Workers in the Maui Health System, which includes Maui Memorial Medical Center, Kula Hospital and Lanai Community Hospital, assemble picket signs on Sunday in preparation for a three-day strike starting Monday morning. Eli Pace/The Maui News

About 900 workers in the Maui Health System are ready to go on a three-day strike after their requests for guaranteed staff-to-patient ratios have been rejected by the Maui Health’s management team, according to union representatives.

United Nurses and Health Care Employees of Hawaii represents about 900 employees in the Maui Health System on Maui and Lanai including registered nurses, social workers, physical and occupational therapists, as well as speech and language pathologists, MRI, imaging, and mammography technicians, financial counselors, admitting clerks, receptionists and more.

UNHCEH is a chapter of the United Nurses Associations of California and Union of Health Care Professionals, which represents more than 40,000 registered nurses and health care professionals in California and Hawaii.

Dozens of members of the local chapter of UNAC/UHCP spent their Sunday making signs and preparing for the three-day strike, which is set to begin at 7 a.m. Monday when workers at Maui Memorial Medical Center walk off the job.

The strike will continue Tuesday and Wednesday from 7 a.m. to 7 p.m. at Maui Memorial, 9 a.m. to 2 p.m. at Kula Hospital and 9 a.m. to noon at Lanai Community Hospital. The walkout is set to end Thursday morning at Maui Memorial when the day shift comes back into work.

The primary issues for the union are staffing and workers’ wages, according to members of the union’s bargaining team who say they have proposed the same staffing ratios that Kaiser Permenente has agreed to in its contract with registered nurses in California.

In a previous statement, officials with Maui Health noted that while Kaiser Permanente is contracted to manage the nonprofit Maui Health System, they are separate entities and Maui Health is governed by a board of directors, which includes members of the Maui community. Maui Health is affiliated with Kaiser Permanente, but is a separate entity.

“Safe staffing is huge not just for the nurses but for our patients and our community,” said Melissa Robinson, a registered nurse and co-chair of the United Nurses and Health Care Employees of Hawaii union. “Our patients come first. Our community, it’s why we live here, to take care of our community, so yeah, that’s huge.”

Wearing blue union T-shirts, Melissa Robinson (center left) and Stephanie Castro (center) help out on Sunday as workers with the Maui Health System get ready for a three-day strike starting Monday morning. Eli Pace/The Maui News

On Sunday, Robinson said the strike is imminent.

“We are doing this unless management calls us at the last minute and comes to their senses and really wants to give us the safe staffing that we deserve,” she said.

According to Robinson, the management team at Maui Health System came to them about a week ago and asked the union representatives if they’d be willing to put together a side committee to come up with safe staffing ratios.

“We agreed,” Robinson said. “They gave us nurse managers from their side. We gave them nurses from our side. We sat in a room together. We hashed out over the course of a couple days, many hours, we hashed out a full proposal on staffing ratios that both sides agreed upon and we gave them our proposal on Tuesday.”

However, the management team “struck out everything” in that agreement on Friday, according to Robinson. “They do not want to give us anything on that proposal that together we came up with,” she said.

Robinson explained that the breakdown of staff-to-patient ratios varies based on positions and departments, but “basically what we were suggesting are a lot of the things that are already in place.”

“Management even struck through their own policy for our Molokini nurses, which are our psychiatric nurses,” Robinson said. “They have a policy currently in place that tells what nurse and tech ratio that they follow, but they struck through that. At this point in time, it just seems that upper leadership is not even respecting their management’s time because we essentially wasted it all.”

Robinson said that as a result of the failed negotiations, they are going to strike but anticipate continuing negotiations after that.

“We have not come to an impasse at this time,” she said. “We’re always willing to bargain. We just want our time, and our efforts and our energy respected.”

Regarding negotiations over wages, Robinson said the two sides are still working on that front but Maui Health and the union have some agreements in place, including one to pay staff, not just nurses, for any health-care related bachelor’s, master’s and doctoral degrees and another to pay workers for longevity.

“For the longest time, it was just nurses and we’ve now been able to open that up to the people who have been here for decades or longer,” said Robinson, who added that those agreements are huge wins for the workers but still won’t get them where they need to be to keep up with the cost of living.

Stephanie Castro, an outpatient clinic clerk, is on one of the lowest-paid tiers for the Maui Health System. For her, making progress in staff-to-patient ratios and wages are both critically important, as she struggles to make rent and keep up with the high cost of living on Maui.

“Rent of course just gets higher and higher, and I think after the fires we’re already having a housing shortage prior to that, so it just got worse after that,” Castro said.

However, Castro also sees the future as a major piece of the discussions. She said her son, who’s a senior in high school right now, is considering getting into the medical industry and he wants to be a cardiothoracic surgeon surgeon.

However, Castro has concerns not just about paying for his college, but she doesn’t know if she can recommend that he returns to the community he’s from even if he is able to pursue his goal.

“This is the future of our health care, and if I have a son who wants to come back here and help his community, I’m like hesitant to even support that with what we’re going through now,” she said. “I’m like, ‘Go away and work wherever you need to work,’ because I look out for his safety too, right? I think what we’re fighting for is people like my son that are trying to go school to be in health care that want to come back and take care of their community, but actually have safe working conditions and fair wages.”