Nurses at North Hawai‘i Community Hospital Raise Concerns Over Understaffing, Pay Equity

Nurses at Queen’s North Hawai‘i Community Hospital are raising their voices for equity in pay to Honolulu colleagues as they continue to battle understaffing and retention issues at the Waimea facility.

The Hawaii Nurses’ Association is currently in mediation with the Queen’s Health Systems regarding nurse contracts at QNHCH that expired on April 1.

Within the past week, off-duty nurses have held two picketing campaigns outside the Waimea hospital to inform the public of their growing concerns regarding understaffing and wages.

“Consistent with our mission, patients will continue to remain our priority during HNA’s informational picket, and there will be no impact to our operations,” Queen’s Health System officials stated.

Daniel Ross, President of the Nurses Association and working RN at Queen’s Medical Center in Honolulu, said nurses at QNHCH make about 20% less than their counterparts at Queen’s on O‘ahu, have no pension, and pay higher shares of health insurance premiums, even though the cost of living is higher on North Hawai‘i.

“Everything you can think of, they’re giving them less,” Ross said. “The only reason the nurses stay is because they’re part of that community, but people are fed up.”

North Hawai‘i is a small hospital. Like many hospitals on Hawai‘i Island, QNHCH utilizes travel nurses to fill the gaps in staffing. However, Ross said the Waimea facility has a hard time attracting those employees due to the cost of living and compensation.

“So what happens is nurses are working multiple shifts,” the HNA president said. “It’s exacerbated because they don’t have pools (of nurses) to pull from.”

Jennifer Johnson has been a recovery room nurse at QNHCH since 2019. She said her work schedule entails eight-hour shifts Monday through Friday.

Johnson spoke to the understaffing of RNs at QNHCH. She told Big Island Now that due to a staffing shortage, she’s been called back into work for scheduled ORs while on call for emergency issues since the hospital doesn’t have nurses available to assist with the scheduled appointments.

“It’s high burnout, high stress,” Johnson said. “It’s a patient and nurse safety issue.”

Johnson said nurses will stay as late as they can beyond their scheduled shift so a nurse isnʻt left alone. The nurse explained a fully staffed OR is seven nurses. Currently, she said the OR is down to two circulating RNs, adding the hospital used to be staffed with four or five.

“It’s been critical for over two years and there’s no end in sight,” Johnson said. “If they want to retain staff they need to look at compensation.”

Queenʻs Health Systems officials confirmed QNHCH has 10 full-time vacancies that they are actively working to fill. There are 10 travel nurses and officials say a few more are scheduled to start soon.

Johnson did say she feels management is trying to find ways to help the nurses but feels they’re limited, adding they haven’t met the needs to what it costs to live in Waimea.

Situations for nurses become especially difficult as an on-call nurse needs to live to 20 to 30 minutes away from the hospital.

“To stay, we need recruitment and retention of nursing staff,” Johnson said. “And a wage that’s able for me to raise my family on this island.”

Currently, the association and Queen’s are in mediation and Ross said they are still bargaining in good faith. Eventually, any agreement reached between the two parties will have to be voted on by members of HNA.

Ross told Big Island Now on Monday he wasn’t sure how many mediation meetings they’ll have before they take it to a ratification vote.

“Our goal is to get exactly the same pay but we’re likely to be a little behind Honolulu,” Ross said. “We have no interest in dragging this out. We want fair treatment for the nurses.”

QNHCH nurses went through contract negotiations with Queen’s three years ago where parties were able to close the wage gap by a few percentage points. But it’s not enough, Ross said.

Working on a neighbor island is no reason to make less, he added.

“They’re just as qualified and deserve it,” Ross said. “Treat them the same, they’re not second-class citizens.”

The hourly hour rate for a nurse at North Hawaii is $56.49. In Honolulu, the hourly wage is $63.89. Employees do get differentials for being a charge nurse or working night shifts. However, HNA argues that QNHCH gets less compensation in everything.

“What North Hawai‘i is looking for is equity,” Ross said, adding a strike is a real possibility.

This whole profession, Ross said is going into crisis.

“I don’t know a bedside nurse who isn’t looking for a different career path,” he said.

What it really comes down to is safety, Ross said. The safety aspect is the hospital doesn’t have enough staff.

“The nurses are doing their best to give the best care they can but when theyʻre shorthanded things get left off,” Ross said.

Officials with the Queen’s System say they are committed to working with the association to reach a positive outcome for all parties.

“The Queen’s Health System respects the nurses’ right to participate in lawfully protected activities and looks forward to reengaging in constructive, good-faith bargaining in order to reach an agreement that is fair and competitive for the nurses and sustainable for Queen’s North Hawai‘i Community Hospital,” a statement from the Queen’s Health System read.

“Our pledge throughout these negotiations has been to bargain in good faith to reach a mutually
acceptable agreement that provides wage increases and other improvements that support our nurses and their profession,” it stated. “We continue to have constructive conversations with HNA and have taken great care to listen and consider every proposal that has been submitted by the union’s bargaining team.”