they should all be fired and let HPH hire new nurses who are willing and able to do the job.
It seems like a good wage schedule. To me, if the priority is patient ratios and not pay, negotiations could focus more on finding a balance with better ratios and less pay.
@@HelloFromHawaii Non negotiable. If contracts start talking about patient ratios than it opens up all other health care centers in the state to have those included. If the nurses truly care about patients; than the hospital can word it into something like "minimum staffing levels" rather than call it patient ratios; and cut pay by 25% and hire more nurses.
My mom was a rn for 40 years and my sister is a NP. 150k for 3 days with those ratios are fair. One or two days over time per week, that's 200k plus benefits. All they have to do is hire mainlander RNs. More costs from RNs means higher hospital costs. If it's about the ratios, reduce pay 25k a year and hire more Rns. Problem solved. Bi weekly schedule. 3 days in, 4 days out. 4 days in, 3 days out. Graveyard shifts should get paid 12.5k more per year. Cut the bottom 20% of performers and trouble makers and get new Rns in. Give over time to the hard workers that don't complain. That is what I would do. Entitlement is a disease.
Thank you for suggesting the obviously reasonable solution to this problem. Unions unfortunately are not reasonable.
They asking for more staff... staff to patient ratio is overwhelming.
@77mkg Understood. I'm a real estate appraiser. Fees dropped by 40%. Deal with it. We have been overwhelmed numerous times in boom cycles. Deal with it. We worked 7 days a week, week after week before. Don't complain. 150k plus benefits is great.
@fookbia8875 that's not the point they're trying to make. They'd rather have more staff than more money so they can give the care to patients. It's not always about money.
@@77mkg Then read my post. Take a pay cut. Hire more RNs.
So, I am niele… who cleans the bathroom in your house now?
If the sticking point the nurse to patient ratio then the nurses union should disclose to the public what the ratio they want ands what Kapiolani offered and take a pay cut to help meet that ratio because it means you need to hire more staff and if you raise the pay rate and just have 3 days of work then you need it balance it out. Most people in Hawaii don’t get the joys of only 3 days work for 130-160k a year. Didn’t the news say before that most of Hawaii is average couple making 90k??? That’s an average couple and not a single person and that’s working 5 days or more per week.
It’s not quite that simple. Ratios vary according to the acuity of the patient.
A critically-ill, unstable patient who requires constant adjustments should be a 1:1 ratio. If they are critically ill but fairly stable it’s a 2:1 ratio. Not critically ill but requiring a lot of hands-on (babies in the nursery, for instance) 3-4:1, and regular , uncomplicated pediatric patients can usually safely be 5:1 unless they are getting chemo or blood transfusions for example.
So the question of ratios doesn’t have a simple answer. My guidelines above come from my many years of personal experience as a pediatric/NICU/PICU nurse and former Kapi’olani employee. Safe patient ratios are a hill most nurses are willing to die on because we know (and studies back this up) that it is critical to patient safety.
@@FreshEclecticism if the union is going to argue for ratios then there needs to be some line to be drawn. You can always go with hypothetical situations. But you still need to put a number down to work with. If not you keep moving the goal post. No one likes on call scheduling. If it’s a contract negotiations you are dealing with numbers that are written and signed by lawyers and management. The public deserves to know what are these goal posts that the management and unions claim. Right now the public is pissed off at the unions because nurses are being offered salaries that majority of Hawaii don’t have. But that is only from the management side are saying that. All we heard from the news report is that the union said it’s not about pay. But the public doesn’t have the information on what does that mean and how it’s spelled out.
@@FreshEclecticism the union needs to disclose the information on what the demands are if they want to gain more traction from the public. The hospital was smart to throw out the information on pay and 3 days work. That really will drive a wedge in public perception. So the unions needs to do information educational. Those union leaders get paid nice paychecks so they need to work their assess off to get the nurses back their jobs.
@@oregonduc absolutely agree with you 💯
@@oregonducI agree with you.
By the way, nursing wages on the island are substantially lower than on the mainland, although the cost of living is substantially higher. This is why there is such a terrible nursing shortage in Hawai’i and it will continue until wages catch up to mainland wages or better.
I definitely didn’t move here to get rich-I took a big pay cut and my expenses nearly doubled. I had to make some major lifestyle adjustments (I don’t make nearly what the Kapi’olani nurses do). But I’m here to serve the people of Hawai’i nonetheless and enjoy all the island has to offer…at least what parts of it I can afford.
You should run for office you’re local and lived on the mainland so you can see outside the box small kine
They won’t have a nice lunch, they’ll start hiring aggressively from mainland 😂
It'll be a revolving door. But at least it's sustainable.
