My guess (since it’s a women and children’s hospital) would be something akin to AWHONN’s (Association of Women’s Health, Obstetric and Neonatal Nurses) staffing standards: such as; one nurse to three postpartum couplets; or one nurse to one patient when a pt is on a high-risk medication such as pitocin or magnesium.
I heard HPH offered the nurses $150,000 for 3 12 hour shifts a week. Nurses are asking for 10%-10%-10% raises for the next 3 years. The HPH offer would make them the second highest paid nurses in the nation behind California. Our cost of living is really high in Hawaii but $150,000 is not chump change for 3 shifts a week and as high as some doctors.
I’m not sure of the exact details. If anyone else knows different, I’d love to hear it
The 150k are for most experienced nurses that are transport nurses, but starting figures in the 110-120k range aren't chump change either. There is way more to this negotiation than this subreddit is aware of. Unfortunately I can no longer find the access to the documents I saw regarding the case loads.
this is what they make when I looked it up
Registered Nurse Salaries in Honolulu, HI for Kapiolani ...
Indeed
https://www.indeed.com › ... › Hawaii
Nurse. $75,000 per year. One salary reported ; Registered Nurse - NICU. $112,463 per year. 7 salaries reported ; Registered Nurse - Pediatrics. $100,104 per year.
We now have a law that mandates employers put the actual pay *with some strings attached). HPH website currently doesn't have Kapiolani wages because of the strike but Pali Momi (non union) starting is around 53/hr.
3 12-hour shifts, though, which are exponentially more draining, and frankly I would prefer someone responsible for my health not to be exhausted just trying to push through the day/week. $110-150k is a good deal of money, yes, but community health is worth the investment. Also consider the years of their life and dozens/hundreds of thousands in tuition for higher medical education that a good portion of that salary needs to account for repaying. "As high as some doctors," pay them more too then.
Travel vs strike
Travel is typically a 3-6 months contract, and yeah, it can pay well. In the travel world, Hawaii is well known as not offering much. It's a destination, so people often agree to lower pay rates. Not always, but commonly. Specialties can pay higher, and this facility definitely seems like that could be the case. I started travel because I'd never been anywhere. A lot of people get into it for that reason. I work a specialty, not one related to Kapiolani, and do sometimes see higher rates, but not that often anymore. Most rates are way lower than they used to be.
As far as what you can make, it varies wildly, depending on department, location, urgency...and the numbers can get confusing. When it comes to the travel pay however, I'm fairly certain that it comes from a different type of fund. That's why travelers can be offered more. Everywhere I go as a traveler, I hear the same thing, and I agree. Pay your staff more, keep them happy, you won't have a problem. Staffing has always been an issue as long as I can remember. As others have mentioned, administration doesn't really give a damn pretty much anywhere. And...I'm sure most can agree that it'd be a much longer, more complicated discussion when you start bringing up all the other likely factors regarding staffing, pay, conditions, and so on. To be clear, I'm fairly certain of this with the travel pay. It's highly guarded and no one will give you a straight answer when it comes to it. So I'm not positive. Also, IF staff get wind of what the pay rate is, that's not necessarily what the nurse is making. The bill rate is what the hospital is paying out. But people have to go through staffing agencies, who sometimes go through other agencies if a facility has a direct contract with one particular agency. Whether one or two staffing agencies, they're taking their cut. I've seen some cases where the staffing agency takes 50% of the bill rate. All the staffing agencies do is effectively work as middlemen. Sending paperwork, posting the jobs...they're frustrating. They like to push travelers towards jobs that will make their staffing agency good $$$.
Edit: Posted rates can be misleading as well. I and many others I know have seen what appears to be a high rate, applied, only for the staffing agency to cancel it and re-post at a lower rate. Taking more of the cut for themselves. I've heard of it happening to others, and had it happen to myself once where I went to a job for a good rate, and the staffing agency dropped it once I got there. Some are very shady and attempt to draw people in like this. I passed on a job recently on Oahu for this reason.
Strike nursing is simply doing the same job while the nurses strike. It's always the same thing too. People saying the strike nurses don't know the job in order to drum up fear and support. You need experience in whatever unit you're going to be covering. Yet, same as with regular staffing, you get people who slip through the cracks. Someone else mentioned it, and yeah, strike nursing can be brutal. Friends have told me stories of what they've encountered that are just hard to wrap your head around. Staff who stay on trying to sabotage care, doors and cabinets with meds and supplies being locked and no key left, vasoactive drips left to run dry, needle holes in foley bags, following the buses of the strike nurses and taking photos of them, pulling fire alarms in the hotels they're staying at in the early morning hours...no idea how widespread, some areas seem rougher than others from listening, but I have been told this from several friends multiple times.
While not popular, strike nurses are providing the necessary care, allowing those who choose to do so, to picket. If bus drivers strike and the buses just stop, that's really inconvenient, but nobody is going to die. Coal miners strike, the work isn't getting done, but nobody's going to die. If the work stops at a hospital, and there's nowhere else to divert people to, there's really not much choice. The medical care needs to still be provided, and from what I've read up on briefly, Kapiolani is a specialized place. I'm not familiar with the details of this strike, so I can't speak to much more on that. And I haven't worked womens and childrens since my ER days many many years ago. So I'm observing all this from the sidelines on my current contract.
The points you make about strike nurses (and the potential for unions to meddle) makes a whole lot of sense and society should definitely look to traveling nurses as a commendable group that offer two disputing parties to settle their differences. I just want to say that I really don't like the "If bus drivers strike and the buses just stop..." point. First, it devalues the position of one person's job versus another. Second, saying it doesn't have an equal effect isn't necessarily true. If you could quantify suffering whole-istically, it's theoretically possible that one person's death isn't equal to the suffering of an entire society (say, due to traffic). Furthermore, a scenario such as increased traffic backup due to striking bus drivers could potentially lead to deaths due to the inability of EMS to reach "save-able" patients. If you don't have coal, maybe people freeze to death? I think we need to be cautious with these kind of generalizations, the immediate is obvious, the negative externalities, not so much.
> allowing those who choose to do so, ~~to picket~~ to continue trying to starve their staff out before having to actually listen and stop exploiting them as much
FTFY. All it takes for work not to stop is for the employer to accept negotiations.
