Even though the Petaluma Valley Hospital's first ever one-day nurses strike held last Wednesday has concluded, union nurses and hospital management remain at odds, leaving the nurses looking to the Petaluma Health Care District to intervene.

Labor negotiations between hospital management and the union nurses broke down last month when the hospital tried to get the nurses to ratify the following: a reduction in on-call -shifts where nurses must be available to work at the hospital within 30 minutes of a call; a pay reduction from 50 percent of their regular salary down to 30 percent for being on call; and an increase in the length of on-call shifts from 16 hours up to 48 and 72 hours.

When the nurses refused to accept these changes and asked to shelve the issue until formal contract negotiations begin in September, the hospital declared negotiations at an impasse, which allowed management to circumvent further negotiations and implement the new policy without nurses agreeing.

Union nurses responded by staging a one-day strike in protest of the changes. What started out as a one-day statement turned into a five-day lockout for the nurses who chose to participate in the strike. The hospital was forced to bring in replacement nurses for the one-day strike and used a staffing company whose contract with the hospital stipulated that replacements nurses be on staff for a minimum of five days.

Pam Koch, an obstetrics nurse at Petaluma Valley and a negotiation representative for the union nurses, said that the hospital used the contract with the staffing company as an excuse to lock out the nurses and that it was reflective of the rocky relationship between the nurses union and hospital management.

Koch added that nurses expected the Health Care District to mediate between hospital management and the bargaining units once negotiations became dead-locked. She said that the district set up meetings with all three parties, but did little to facilitate the talks — something she said is inexcusable for an elected body charged with maintaining the hospital's operating standards.

"We will be coming to the board again because we aren't convinced they are best serving our community," she said. "We understand that St. Joseph's runs the hospital, but if the board is really concerned about the community, then they need to step in."

The district owns the hospital's building and land. It leases the facility to St. Joseph's Health System, which runs the hospital itself and contracts staff.

The district's lease with St. Joseph's will be expiring in approximately four years, at which point the district can either renew its agreement with St. Joseph's, contract with a different health care organization, or manage the hospital itself.

A publicly elected, five-member board oversees the Health Care District, with each member serving a four-year term. Koch contended that nurses speak for the community and said that because the district is responsible for representing the community, it should have a board composed of people who are listening to the nurses.

"With three seats up for reelection this November, we need to be thinking about who is representing us on that board," she added.

Health Care District CEO Ramona Faith, who started with the district approximately 14 months ago, said this week that while St. Joseph's has told the nurses that reducing on-call pay is the least-invasive strategy to cutting costs — rather than eliminating positions — the nurses have the right to advocate for what they believe they need and that the district respects both sides.

"But I'm disappointed that an agreement hasn't been reached and the nurses felt the need to strike," she said.

Faith pointed out that nurses at Petaluma Valley Hospital are being paid a competitive salary and that hospitals across the state and country are looking for ways to decrease costs due to the increasing financial struggles that are partly due to decreased reimbursement rates for patient care.

Debra Miller, vice president of human resources at Petaluma Valley and Santa Rosa Memorial Hospitals added that the average nurse's salary at Petaluma Valley Hospital is over $100,000 a year and said that pay at the hospital remains competitive.

But nurse representative Jim Guerlich said that this issue over call-pay and scheduling isn't the first time the nurses have had difficulty negotiating with hospital management, adding that when they reached out to the Health Care District for assistance in the past, it did very little to solve their issues.

"We've felt like we couldn't get anything done with this administration, both the hospital and the district, for quite some time," he said.

Guerlich said that striking was about raising community awareness so that the district and hospital management would be forced to listen to their concerns, though he wishes that it had never come to that.

During the strike last Wednesday the hospital reported it was performing to its usual quality standards. Union nurses said that all but approximately 15 of its 162 regular nursing staff participated in the strike, a number that the hospital would not confirm.

Nurses returned to their regular schedules Monday. Miller said that the hospital was happy to have them back and hoped that the nurses would ratify changes that have already been implemented in on-call pay and scheduling. But Guerlich said that returning to the table before their formal negotiations in September is unlikely if hospital administration did not offer something new.

"We feel that we've dealt long enough with management who doesn't really want to negotiate with us," he said. "We eventually had to say &‘enough is enough'."

The current nurses union contract expires on Dec. 1.

(Contact Janelle Wetzstein at janelle.wetzstein@arguscourier.com)