I hope the hospital does something to mend those relationships.
Unions, public good/welfare, reliability and management are finicky points. If the strikers are a private owner, the public may/may not notice the strike due to lack of impact on the public's everyday life. When the sugar & pineapple workers wanted better wages/working conditions, the plantation owners broke up the strikes with violence, sometimes resulting in injury & death. When unions, returning WWII veterans, Democrats taking majority of State & Federal elected positions, it touched on government/private management of wages but also working conditions. The Longshore union strike in the 70's impacted the island wide economy, whereas a strike of Safeway, private business, and teachers are selective impact on the public, so they last longer. Back when the Air Traffic Controllers went on strike, the Federal government under Reagan, made it a point to terminate those striking Controllers unions. When the HPD, FD, UPW, State, if they strike, it's not for just one day, as it will impact longer than one day. It's major when the majority of the public is impacted. Working conditions, such as ratio of workers impacts safety of workers, and clients. If the management sees that too thin a staff impacts client's safety/stability, business operations and manpower, they might reflect on the numbers, which is a long term/statistical proof of impact. Lawsuits on failing patient care, shortages due to sick/annual/emergency leave reflect those number, ratings by consumers/patient on quality of care. Striking for one day is something that a manager/supervisor damages their perspective of the workers, like a tantrum from a infant, bad that day/forgotten the next. How would the coworker who didn't strike view the one who did? It increased their workload for that person, whether management, contract nurse or nonunion staff, then it's expected to be the same as before. When the next time for performance award/recognition/promotion/increase comes along, will the manager remember that action? I remember when coworkers deciding to unionize thought they could get a pension plan and take all the profit sharing that the company gave them (which at the time was 3x what they put in). They thought they could get their cake & eat it too. They unionized, but right after that everyone in that group of workers, union or not, had their profit-sharing assets frozen until they left the company, or the company decided which was several years. Like the ATC strikers being terminated, When the management says somethings, it's something to consider the impact, which in the long run, who will lose out and how many are willing to accept the consequences.
Mahalo for sharing some great historical examples of labor strikes in the past. And great point about the scale of a particular group's impact and how it relates to the length of the strike. 🤙
Some things should never have been privatized, healthcare is one of them. Once you make them based off of profitability there is no reason to keep anyone healthy. Back before it all became privatized we came up with public funded research and we got some amazing cures, now all we seem to get is chronic illnesses and some to me seem to be made up just to cash in. I do believe that if it was publicly run that we would have better outcomes for everyone. No bankruptcies because they charge to much staff appropriate for the patient size and no more doctors having to fit into the confines of the private health or should l say illness industry mandates. I hope the people in Hawaii. Stand w8th the nurse for better quality for the times you have to go to a healthcare institute.
Huh? Doctors in socialized medicine are overall competent but do not have an incentive to do more than the basics. Do you know how many Canadians cross the border for medical care? The Canadian government pays for that care also.
Interesting that you would pick canada instead of Sweden, Denmark, Norway or Finland. Canada has a unique system that is broken up into 13 provinces and even though they are all funded by the government they do not offer the same services in each province. I don't know why that is but some places take better care of you then others. I am not sure, but if it is anything like the states l am sure plenty of that could be the color of your skin. Universal Healthcare is not universally the same across the world. Some are much better then others but maybe we should pick one that doesn't work just so we can pretend the system the states has is working perfectly. I have had to deal with our system four 24 years and there are wait periods and denials all the time. I can't get the best service because l am not wealthy. We pay at least 3 times what people pay in some countries in Europe and they can see any doctor they want because they don't have a network of doctors that the insurance companies force on people living in the states. I think there is a better way and medicare for all could be a start. What good is a helathcare system if you can't access it. Sicko was a good watch.
@@briangarnier5714I do not live in Europe. I live in Michigan just across from Windsor. Henry Ford Health has a section of its website specifically for Canadians. There is a huge parking lot down the street from the main campus of Henry Ford that is always filled with cars with Canadian tags.
@@briangarnier5714 Thanks to Justin, Canada has become inundated and overwhelmed by Punjabis, et al, to the point where both locals and immigrants are fleeing the sinking ship.
Public vs private health care is a different topic for a different discussion, but appreciate the perspective 🤙
Hawaii needs to leave the tourist city in the past and focus on hawaii first. Seriously,we should charge the tourism industry a massive tax and concentrate on hawaii
If you don’t like your job, go get a better one. Employees really have no right to tell an employer how to run their business, including how to pay or treat employees. You don’t like it… LEAVE!