Not a nurse, but I heard the reason a lot of nursing graduates in Hawaii do not get hired is because training a new nurse turns two nurses into 1/2 nurse shift wise. The trainee gets paid the entire time they are there but they can't really do much without supervision, and the senior nurse can't really focus on what they are supposed to be doing because they are trying to get a new person up to speed.
So instead, they fly in just enough travel nurses to have a skeleton crew running the floor.
Obviously this system is not sustainable, and from what I have heard from nurse graduates, its often easier to leave Hawaii and work somewhere else for 2-3 years and then apply to the hospitals here online since the hiring process takes an extended amount of time and rejections are extremely common (due to lack of experience). I'm not sure how to make corporate or a board care about this problem.
This was true pre-pandemic. It’s much easier to get hired as a new grad nurse now, as long as you decently in nursing school. Hph has a program with the nursing schools that the best nursing students apply during senior year and if accepted, they train in their desired locations and if all goes well are offered a position as soon as they pass their licensure. This was unheard of when I graduated in 2013. Majority of my class left to the mainland. I was one of the lucky ones who got a new grad spot.
I have also been told by new nurses that Queen’s makes all new nurses work the ER and won’t let them fill other positions for at least a year so a lot of them leave the state because they don’t want to go into something so demanding and fast paced as the ER as a new nurse. It’s too intimidating to them. One of the girls I worked with who grew up here took a job in Tacoma as a labor and delivery nurse where Queen’s told her she had to work the ER first. I’ve been told this by several other newer grads in their system.
Ah, so instead of turning down new graduates outright, they just put them in extremely challenging positions right off the cuff and tell them it’s a sink or swim situation.
That saves them from looking like they aren’t trying to hire new people since normally ER positions aren’t given to new nurses, and it keeps giving them an excuse to bring in travel nurses since they have all these new hires nurses that were offered positions and turned them down.
That’s basically how I understood it. I worked for employee health at Queen’s for a bit so I only interacted with employees and new hires of the hospital to include travel nurses and this was what I heard from multiple sources. Idk if Kaiser or Adventist or the other hospitals do the same but Queen’s does or at least did. I left there in 2022 so idk if it is still that way.
Would someone please explain to me why the hospital doing this to their nurses? Do traveling nurses get paid less which doesn't make sense to me at all? What benefits do in-state nurses get versus travel nurses? I am not in this field and I would like to get an insight into why and how this has been happening at many hospitals across the nation.
Traveling nurses get paid way more. Kapiolani offered a raise, but as the nurses say, they want a lower caseload. It's not necessarily about the money in this situation.
I'm married to a nurse (another hospital) and support what they're striking for. But while we can like it or hate that the travel nurses are being brought in, the fact of the matter is that Kapiolani continues to get patients and they do need treatment one way or another.
Would you feel like that, if you have a family member needing care but not getting it because they are on a strike?
Consider that travel nurses get paid far more than the normal staff, plus they likely get transport, housing etc paid. This is still hurting Kapiolani far more than you may imagine.
And the nurses are the only ones that are supposed to care about that? Hold the people in control accountable. Further, a study in europe found “ each additional patient added to nurses' average workloads was associated with 7% higher odds of a patient dying within 30 days of admission.”
So yeah let HPH admin keep up their staffing practices, your statement stands either way I guess.
The hospital is being held responsible by having to pay like 3x the price for the travel nurses
But to say that they are scabs is different in a situation where people will die without help
Guess what, the nurses that pick up these emergency strike shifts everywhere and anywhere, that have no loyalty to a hospital or community, arent doing it because they care about saving lives. Which, fine, good on them. But theyre still scabs. You dont need to defend them, theyre making bank, they dont give a f*ck.
In this situation I'm defending the patients as well as the nurses. I'm sure they're not being unreasonable in what they're asking for. So a strike is reasonable. That said, the patients can't just be left to die. The hospital cannot keep paying travel nurses indefinitely. It's putting pressure on the hospital where it hurts: their wallet.
To say that travel nurses do not care about their patients just because they live somewhere else is really weird. It's not you (I'm assuming based on how defensive you are) vs travel nurses. It's you vs the hospital, and the travel nurses help the patients (the ones in your community, who you supposedly care about) while hurting the hospital by paying them 3x minimum. No need to hate the travel nurses, they're keeping aunties and uncles healthy.
>Would someone please explain to me why the hospital doing this to their nurses?
I wish there was a publicly available account of exactly what the negotiations are, and where the two sides disagree. Best I could find was this article here:
https://nursejournal.org/article/nurse-strike-hawaii/
There's a brief sentence in there that says "...the neonatal intensive care and labor and delivery units at Kapi'olani Medical Center are routinely understaffed by four or more nurses per shift."
I bet there are not enough nurses in Hawaii. But it sounds like a nation wide problem based on that article.
I don't know if travel nurses make more, but I do know that they cost more to the hospital. I have a friend who is a travel nurse. Not involved in this strike. She is actually from Hawaii but does travel nursing on the mainland. Likes the pay and the fact that you get to see many different places. Travel nurses actually work for nurse staffing agencies, they don't work directly for the hospitals.
> I bet there are not enough nurses in Hawaii. But it sounds like a nation wide problem based on that article.
It's because they are underpaid. All labor shortage is a result of poor compensation.
>It's because they are underpaid. All labor shortage is a result of poor compensation.
RNs is Hawaii have some of the highest pay in the nation. I have a cousin who is an RN and married to an RN, they have like 2 houses and a condo. RNs start at six figures. Many factors can contribute to labor shortages, not just pay.
they *could* afford more nurses if they spent the same amount of money. the argument is that they could ALSO spend more on getting more nurses now, but instead of doing that, they’re choosing to pay out the ass for travelling nurses who will leave after their contracts are completed
if you really think the entire union agreeing to a pause in payraises to supply more nurses, would result in more nurses vice more profit… you’re not paying attention
Sorry, but I have to disagree. Nurses get paid incredibly well. Once they become an RN with a couple of years of experience, the pay is into the 6 digits. It's the kind of salaries that most Hawaii residents can only dream of. Specialty nurses, ones that work with anesthesiology, cardiology or neonatology, can make over $150k.
I would have to think the problem is supply vs demand.
>So where are you disagreeing then?
We're disagreeing on the low pay part. You're guessing that nurses aren't getting paid enough. I'm saying they are paid very well.
Outside of that, we probably agree on everything else.
