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Scores of nurses picketed in front of Santa Rosa Memorial Hospital Saturday, the latest action in an ongoing labor dispute that has seen two strikes in 30 days.

This time, members of the Santa Rosa-based Staff Nurses Association, which represents about 660 Memorial Hospital nurses, were joined by burly men in baseball caps, t-shirts and jeans — members of Local 39 Stationary Engineers.

The local represents building equipment workers at both Memorial and Petaluma Valley hospitals who operate heating, ventilation, air conditioning, electrical and nurse call systems, as well as perform carpentry and painting work. Local 39 workers struck at both Petaluma Valley and Memorial hospitals.

The strike was set to last three days, but the hospitals will keep strikers out for an additional two days through the use of temporary hires.

Nurses walking the picket line Saturday insisted that patient safety was their primary issue, while hospital officials contend that unresolved issues are primarily related to wages and benefits.

Carrying a sign that read, "Patient Care is the Issue," Maureen Flanagan, a registered nurse in the hospital's neuroscience department, said she was striking to get hospital administration to agree to "appropriate staffing" that would ensure patient safety.

"Let's say I have five acutely ill patients. I might need one extra care partner to ensure patient safety," she said. "I've got people crawling out of bed because they're confused, at risk for injury. If I have four people doing that . . ."

Sue Gadbois, president of the nurses union, said the union is trying to get St. Joseph Health, which runs both hospitals, to agree to language in the union contract that would establish staffing requirements in accordance with the level of illness of patients.

Gadbois said that state law already mandates nurse-to-patient staffing ratios, but these ratios are not tied to the level of "patient acuity."

Debra Miller, vice president of human resources for St. Joseph Health in Sonoma County, said such language exists. She said St. Joseph was committed to maintaining safe levels of patient care.

She said that during labor negotiations two years ago the hospital "agreed to add additional staffing and float nurses to the extent of several million dollars." And she rejected claims made Saturday that the hospital was trying to reduce nursing staffing.

In its most recent proposal, the nurses union proposed wage increases of 4 percent in 2013 and 4 percent in 2014. Union officials said Saturday that these increases are lower than what they previously proposed. The hospital is proposing a 2 percent increase over two years.

The hospital also wants nurses to agree to a near quadrupling of nurses contributions to their health care coverage, from 3 percent of the total premium cost to 11 percent. Other issues include a proposed reduction in on-call pay.

Gadbois said current levels of pay are not competitive when compared to hospitals such as Kaiser Permanente Medical Center.

"You have to be able to retain nurses you have and attract new nurses as you need them," she said.

St. Joseph has hired replacement nurses for Memorial Hospital and replacement stationary engineers to keep both hospitals running. Miller said the replacement workers were given orientation and training prior to taking over operations at the hospital.

On Saturday, striking workers said they were getting reports from "people on the inside" of problems in the hospital, such no water on the fourth floor.

"We did have some water pressure issues today," said Miller. "But they were all resolved" without patient-safety issues, she said,

The nurses union also struck on Oct. 2, two days after its contract expired. The sides last met Oct. 31 and they're expected to meet again Saturday.

Local 39 has been without a contract since June 30, 2010, though the union and St. Joseph twice to extended the existing contract. The last extension expired in May.

Local 39 members said Saturday the hospital is trying to remove contract language that guarantees a 40-hour work week — a move they fear could jeopardize workers' full-time status.

Miller rejected that claim.

"The hospital has merely proposed to have the ability to hire part-time engineers in the future if needed," she said. "We did not propose to change any full-time engineers to part-time."