No new contract talks are scheduled a day after 1,300 Duluth nurses rejected contract offers and authorized their union to call a one-day strike against the city's two hospitals. A strike date has yet to be set.
But in Duluth, reaction to the nurses' contract rejection seems relatively tame.
Among those taking it in stride are Mary Cohen, an expectant mother who lives in west Duluth.
Cohen's first child could come as soon as next week. If so, she's probably safe from getting caught in a one-day nurses strike, which couldn't happen without a 10-day notice.
"I don't have a fear that patients for that day that the nurses would be on strike will go completely untreated or that the treatment will be substandard," Cohen said.
Theodore Johnson had a similar reaction. He and his partner, Angela, expect their first baby about Nov. 1, and Johnson expects things to work out.
"I think the bottom line is these nurses don't want to be off the job and the administration doesn't want to have them off the job," he said. "If worse comes to worse well they're going to go on strike, but I really believe that get it resolved without more than a day or two."
Earlier this summer 12,000 nurses in the Twin Cities held a one-day strike and reached a settlement on the eve of an indefinite walkout.
Staffing is a key issue in both disputes.
In Duluth, the nurses turned down contracts they say gives them little say in stopping new admissions to understaffed units. They're frustrated with long shifts, extra shifts and high patient loads. They're not demanding strict nurse to patient ratios as the Twin Cities nurses wanted.
Whatever the outcome, the rift is causing tension in the city's hospitals, according to Dr. Jeff Lyon, who specializes in treating hospitalized patients at St. Mary's Medical Center.
"There's certainly a lot of anxiety and sadness on the part of some nurses and physicians, because I think anytime that a strike happens it's a sign of failure on one part or another to try to agree on things that should be settled more amicably," he said.
Lyon has seen such tensions before. He was an intern in Hennepin County Medical Center in 1984 when nurses walked off the job at 15 Twin Cities hospitals for 38 days. He said a strike can have a long-lasting impact.
"It shakes up the institutions," Lyon said. "It shakes up the nursing practice somewhat."
But nurses say even just the threat of a strike is an important tool.
"Both hospitals need to know that as a group the nurses are serious about what it is we want in the contract," said Kate Donovan, a nurse who is a member of the SMDC bargaining unit. "We're going to need all the tools in our tool box to make that happen, and this is one of the tools in our tool box."
Officials with both St Luke's Hospital and SMDC Health System say they felt their contract proposals were fair and addressed the nurses concerns.
"We really felt that we had bargained in good faith and presented a contract offer that was fair, and that had exceeded our current contract," said Dr. Gary Peterson, St Luke's medical director.
He said the hospital's offer exceeded the contract that was recently ratified by the nurses in the Twin Cities.
Peterson said officials at St Luke's hope that nurses do not strike, but are working on a contingency plan to provide high quality care in the event of a walkout.
"We have signed a contract with a firm that will provide us with replacement RN's in the event of a strike, and it's possible that there will be some supervisory people that will be filling in as well," he said.
Meanwhile, the nurses union says a new round of talks with the other system, SMDC, is in the works for next week, though nothing's final yet.