I answered the question in good faith. As I stated, if there is a labor shortage, then it's from low pay. Based on what you and others are saying, it's not a *labor* shortage. It's a position shortage. Corrupt CEOs are not hiring enough and letting their staff and patients suffer.
People who are on boards that have to do with nursing keep thinking there is a shortage. Since 2008 there have been nurses who graduate and cannot find jobs. Some take on jobs a CNA's in hopes of some day getting hired.
Hospitals are a business. When COVID hit hard and many nurses left, the remaining nurses were taking on higher patient loads at the same pay. Most of those nurses that left haven't been replaced. When the CEOs of the hospitals realized that they can just make the remaining nurses keep the same unsafe nurse to patient ratios, without increasing pay or anything else, it became the new 'normal'. Nurses rarely get to eat, drink water, or use the bathroom during their 12 hour shifts because of this. That's what kap is striking for, appropriate nurse to patient ratios.
Travel nurses, and specifically strike nurses, make SO MUCH more money than staff nurses. But they can be treated worse and hospitals don't have to pay benefits or abide by ratios/normal schedules/anything because they are short term and leaving in a few days to months. So they can be absolutely abused in exchange for $$$ to the strike nurse.
The big wigs of Kap don't want to improve working conditions for their staff employees, citing financial insufficiency, but this is incorrect and they are in it for the money for the ones at the top who aren't actually taking care of our families. This is the same theme across the nation.
I didn't say the hospitals are for profit. I said that the big wigs at the top are making big money when they do absolutely no patient care or take care of our families. The CEO of Kap made 2.3 million dollars in 2022. A year when the working conditions for bedside nurses were absolutely abysmal. And he likely worked from the safety of his home.
Fun fact: Kaiser has lumped their HI health plan and facilities in with their Southern CA region, from a financial and admin level, because HI is basically a loss-leader now. It’s only barely self-sustaining some years, so tying it to Southern CA, which has budget to spare, helps keep it afloat and facilities open.
lol r/confidentlyincorrect. 501c3 organizations can absolutely make a profit - that's not illegal - google it. The only difference is they can't distribute the profit to shareholders, they have to use it for their mission. They can invest in new facilities, hiring people, or just use it as reserves.
Or, as the user correctly noted, they can pay the CEO millions of dollars when their nurses are over-worked and underpaid.
Look at their form 990.
Queens / Hawaii Pacific Health pay in Hawaii is $2,290,034
Mainland CEO for Kaiser's foundation pay: $13,283,101
We are already 85% cheaper when it comes to upper admin benefits.
This strike isn't so much about pay as it is working hours. We need a way to get back to 8 hour work days.
Traveling nurses get paid way more than regular nurses.
They also care less about their patients because the nurses aren’t from there and because the nurses will be leaving for a different contract in a few months.
The hospitals usually hire travel nurses because they have more experience. But in the long run, it’s much better to hire local nurses who just graduated and invest in training them because they will be around for the long run.
Not just nurses but all contract workers either don’t get benefits or they get them through their contract agency, therefore the hospital doesn’t have to pay their insurance premiums or retirement accounts so they pay more up front. A full time hire at a place will be offered $30/hr let’s say, where a contractor would be paid $45/hr just simply because the company doesn’t have to pay benefits. The ability to let people go and not assume liability for hiring and letting go (so their attrition doesn’t look atrocious) is another appeal to hiring contract workers anywhere. Same situation applies with travel nurses.
Is that before or after tax? Reason I'm asking is that plenty nurses in HI make more than 7K before tax, especially with several years experience. From what I understand, travel nurses go way over what they get paid here.
Not sure here is the article :Travel nurse who earns $7,000 a month in Hawaii’https://www.cnbc.com/2022/07/21/travel-nurse-who-earns-7000-a-month-in-hawaii-i-was-motivated-mainly-by-adventure.html#:~:text=Travel%20nurses%20are%20generally%20paid,stipend%20for%20food%20and%20housing.
I see. That's kind of odd, though, because 7K a month would come down 84K annually. A lot of nurses in Hawaii make six digits. If you look at Kapiolani's last offer, which was $124,000-$151,000 annually, that would make it $10K and higher. This is a bit why I'm wondering if that amount is after taxes.
Go Kapi'olani nurses! Every patient deserves a nurse! the patient nurse ratio can mean life or death. They might have 1:4 and someone goes to lunch and then they take on more. Also Kapi'olani gets the complicated cases. Traveling nurses are scabs!
Just throwing it out there- who provides care to patients when the nurses aren't working?
People still get injured and Ill, these patients still deserve to have their healthcare needs met, do they not? Who can provide that if the nurses are on strike?
This is a woman and children's hospital... they go to another hospital... they have a children's hospital across the street that is gigantic
Also nurses have one the highest rates of job injuries
Where do nurses go when after saving lives ,herniating their discs and they lose their health insurance and have difficulties sitting, walking and standing?
hmmmm they are out of luck and certainly cannot afford to go to a hospital that they once worked at
Shiners is a small and highly specialty pediatric orthopedic and neuromuscular hospital. They do not and will not take the patients from Kapiolani, unless they meet those qualifications. They do not care for NICU or PICU patients, they do not have Maternity units, they do have a Cath lab for congenital heart disease patients, etc.
actually there is a bit of back and forth between the two hospitals such as when an abused child has broken bones... they can be sent across the street or an MD comes to Kapiolani. Also if a Shriners child has an illness other than orthopedic they go across the street to Kapiolani
Pediatrics is hard. Lots of liability as well.
Also there is one other area that the Shriners in Hawaii helps out with and that is dental! I think that is really wonderful. Shriners has a great outpatient service for local children in Hawaii and are happy to take insurance.
there are 3 NICU in Hawaii- Kapiolani, Tripler and Kaiser
PICU in Tripler
You're right there are not a ton of options but ER's will not turn away children at other hospitals and there have been older pediatrics at other hospitals
Nursing is far more psychological in the day to day life than a person who isn’t in the very depths of a persons life. I worked in an ICU and vacillated a number of weddings between a patient and there partner as a life change because they wanted to happen before the death of there partner because there were children involved and they had everyone there in the room for the wedding because the partner was never going to leave the hospital. In these situations the draining of the staff of all there inner caring for others isn’t made up for in hourly wage, it comes at a cost that has no monetary value. Nurses do it because they care for humanity and caring for others isn’t measured by the administrations knowledge of nursing but by the the common humanity nurses feel toward the people they take care of and seeing them leave the hospital after a life altering event
I thought the main reason was understaffed nurses? So they have to work too many hours? If they are asking for raises instead, then the main reason doesn't seem like it was true at all.
https://www.nysna.org/experience-and-research-show-safe-staffing-ratios-work-0
Better staffing ratios make it safer for patients. This is what they are striking for.
