Nurses at Kauaʻi’s Wilcox Medical Center ratify new contract that addresses pay, staffing levels

After nearly a year of negotiations and a three-day strike in January, Wilcox Medical Center nurses voted for a new three-year contract that went into affect Monday.

The new agreement, which covers about 160 Wilcox nurses in the Hawaiʻi Nursesʻ Association, increases pay and addresses the concerns of nurses about insufficient staffing levels at the medical center in Līhuʻe on Kauaʻi.

“It has been a relentless battle for almost a year,” union president Rosalee Agas-Yuu said. “After countless hours of organizing over 35 bargaining sessions, a three-day strike, and a Kauai County resolution, we are finally seeing a breakthrough.”

Jen Chahanovich, president and CEO of Wilcox Medical Center, said the hospital was pleased they reached the agreement with the nurses: “They are an integral part of the care we provide; and we are proud of the work they do alongside our entire medical team to care for our community.”

The negotiations began May 6, 2024, and the nurses worked since August without a contract. In February, the Kauaʻi County Council unanimously passed a resolution that urged the State Legislature to implement safe nurse-to-patient ratios at hospitals.

The agreement includes across-the-board pay increases that provide a 6% pay increase this year and 4% each in the second and third years of the contract. It also includes longevity pay increases for registered nurses who have 5, 10 and 15 years of experience at Wilcox.

The wage increases, which were agreed upon earlier in the negotiations, are similar to those in the agreement reached last October between nurses and the administration at Kapiʻolani Medical Center in Honolulu, Jonathan Leibowitz, director of field services for the union, said in January.

The sticking point of the negotiations was over staffing levels. The new contract has what the hospital calls an innovative, collaborative and flexible staffing model.

At Wilcox, nurses were especially concerned about staffing of the medical-surgical unit, which contains 45 beds divided between two floors. They are now responsible for six patients at a time, meaning each patient receives about 10 minutes of care per hour. The nurses said in January this staffing ratio is unsafe, and must be reduced to ensure patients receive an appropriate level of treatment.

Under the new agreement, there will be flexible staffing levels in each unit based on the severity of the patients’ individual medical conditions and needs.

Staffing guidelines have been set up that align with national professional nursing organizations, including Association of Women’s Health, Obstetric and Neonatal Nurses, American Nurses Association, American Society of PeriAnesthesia Nurses, Association of periOperative Registered Nurses and American Association of Critical-Care Nurses.

The agreement also features a new Staffing Council made up of Wilcox nurses and nurse leaders who will meet regularly to work collaboratively together on staffing issues and needs.

The medical center said its nurses will be able to use an innovative staffing tool that incorporates workload and acuity to help determine scheduling for each unit based on the ever-changing health care needs of the patients.

Wilcox also has agreed to ongoing recruitment and retention programs aimed at bringing in new nurses and providing support for current nurses.

“Under the new contract, we’re able to establish several committees to take a hard look at staffing, scheduled breaks, and other improvements to enhance patient care so that Kaua‘i residents have the same standard of care as those on O‘ahu,” said Sonya Balian-Grande, a women’s and infant health nurse at Wilcox.

“The Wilcox team is ready to move forward and focus on what matters most to us – our patients,” Chahanovich said.

The Hawai‘i Nurses’ Association also is looking after nurses at the Straub Benioff Medical Center on O‘ahu, whose contract expires on Oct. 31, 2025.

“Patient care should be the same across all Hawai‘i Pacific Health hospitals to provide assurance to the community that there is a high standard of care no matter which hospital they receive care,” Agas-Yuu said. “We hope Hawai‘i Pacific Health leaders are moved with compassion for all the patients they serve.”

Kapi‘olani Medical Center for Women and Children, which also is overseen by the same corporate entity, Hawai‘i Pacific Health, reached a new three-year contract with its 600 nurses on Oct. 2, 2024.