Same here! What’s wild to me is that the audience only sees one side of this, the news nor people in favor of the union see the details to this bargaining/negotiating. I saw how pro union the media was without learning what was the fight about. Our housekeepers are making $28-$33 an hour and make even more when they choose to work overtime if the opportunity is there! The problem is they want $40+ an hour, there’s no way corporate will pay housekeepers more than managers etc. Unions fail to accept or realize that money is also going to maintaining buildings, paying for many other costs that are clearly blind to employees. Every business is entitled to their profit/portion. There is greed in most of these unions! Like you mentioned “go work somewhere else if you feel you’re not getting paid what you want.”
Nurses run the business. A hospital can function alot longer without a CEO or COO than it can without nurses.
@@bentleyfonsworth9604 Sounds like someone who has never held a management position. If it’s so easy, anyone could do it. Hourly workers have no idea what it takes to be responsible for more than themselves. When you’re responsible for 100s or even 1000s of people under you, you wouldn’t think that management is expendable.
@@bentleyfonsworth9604 For the first time, more native Hawaiians live on the Continent than on the Islands. And they aren't looking back.
Sure, they can leave, but I do think employees should provide feedback, whether it's about working conditions or pay, from time to time. And yes, one can always leave.
The last time I remember is the air traffic controller under President Reagan. Nationwide. They were fired and replaced.
And in 1986, Reagan granted amnesty to 2.7 m undocumented migrants, paving the way for massive "White Flight" from California.
Someone else mentioned that. That's wild that that could happen.
With lock outs and more people may end up unemployed, higher cost on everything and everybody.
I'd hope that the RNs could find new jobs really fast, if needed. Hawaii is short on health care workers.
133-160k for just three days is more than doctors are paid.
Doctors make a lot more than that, doctors in Hawaii make about 20k a month. Also don’t believe what management tells you about wages, they always try to spin things to make it about pay to get the public on their side.
Do doctors typically work that many hours per day?
Yes they work 24/7
In the late 80’s in Honolulu, Kaiser Permanente employees were on strike for 6 months. I worked there after the strike, and asked the ladies who were on strike if it was worth it. They all replied it was not worth it. The Kaiser workers were part of the Local 5, the same union as the hotel people.
Mahalo for sharing. We've been going to Kaiser my entire life. I must have been in preschool at that time. Wonder if my parents remember.
Hello hawaii , it's Kapi'olani not kapalani. 👑Queen Kapi'olani 🌺🤍. You are what locals call a Transplant local. Back in my days it was FOB. Fresh off the boat. 😂
Thanks for watching 🤙
If it wasn't about the money, why are they asking for a raise?
one thing i saw was better work conditions, there are less nurses and more patience to care and right there quality of care is real lacking....
I don't think it's just about pay.
Those replacement nurses you called "temporary workers" are SCABS. That's the part you forgot in this. The labor movement has advanced, in part, because SCABS were deterred, blocked, beaten up, threatened from replacing striking workers. Generally, there was solidarity with the labor movement. YOU DON'T CROSS PICKET LINES. Not as a customer, not as a "temporary worker."
The names of those scabs should be taken down and broadcast. Shame them.
The hospital's lockout is powerless without scabs.
But what about patient care? Without the temporary nurses, the patients are the ones suffering.
@@HelloFromHawaii [I'm just now seeing this question]. Why does the patient care burden fall to the employees, the workers? Why not hospital management/owners? The point of any strike is to cause deprivation and inconvenience: that's because all workers have to leverage is our LABOR. Using scabs undercuts our leverage. We would have gained nothing without that leverage. The nurses aren't asking for the overthrow of capitalism. Their demands are reasonable, as anyone living in this state knows. They demand fairer contracts and better nurse/patient ratios - that's patient care.
Thae fact that Management can bring in nurses from where ever to take the place of the striking nurses defeats the purpose of a strike. Don't understand how Managment is allowed to do this. Makes no sense to me.
I’ll explain. They hired temporary work force because they need someone to take care of their patients in the hospital. Since 600 nurses are on the sidewalks striking and not working who will take care of the patients in the hospital? …. The temporary workforce. They didn’t want to do that but since negotiations didn’t go well, the nurses striked. Hence the temporary workforce was then trained and hired. They also got locked out because it was already explained to the nurses that if you don’t accept the generous offer they cant come back to work.
Hope that helps you to understand.
The hospital still needs to continue to care for patients. I believe management said that 75% of the temporary nurses have experience at Kapiolani.
Lots of talented fish in the sea willing to work for much less. Remember capitalism?
I'm not sure capitalism works that way, though. Either way, Hawaii has plenty of openings in the health care industry.
14 minuets to talk about bath room cleaning. Are you a nurse?
Not a nurse, but I used to be a custodian once 😄