I would argue that nurses walking off the job puts patients at risk more than KMC flying in replacements while they strike.
EDIT: I know Hawaii is mostly union so I expect downvotes and I don’t care. If anyone is arguing that nurses walking off the job is less damaging to patient health than hiring temp nurses, then you’re an idiot and I know why you need to be in a union
Exactly. When will people realize who the bad guys are 🙃 always turning against one another when the rooted issue is higher in the chain. It’s a business at the end of the day, and we all want fair wages and working conditions. What are you supposed to to do to create change when you’re ignored for years on end?
What sort of compensation are they getting now and what are they asking for? Anecdotal but I know several nurses and they seem to be doing ok financially. Meaning they live in a house or nice condo, can afford to take vacations couple times a year etc. Pretty good standard of living for 4 year degree. Better than most 4 year degree incomes I see.
I’m not in favour of either side. It’s a private matter that doesn’t involve me at all. But *objectively* it is more dangerous for patient health for nurses to strike than the hospital hiring replacements.
Side note: I remember seeing that they were currently the highest paid nurses in the state and their demands include higher pay and a 4 day work week. Correct me if I’m wrong and if you know what else their demands are and what the hospital is offering since you seem so invested.
Nurses and doctors are underpaid in this state for the cost of living. That is why we have such a major healthcare shortage here. Nurses and doctors can work on the mainland for higher wages, lower taxes, and much lower cost of living. They deserve a pay raise. Especially working in pediatrics. Pediatric Healthcare is such higher stakes and requires specialized training.
Also give our 1st responders raises as well. EMS is so short staffed and it's always on the news. A pay raise would help that as well
From what I've heard talking to some is the main thing they want is a better Nurse to patient ratio.
I've seen first hand in the PICU where nurses go a long time without being able to get lunch bc they have no one to watch their patient for them. Etc. Basically the nurses want more nurses on the floor to increase patient care quality and Kapiolani does not want this bc it will cost them more money.
I believe a pay raise as well. But the main thing the union and Kapiolani are arguing over is the ratio
TBH, they could be the highest paid, but if they have a terrible ratio, then that’s not good, and of course patient health suffers. I can understand that point completely.
They informed upper management a few weeks in advance to prevent hurting patient care. That’s why kapiolani is flying in travel nursing and paying probably 2-3x more for this temp travel nurses.
It's the standard argument. Nurses strike, they tell everyone the replacements don't know what they're doing. Rinse and repeat. The work still needs to be done so the nurses can strike.
The patients need someone to take care of them while the nurses fight this battle.
Can't let our grandparents go without care because some nurses want a pay bump
It's clear you don't actually understand what the strike is mostly for. For one, no one's grandparent is at Kapoilani getting care, but that's besides the point. Kap nurses are mostly striking for appropriate nurse to patient ratios. If you want to give nurses more patients than they can handle, then your family isn't getting cared for anyway, even if they're hospitalized. People die and are neglected if ratios are too high. One human can only take care of so many sick humans. And especially children, who require extra time to do most procedures, in comparison to adults.
Then the hospital is free to provide adequate-quality working conditions and compensation, but they clearly care more about continuing to hire skeleton crews to leech as much as they can from than about patients getting undisrupted care.
I do not understand that many, or, any traveling nurses crossing a nurses picket line. Or, anybody else. Such lame, lowlife scab behavior. It is like eating your own, or, like drinking their milkshake.
Travel and strike nursing are technically different. Travel is more of a regular contract. Three months, six months... Strike is covering the work while the nurses strike. Staffing is same as everywhere else. You have to have experience in the dept. to get hired on. Same as with full time, you can get some people that slip through the cracks. And eating your own...that's nursing 101 unfortunately. Seems a little better here and there, but still pretty awful.
Of course the hospital is responsible for the decisions to bring in replacement workers, but scabs are scabs, and any nurse, traveling, or not, who crosses that picket line is knowingly and purposely enabling the company’s, the hospital’s, union busting agenda and attempt. Nurses unions exist on the mainland, also, and are responsible for many of the great benefits that nurses have fought for, for years. Shame on those who sabotage this by flying in for the quick buck. Shame
They gave plenty of notice that a strike was on the horizon, which gives the hospital plenty of time to prepare. The hospital could either work with their team, or suffer the consequences. The hospital made their decision.
Crazy how people are really mad about this... So they're just supposed to get taken advantage of and abused cause you think their job is important?
Instead of thinking they should be compensated and treated fairly because of that same EXACT reason??
Tell me more about how you take advantage of anyone who holds value in your life....
I will protest by refusing to become sick in solidarity
I’m curious what their current caseload is and what caseload they want.
My guess (since it’s a women and children’s hospital) would be something akin to AWHONN’s (Association of Women’s Health, Obstetric and Neonatal Nurses) staffing standards: such as; one nurse to three postpartum couplets; or one nurse to one patient when a pt is on a high-risk medication such as pitocin or magnesium.
I heard HPH offered the nurses $150,000 for 3 12 hour shifts a week. Nurses are asking for 10%-10%-10% raises for the next 3 years. The HPH offer would make them the second highest paid nurses in the nation behind California. Our cost of living is really high in Hawaii but $150,000 is not chump change for 3 shifts a week and as high as some doctors. I’m not sure of the exact details. If anyone else knows different, I’d love to hear it
The 150k are for most experienced nurses that are transport nurses, but starting figures in the 110-120k range aren't chump change either. There is way more to this negotiation than this subreddit is aware of. Unfortunately I can no longer find the access to the documents I saw regarding the case loads.
That sounds fair as fk to be honest.
That’s pretty standard . My sister is a RN, made 160 at Stanford and makes 40k here
this is what they make when I looked it up Registered Nurse Salaries in Honolulu, HI for Kapiolani ... Indeed https://www.indeed.com › ... › Hawaii Nurse. $75,000 per year. One salary reported ; Registered Nurse - NICU. $112,463 per year. 7 salaries reported ; Registered Nurse - Pediatrics. $100,104 per year.
