A dozen people have been hard at work in the basement of Duluth's Labor Temple, stapling red and white posters to wooden handles -- the signs that a small army in red T-shirts will carry in front of Duluth's SMDC Medical Center Monday afternoon.
Duluth is the next front in a nationwide debate between nurses and health providers over how many patients a nurse can safely care for -- and whether nurse-to-patient ratios have a place in labor contracts.
Their demonstration comes just one week after Twin Cities nurses ratified a new contract, averting an open-ended strike by 12,000 union nurses.
DIFFERENT FROM TWIN CITIES STRIKE
Contract negotiations resume Tuesday between the Minnesota Nurses Association and Duluth's two hospital groups. So far, the nurses are holding out for new requirements on staffing and the number of patients under a nurse's care. Nurse-to-patient ratios were a leading issue in the Twin Cities negotiations, although their contract doesn't address the issue.
In Duluth, staffing is a key issue, said St. Mary's-Duluth Clinic nurse Steve Strand, a negotiator for the Minnesota Nurses Association. He said his hospital has cut up to 200 nursing positions in recent years.
"You have to have the correct number of nurses to be able to assess the patients appropriately so that you can provide the safe care that's necessary for patients," Strand said. "As there's less and less nurses, you have more and more patients to care for, and that just decreases the amount of time that you have for each patient."
Kirsti Hendrickson, a registered nurse at St. Luke's hospital in Duluth, said patients tend to need more time now, because they're arriving more ill than in previous years.
"And you're spending more and more time with those patients," she said. "So when you have nine patients that you're caring for, you're spread too thin."
Patient-to-nurse ratios were a key issue in recent negotiations between Twin Cities nurses and 14 metro-area Hospitals.
But Duluth nurses say the ratios are even more critical in the Twin Ports, where the number of patients under a nurse's care often climbs higher than in Twin Cities hospitals. Strand said Twin Cities nurses do have contract provisions allowing nurses to stop new admissions to an understaffed unit.
"They already have that within their contract," Strand said. "We don't have that up here in Duluth and we really do need to advocate for that because that's kind of the stepping stone toward ratios."
NEGOTIATIONS POSITIVE SO FAR
Mary Greene, a spokeswoman for St. Luke's, declined to comment in detail, saying it's premature to talk to the media. But she said negotiations are continuing in good faith and she wants that process to continue.
Kim Kaiser, a spokeswoman for St. Mary's-Duluth Clinic, said staff levels are safe for patients.
"We monitor our staffing levels every day, for every shift, for every unit, and if we need to we may even make adjustments in the middle of a shift," Kaiser said. "We also benchmark those staffing levels against national standards to make sure we are at or better than national standards."
Though both sides were watching the Twin Cities negotiations, but Kaiser said there are many key differences. Duluth's SMDC and St. Luke's, for example, are negotiating separately with nurses.
"We're not negotiating with a large hospital group as we saw down in the Twin Cities," Kaiser said. "At this point our talks very cordial, respectful, still productive, and so we're hoping we can avoid a strike."
Duluth nurses also are optimistic and describe positive negotiations.
Combined, there are more than 1,300 registered nurses at the two Duluth hospital systems. Staffing has dominated the conversation so far, with no proposals yet on economic issues. But the nurses say their staffing proposals have fallen on deaf ears at least one of the providers - SMDC Health System. That's the hospital targeted for today's informational picketing.