Wil there be enough replacements to cover the strike? Will there be enough replacement nurses to cover the strike? - TwinCities.com

Robin Oliver is prepared to hear chants of "scab" or worse when she is bused past striking nurses and into a Twin Cities hospital next week, but the Norman, Okla., woman believes her role as a replacement nurse empowers those on the picket lines.

"If the striking nurses and allied staff are truly concerned about the welfare of their patients, they should not oppose agency staff covering for them while they protest," she said. "It would be hypocritical of them to leave the bedside without a proper plan.

"That's why I do not feel like a scab," she added. "I'm here to help."

The bigger question, in many ways, is whether enough temporary nurses will be available to help.

On June 10, about 12,000 nurses from 14 Twin Cities hospitals are planning a one-day strike. The historically large number would tax the nation's supply of temporary nurses. Add to that the 13,000 California nurses who will strike the same day, and the likelihood of fully staffed hospitals seems remote.

The Minnesota Board of Nursing processed 2,370 applications in May from nurses seeking "licensure by endorsement," which means they are already licensed elsewhere. That is 10 times the normal number of applications, indicating out-of-state nurses are preparing to work the strike. But the number is smaller than anticipated.

"We have not seen the number of applications that we expected," said Shirley Brekken, executive director of the licensing board. "If I look back to 2001, when only two (Twin Cities) hospitals went out on strike, we processed many more license applications than this."

A spokeswoman for the hospitals said they have contingency plans for a strike that will be adjusted as the total number of replacement nurses becomes clearer. She said the hospitals need far fewer than 12,000 nurses to be fully staffed on any given day, as roughly 80 percent of those nurses work part time.

"We still want to avoid a strike, but can we put a strike contingency plan into place? Yes," spokeswoman Maureen Schriner said. "Can we keep the hospitals open? Yes, we can."

HIGH-PRICED OFFERS

Two staffing agencies — Healthsource Global Staffing and U.S. Nursing — are aggressively recruiting replacements. Nurses outside the metro area report numerous phone calls, postcards and even faxes directly to the units in the hospitals in which they work.

"Take a break from your existing job," one written ad stated.

One firm is offering $1,600 for one day's work plus four hours of orientation while the other is offering $2,224 for one day plus eight hours of orientation. Travel and lodging expenses also are covered.

The high-price offers are frustrating for nurses such as Barb Bjerke, who said a fax from a temp agency came to her obstetrics unit in Bemidji. She isn't part of the metro negotiations.

"If they can spend $1,600 a day and $1,000 per referral," she said, "they could have put that money into hiring more (regular) nurses."

A strike remains scheduled despite renewed negotiations Wednesday between the Minnesota Nurses Association and leaders at the 14 hospitals, which are aligned with the Allina, Children's, Fairview, HealthEast, North Memorial and Park Nicollet health systems. The talks — which included six federal mediators — were the first since the nurses voted May 19 against the hospitals' three-year contract and pension offers.

Schriner said the combination of the Minnesota and California nursing strikes — making it more difficult to hire enough replacements — reveals a national strategy that is trumping local interests and needs. Nurses in both states are aligned with National Nurses United.

"They are interested in a strike," Schriner said. "Not just a strike, but a big-movie-production kind of strike."

The nurses are fighting proposed pension and benefit cuts and seeking wage increases beyond what the hospitals have offered. They also want the hospitals to commit to strict nurse-to-patient ratios, arguing that they are necessary to ensure safe care. The hospitals instead want more flexible work rules to call in or float nurses to busy units and to send nurses home on slow days.

"Our nurses remain committed to negotiate, but so far the hospitals aren't giving us anything to negotiate over," union spokesman John Nemo said.

WHAT HAPPENS TO CARE?

If the hospitals are short-staffed June 10, they could delay elective surgeries and divert ambulances to hospitals that aren't under strike — including Regions Hospital in St. Paul and HCMC in Minneapolis.

Allina might have to scale back operations at its five involved hospitals "but can assure the community that all emergency and critical services like OB, mental health, emergency rooms, etc., will be fully available," spokesman David Kanihan said.

A statement from Fairview urged patients "to seek medical care as they normally would."

Whether hospital care declines in a strike is a matter of dispute.

Nurses who struck at Temple University Hospital in Philadelphia this spring claimed incidents of inadequate care by their replacements during their 28-day work stoppage. A study released this spring of hospital care in New York also found higher inpatient death rates during nursing strikes.

The specific impact of a one-day strike — a somewhat new labor tactic — hasn't been studied. The union's 24-hour strike will start at 7 a.m. June 10.

Incoming nurses said they are determined to provide safe care during their whirlwind 12-hour shifts.

Katie Gay announced on a staffing company website that she would be coming from northeast Louisiana. She promptly received e-mails from local nurses calling her a scab. Adapting to a new hospital won't be that difficult, she said, as she already floats among hospitals in her home state.

"It's always difficult to find supplies," Gay said. "But after a while, you develop your own routine anywhere you go and remember that your goal is to take care of patients."

Gaining a rapport with patients in one day will be key, she said, as she specializes in endoscopy and assists in procedures that can be invasive and make patients anxious.

Like Oliver, Gay said she is sympathetic to the local nurses and believes she is helping by tending to their patients on the strike day. Both are coming to Minnesota for their first travel nursing assignments.

Oliver said she was scheduled to work in Pennsylvania until striking nurses reached a deal there. She called this first assignment an experiment but said she eventually wants to semi-retire with her husband, also a nurse, by accepting traveling assignments around the country. She looks forward to patient care away from the politics of her current hospital, where she works as a charge nurse in obstetrics.

As for coming to Minnesota, she said it isn't about the money. She is required to arrive three days early but will make money only for the fourth day.

"If you spread that out," she said, "I'll make more money back here than taking this assignment."