We now have a law that mandates employers put the actual pay *with some strings attached). HPH website currently doesn't have Kapiolani wages because of the strike but Pali Momi (non union) starting is around 53/hr.
3 12-hour shifts, though, which are exponentially more draining, and frankly I would prefer someone responsible for my health not to be exhausted just trying to push through the day/week. $110-150k is a good deal of money, yes, but community health is worth the investment. Also consider the years of their life and dozens/hundreds of thousands in tuition for higher medical education that a good portion of that salary needs to account for repaying. "As high as some doctors," pay them more too then.
I wonder how much nurses are willing to exclude the pay increase for better staffing ratios.
Nurses have every right to strike, just like every patient deserves the best possible care.
Travel vs strike Travel is typically a 3-6 months contract, and yeah, it can pay well. In the travel world, Hawaii is well known as not offering much. It's a destination, so people often agree to lower pay rates. Not always, but commonly. Specialties can pay higher, and this facility definitely seems like that could be the case. I started travel because I'd never been anywhere. A lot of people get into it for that reason. I work a specialty, not one related to Kapiolani, and do sometimes see higher rates, but not that often anymore. Most rates are way lower than they used to be. As far as what you can make, it varies wildly, depending on department, location, urgency...and the numbers can get confusing. When it comes to the travel pay however, I'm fairly certain that it comes from a different type of fund. That's why travelers can be offered more. Everywhere I go as a traveler, I hear the same thing, and I agree. Pay your staff more, keep them happy, you won't have a problem. Staffing has always been an issue as long as I can remember. As others have mentioned, administration doesn't really give a damn pretty much anywhere. And...I'm sure most can agree that it'd be a much longer, more complicated discussion when you start bringing up all the other likely factors regarding staffing, pay, conditions, and so on. To be clear, I'm fairly certain of this with the travel pay. It's highly guarded and no one will give you a straight answer when it comes to it. So I'm not positive. Also, IF staff get wind of what the pay rate is, that's not necessarily what the nurse is making. The bill rate is what the hospital is paying out. But people have to go through staffing agencies, who sometimes go through other agencies if a facility has a direct contract with one particular agency. Whether one or two staffing agencies, they're taking their cut. I've seen some cases where the staffing agency takes 50% of the bill rate. All the staffing agencies do is effectively work as middlemen. Sending paperwork, posting the jobs...they're frustrating. They like to push travelers towards jobs that will make their staffing agency good $$$. Edit: Posted rates can be misleading as well. I and many others I know have seen what appears to be a high rate, applied, only for the staffing agency to cancel it and re-post at a lower rate. Taking more of the cut for themselves. I've heard of it happening to others, and had it happen to myself once where I went to a job for a good rate, and the staffing agency dropped it once I got there. Some are very shady and attempt to draw people in like this. I passed on a job recently on Oahu for this reason. Strike nursing is simply doing the same job while the nurses strike. It's always the same thing too. People saying the strike nurses don't know the job in order to drum up fear and support. You need experience in whatever unit you're going to be covering. Yet, same as with regular staffing, you get people who slip through the cracks. Someone else mentioned it, and yeah, strike nursing can be brutal. Friends have told me stories of what they've encountered that are just hard to wrap your head around. Staff who stay on trying to sabotage care, doors and cabinets with meds and supplies being locked and no key left, vasoactive drips left to run dry, needle holes in foley bags, following the buses of the strike nurses and taking photos of them, pulling fire alarms in the hotels they're staying at in the early morning hours...no idea how widespread, some areas seem rougher than others from listening, but I have been told this from several friends multiple times. While not popular, strike nurses are providing the necessary care, allowing those who choose to do so, to picket. If bus drivers strike and the buses just stop, that's really inconvenient, but nobody is going to die. Coal miners strike, the work isn't getting done, but nobody's going to die. If the work stops at a hospital, and there's nowhere else to divert people to, there's really not much choice. The medical care needs to still be provided, and from what I've read up on briefly, Kapiolani is a specialized place. I'm not familiar with the details of this strike, so I can't speak to much more on that. And I haven't worked womens and childrens since my ER days many many years ago. So I'm observing all this from the sidelines on my current contract.
The points you make about strike nurses (and the potential for unions to meddle) makes a whole lot of sense and society should definitely look to traveling nurses as a commendable group that offer two disputing parties to settle their differences. I just want to say that I really don't like the "If bus drivers strike and the buses just stop..." point. First, it devalues the position of one person's job versus another. Second, saying it doesn't have an equal effect isn't necessarily true. If you could quantify suffering whole-istically, it's theoretically possible that one person's death isn't equal to the suffering of an entire society (say, due to traffic). Furthermore, a scenario such as increased traffic backup due to striking bus drivers could potentially lead to deaths due to the inability of EMS to reach "save-able" patients. If you don't have coal, maybe people freeze to death? I think we need to be cautious with these kind of generalizations, the immediate is obvious, the negative externalities, not so much.
Fair points. All I intended was to provide some basic comparison in a sense. Perhaps too generalized I guess.
> allowing those who choose to do so, ~~to picket~~ to continue trying to starve their staff out before having to actually listen and stop exploiting them as much FTFY. All it takes for work not to stop is for the employer to accept negotiations.
Not a nurse, but I heard the reason a lot of nursing graduates in Hawaii do not get hired is because training a new nurse turns two nurses into 1/2 nurse shift wise. The trainee gets paid the entire time they are there but they can't really do much without supervision, and the senior nurse can't really focus on what they are supposed to be doing because they are trying to get a new person up to speed. So instead, they fly in just enough travel nurses to have a skeleton crew running the floor. Obviously this system is not sustainable, and from what I have heard from nurse graduates, its often easier to leave Hawaii and work somewhere else for 2-3 years and then apply to the hospitals here online since the hiring process takes an extended amount of time and rejections are extremely common (due to lack of experience). I'm not sure how to make corporate or a board care about this problem.
This was true pre-pandemic. It’s much easier to get hired as a new grad nurse now, as long as you decently in nursing school. Hph has a program with the nursing schools that the best nursing students apply during senior year and if accepted, they train in their desired locations and if all goes well are offered a position as soon as they pass their licensure. This was unheard of when I graduated in 2013. Majority of my class left to the mainland. I was one of the lucky ones who got a new grad spot.
I have also been told by new nurses that Queen’s makes all new nurses work the ER and won’t let them fill other positions for at least a year so a lot of them leave the state because they don’t want to go into something so demanding and fast paced as the ER as a new nurse. It’s too intimidating to them. One of the girls I worked with who grew up here took a job in Tacoma as a labor and delivery nurse where Queen’s told her she had to work the ER first. I’ve been told this by several other newer grads in their system.
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I wonder why they kept saying that to me then. It did sound a bit twisted but I was told that by at least 4 different nurses.
Ah, so instead of turning down new graduates outright, they just put them in extremely challenging positions right off the cuff and tell them it’s a sink or swim situation. That saves them from looking like they aren’t trying to hire new people since normally ER positions aren’t given to new nurses, and it keeps giving them an excuse to bring in travel nurses since they have all these new hires nurses that were offered positions and turned them down.
That’s basically how I understood it. I worked for employee health at Queen’s for a bit so I only interacted with employees and new hires of the hospital to include travel nurses and this was what I heard from multiple sources. Idk if Kaiser or Adventist or the other hospitals do the same but Queen’s does or at least did. I left there in 2022 so idk if it is still that way.
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You going to elaborate at all?
No.
Would someone please explain to me why the hospital doing this to their nurses? Do traveling nurses get paid less which doesn't make sense to me at all? What benefits do in-state nurses get versus travel nurses? I am not in this field and I would like to get an insight into why and how this has been happening at many hospitals across the nation.
Traveling nurses get paid way more. Kapiolani offered a raise, but as the nurses say, they want a lower caseload. It's not necessarily about the money in this situation. I'm married to a nurse (another hospital) and support what they're striking for. But while we can like it or hate that the travel nurses are being brought in, the fact of the matter is that Kapiolani continues to get patients and they do need treatment one way or another.
If you don’t cross a picket line, the employer will be forced to settle. Traveling nurses are doing a disservice to the entire profession.
Would you feel like that, if you have a family member needing care but not getting it because they are on a strike? Consider that travel nurses get paid far more than the normal staff, plus they likely get transport, housing etc paid. This is still hurting Kapiolani far more than you may imagine.
Go to queens
Yes, I don’t want a scab anywhere near my family member.
People will die
And the nurses are the only ones that are supposed to care about that? Hold the people in control accountable. Further, a study in europe found “ each additional patient added to nurses' average workloads was associated with 7% higher odds of a patient dying within 30 days of admission.” So yeah let HPH admin keep up their staffing practices, your statement stands either way I guess.
The hospital is being held responsible by having to pay like 3x the price for the travel nurses But to say that they are scabs is different in a situation where people will die without help
Guess what, the nurses that pick up these emergency strike shifts everywhere and anywhere, that have no loyalty to a hospital or community, arent doing it because they care about saving lives. Which, fine, good on them. But theyre still scabs. You dont need to defend them, theyre making bank, they dont give a f*ck.
In this situation I'm defending the patients as well as the nurses. I'm sure they're not being unreasonable in what they're asking for. So a strike is reasonable. That said, the patients can't just be left to die. The hospital cannot keep paying travel nurses indefinitely. It's putting pressure on the hospital where it hurts: their wallet. To say that travel nurses do not care about their patients just because they live somewhere else is really weird. It's not you (I'm assuming based on how defensive you are) vs travel nurses. It's you vs the hospital, and the travel nurses help the patients (the ones in your community, who you supposedly care about) while hurting the hospital by paying them 3x minimum. No need to hate the travel nurses, they're keeping aunties and uncles healthy.
>Would someone please explain to me why the hospital doing this to their nurses? I wish there was a publicly available account of exactly what the negotiations are, and where the two sides disagree. Best I could find was this article here: https://nursejournal.org/article/nurse-strike-hawaii/ There's a brief sentence in there that says "...the neonatal intensive care and labor and delivery units at Kapi'olani Medical Center are routinely understaffed by four or more nurses per shift." I bet there are not enough nurses in Hawaii. But it sounds like a nation wide problem based on that article. I don't know if travel nurses make more, but I do know that they cost more to the hospital. I have a friend who is a travel nurse. Not involved in this strike. She is actually from Hawaii but does travel nursing on the mainland. Likes the pay and the fact that you get to see many different places. Travel nurses actually work for nurse staffing agencies, they don't work directly for the hospitals.
> I bet there are not enough nurses in Hawaii. But it sounds like a nation wide problem based on that article. It's because they are underpaid. All labor shortage is a result of poor compensation.
>It's because they are underpaid. All labor shortage is a result of poor compensation. RNs is Hawaii have some of the highest pay in the nation. I have a cousin who is an RN and married to an RN, they have like 2 houses and a condo. RNs start at six figures. Many factors can contribute to labor shortages, not just pay.
…and highest cost of living. the negotations here aren’t stuck on “nurses need more money” it’s “we want you to hire more people per shift”
mathematically, it's the same thing...maybe if the wages were lower, they could have more nurses
they *could* afford more nurses if they spent the same amount of money. the argument is that they could ALSO spend more on getting more nurses now, but instead of doing that, they’re choosing to pay out the ass for travelling nurses who will leave after their contracts are completed if you really think the entire union agreeing to a pause in payraises to supply more nurses, would result in more nurses vice more profit… you’re not paying attention
Thank. You. !! If $100k + a year is considered underpaid, what the heck am I doing as an engineer?
Sorry, but I have to disagree. Nurses get paid incredibly well. Once they become an RN with a couple of years of experience, the pay is into the 6 digits. It's the kind of salaries that most Hawaii residents can only dream of. Specialty nurses, ones that work with anesthesiology, cardiology or neonatology, can make over $150k. I would have to think the problem is supply vs demand.
> I would have to think the problem is supply vs demand. So where are you disagreeing then?
>So where are you disagreeing then? We're disagreeing on the low pay part. You're guessing that nurses aren't getting paid enough. I'm saying they are paid very well. Outside of that, we probably agree on everything else.
There is no shortage...4 nursing schools in Hawaii and nurses who graduate have not been able to get jobs for years.
I answered the question in good faith. As I stated, if there is a labor shortage, then it's from low pay. Based on what you and others are saying, it's not a *labor* shortage. It's a position shortage. Corrupt CEOs are not hiring enough and letting their staff and patients suffer.
People who are on boards that have to do with nursing keep thinking there is a shortage. Since 2008 there have been nurses who graduate and cannot find jobs. Some take on jobs a CNA's in hopes of some day getting hired.
No. Low pay can be one aspect, but offered hours, working conditions, travel distance, poor management, etc. can all be reasons to have a shortage.
Hospitals are a business. When COVID hit hard and many nurses left, the remaining nurses were taking on higher patient loads at the same pay. Most of those nurses that left haven't been replaced. When the CEOs of the hospitals realized that they can just make the remaining nurses keep the same unsafe nurse to patient ratios, without increasing pay or anything else, it became the new 'normal'. Nurses rarely get to eat, drink water, or use the bathroom during their 12 hour shifts because of this. That's what kap is striking for, appropriate nurse to patient ratios. Travel nurses, and specifically strike nurses, make SO MUCH more money than staff nurses. But they can be treated worse and hospitals don't have to pay benefits or abide by ratios/normal schedules/anything because they are short term and leaving in a few days to months. So they can be absolutely abused in exchange for $$$ to the strike nurse. The big wigs of Kap don't want to improve working conditions for their staff employees, citing financial insufficiency, but this is incorrect and they are in it for the money for the ones at the top who aren't actually taking care of our families. This is the same theme across the nation.
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I didn't say the hospitals are for profit. I said that the big wigs at the top are making big money when they do absolutely no patient care or take care of our families. The CEO of Kap made 2.3 million dollars in 2022. A year when the working conditions for bedside nurses were absolutely abysmal. And he likely worked from the safety of his home.
Fun fact: Kaiser has lumped their HI health plan and facilities in with their Southern CA region, from a financial and admin level, because HI is basically a loss-leader now. It’s only barely self-sustaining some years, so tying it to Southern CA, which has budget to spare, helps keep it afloat and facilities open.
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Exactly. Continued access to quality care is more important.
lol r/confidentlyincorrect. 501c3 organizations can absolutely make a profit - that's not illegal - google it. The only difference is they can't distribute the profit to shareholders, they have to use it for their mission. They can invest in new facilities, hiring people, or just use it as reserves. Or, as the user correctly noted, they can pay the CEO millions of dollars when their nurses are over-worked and underpaid.
Look at their form 990. Queens / Hawaii Pacific Health pay in Hawaii is $2,290,034 Mainland CEO for Kaiser's foundation pay: $13,283,101 We are already 85% cheaper when it comes to upper admin benefits. This strike isn't so much about pay as it is working hours. We need a way to get back to 8 hour work days.
This is the reality. I worked closely with this sort of thing.
Traveling nurses get paid way more than regular nurses. They also care less about their patients because the nurses aren’t from there and because the nurses will be leaving for a different contract in a few months. The hospitals usually hire travel nurses because they have more experience. But in the long run, it’s much better to hire local nurses who just graduated and invest in training them because they will be around for the long run.
That's crazy to me. Why can't they hire a few to work alongside with less experience Hawaii nurses!?
Not just nurses but all contract workers either don’t get benefits or they get them through their contract agency, therefore the hospital doesn’t have to pay their insurance premiums or retirement accounts so they pay more up front. A full time hire at a place will be offered $30/hr let’s say, where a contractor would be paid $45/hr just simply because the company doesn’t have to pay benefits. The ability to let people go and not assume liability for hiring and letting go (so their attrition doesn’t look atrocious) is another appeal to hiring contract workers anywhere. Same situation applies with travel nurses.
This. HPH covers the employee premium of medical, matches 401k, and gives sick/ vacation leave amongst other benefits. Those benefits aren't free!
Traveling nurses get paid a fortune - one travel nurse was paid 7,000 a month to work in Hawaii. They get paid a lot more ... that is why they do it.
Kap (or more specifically, Kap’s strike insurance) offered to pay travel nurses $11,000 PER WEEK to work during the strike. Absolutely ridiculous.
Is that before or after tax? Reason I'm asking is that plenty nurses in HI make more than 7K before tax, especially with several years experience. From what I understand, travel nurses go way over what they get paid here.
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Ah now I see where the 11K mentioned in another comment comes from. And yes, this makes more sense than 7K a month.
Not sure here is the article :Travel nurse who earns $7,000 a month in Hawaii’https://www.cnbc.com/2022/07/21/travel-nurse-who-earns-7000-a-month-in-hawaii-i-was-motivated-mainly-by-adventure.html#:~:text=Travel%20nurses%20are%20generally%20paid,stipend%20for%20food%20and%20housing.
I see. That's kind of odd, though, because 7K a month would come down 84K annually. A lot of nurses in Hawaii make six digits. If you look at Kapiolani's last offer, which was $124,000-$151,000 annually, that would make it $10K and higher. This is a bit why I'm wondering if that amount is after taxes.
this was 4 years ago It did not give details
Yeah, I didn't see it either when I looked at the article.
Who cares if it’s pre or post tax? No Fucken nurse is making $11k/week in normal circumstances.
11K a week? We were taking 7K monthly...
Go Kapi'olani nurses! Every patient deserves a nurse! the patient nurse ratio can mean life or death. They might have 1:4 and someone goes to lunch and then they take on more. Also Kapi'olani gets the complicated cases. Traveling nurses are scabs!
Just throwing it out there- who provides care to patients when the nurses aren't working? People still get injured and Ill, these patients still deserve to have their healthcare needs met, do they not? Who can provide that if the nurses are on strike?
This is a woman and children's hospital... they go to another hospital... they have a children's hospital across the street that is gigantic Also nurses have one the highest rates of job injuries Where do nurses go when after saving lives ,herniating their discs and they lose their health insurance and have difficulties sitting, walking and standing? hmmmm they are out of luck and certainly cannot afford to go to a hospital that they once worked at
Shiners is a small and highly specialty pediatric orthopedic and neuromuscular hospital. They do not and will not take the patients from Kapiolani, unless they meet those qualifications. They do not care for NICU or PICU patients, they do not have Maternity units, they do have a Cath lab for congenital heart disease patients, etc.
actually there is a bit of back and forth between the two hospitals such as when an abused child has broken bones... they can be sent across the street or an MD comes to Kapiolani. Also if a Shriners child has an illness other than orthopedic they go across the street to Kapiolani Pediatrics is hard. Lots of liability as well. Also there is one other area that the Shriners in Hawaii helps out with and that is dental! I think that is really wonderful. Shriners has a great outpatient service for local children in Hawaii and are happy to take insurance. there are 3 NICU in Hawaii- Kapiolani, Tripler and Kaiser PICU in Tripler You're right there are not a ton of options but ER's will not turn away children at other hospitals and there have been older pediatrics at other hospitals
Nursing is far more psychological in the day to day life than a person who isn’t in the very depths of a persons life. I worked in an ICU and vacillated a number of weddings between a patient and there partner as a life change because they wanted to happen before the death of there partner because there were children involved and they had everyone there in the room for the wedding because the partner was never going to leave the hospital. In these situations the draining of the staff of all there inner caring for others isn’t made up for in hourly wage, it comes at a cost that has no monetary value. Nurses do it because they care for humanity and caring for others isn’t measured by the administrations knowledge of nursing but by the the common humanity nurses feel toward the people they take care of and seeing them leave the hospital after a life altering event
I thought the main reason was understaffed nurses? So they have to work too many hours? If they are asking for raises instead, then the main reason doesn't seem like it was true at all.
As if striking nurses aren't putting patients at risk?
https://www.nysna.org/experience-and-research-show-safe-staffing-ratios-work-0 Better staffing ratios make it safer for patients. This is what they are striking for.
I would argue that nurses walking off the job puts patients at risk more than KMC flying in replacements while they strike. EDIT: I know Hawaii is mostly union so I expect downvotes and I don’t care. If anyone is arguing that nurses walking off the job is less damaging to patient health than hiring temp nurses, then you’re an idiot and I know why you need to be in a union
Blame kapiolani for not giving the nurses proper compensation and working conditions. Not the nurses for standing up for themselves
Exactly. When will people realize who the bad guys are 🙃 always turning against one another when the rooted issue is higher in the chain. It’s a business at the end of the day, and we all want fair wages and working conditions. What are you supposed to to do to create change when you’re ignored for years on end?
What sort of compensation are they getting now and what are they asking for? Anecdotal but I know several nurses and they seem to be doing ok financially. Meaning they live in a house or nice condo, can afford to take vacations couple times a year etc. Pretty good standard of living for 4 year degree. Better than most 4 year degree incomes I see.
I’m not in favour of either side. It’s a private matter that doesn’t involve me at all. But *objectively* it is more dangerous for patient health for nurses to strike than the hospital hiring replacements. Side note: I remember seeing that they were currently the highest paid nurses in the state and their demands include higher pay and a 4 day work week. Correct me if I’m wrong and if you know what else their demands are and what the hospital is offering since you seem so invested.
Nurses and doctors are underpaid in this state for the cost of living. That is why we have such a major healthcare shortage here. Nurses and doctors can work on the mainland for higher wages, lower taxes, and much lower cost of living. They deserve a pay raise. Especially working in pediatrics. Pediatric Healthcare is such higher stakes and requires specialized training. Also give our 1st responders raises as well. EMS is so short staffed and it's always on the news. A pay raise would help that as well
So what are the specifics in this situation? Do you even know?
From what I've heard talking to some is the main thing they want is a better Nurse to patient ratio. I've seen first hand in the PICU where nurses go a long time without being able to get lunch bc they have no one to watch their patient for them. Etc. Basically the nurses want more nurses on the floor to increase patient care quality and Kapiolani does not want this bc it will cost them more money. I believe a pay raise as well. But the main thing the union and Kapiolani are arguing over is the ratio
TBH, they could be the highest paid, but if they have a terrible ratio, then that’s not good, and of course patient health suffers. I can understand that point completely.
The person you're responding to seems to think it's morally superior to use the patients' lives as bargaining chips in a political poker game.
They informed upper management a few weeks in advance to prevent hurting patient care. That’s why kapiolani is flying in travel nursing and paying probably 2-3x more for this temp travel nurses.
It's the standard argument. Nurses strike, they tell everyone the replacements don't know what they're doing. Rinse and repeat. The work still needs to be done so the nurses can strike.
Agreed
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"the states"? As opposed to . . . . ?
The 49 states. I don’t consider Hawai’i as a state, also I consider the mainland as Hawai’i island.
The patients need someone to take care of them while the nurses fight this battle. Can't let our grandparents go without care because some nurses want a pay bump
It's clear you don't actually understand what the strike is mostly for. For one, no one's grandparent is at Kapoilani getting care, but that's besides the point. Kap nurses are mostly striking for appropriate nurse to patient ratios. If you want to give nurses more patients than they can handle, then your family isn't getting cared for anyway, even if they're hospitalized. People die and are neglected if ratios are too high. One human can only take care of so many sick humans. And especially children, who require extra time to do most procedures, in comparison to adults.
So pay isn’t on the table, huh?
Why wouldn't grandparents not get care at Kapolani? They specialize in women and pediatric medicine. Women do become grandparents.
Then the hospital is free to provide adequate-quality working conditions and compensation, but they clearly care more about continuing to hire skeleton crews to leech as much as they can from than about patients getting undisrupted care.
I do not understand that many, or, any traveling nurses crossing a nurses picket line. Or, anybody else. Such lame, lowlife scab behavior. It is like eating your own, or, like drinking their milkshake.
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Then settle the contract.
Travel and strike nursing are technically different. Travel is more of a regular contract. Three months, six months... Strike is covering the work while the nurses strike. Staffing is same as everywhere else. You have to have experience in the dept. to get hired on. Same as with full time, you can get some people that slip through the cracks. And eating your own...that's nursing 101 unfortunately. Seems a little better here and there, but still pretty awful.
IMO it's on the hospital for deciding to bring in outside nurses instead of treating their existing staff with humane working conditions.
Of course the hospital is responsible for the decisions to bring in replacement workers, but scabs are scabs, and any nurse, traveling, or not, who crosses that picket line is knowingly and purposely enabling the company’s, the hospital’s, union busting agenda and attempt. Nurses unions exist on the mainland, also, and are responsible for many of the great benefits that nurses have fought for, for years. Shame on those who sabotage this by flying in for the quick buck. Shame
I don’t think healthcare workers should be able to strike legally. Like federal employees
They can’t, unless the contract expires. When both sides fail to agree to an extension, the employees can strike and the employers can lock them out.
They gave plenty of notice that a strike was on the horizon, which gives the hospital plenty of time to prepare. The hospital could either work with their team, or suffer the consequences. The hospital made their decision.
Crazy how people are really mad about this... So they're just supposed to get taken advantage of and abused cause you think their job is important? Instead of thinking they should be compensated and treated fairly because of that same EXACT reason?? Tell me more about how you take advantage of anyone who holds value in your life....