HARLAN, Ky. (AP) -- Jerry Blevins has stood for weeks on a picket line with his fellow nurses, thinking about his mortgage, his tearful wife, his four children.þþPam Pace has been called names and listed on the ''wall of shame'' posted outside her hospital for crossing the picket line and continuing to work. Last week, her tires were slashed. ''Someone's got to stay in here and take care of the patients,'' she said.þþIt's been a stressful seven weeks for the 750 registered nurses at Appalachian Regional Healthcare, the region's largest hospital system, which has nine facilities in eastern Kentucky and West Virginia. Six hundred nurses have refused to cross the picket line.þþSome, like Blevins, have put their livelihoods on the line since Oct. 1, saying their goal is to ensure better care for patients. Others, like Pace, say they either cannot afford to walk off their jobs or don't want to abandon their patients.þþAfter weeks of stalemate, negotiators on both sides of the bargaining table indicated this week that some progress has come from talks with a federal mediator and state officials. Negotiations were to resume Friday and continue through the weekend.þþ''I am willing to do what it takes,'' Blevins said recently while bottle-feeding his baby boy on the picket line. He insists that nurses at ARH hospitals are overworked, which jeopardizes patient care.þþHowever, the strike has taken an emotional and financial toll on his family, he said.þþ''I did have that moment of, `Oh my God, what am I going to do?''' Blevins recalled.þþARH President and CEO Jerry Haynes, a native of the Harlan County mountain region, said he appreciates the conviction of those on the line.þþ''We are a stubborn people,'' he told The Associated Press. ''Unfortunately, that doesn't always serve us all well. There is a strong culture in Appalachia that's grounded in the coal mining industry. You have a strong culture of unions. You have a lot of heritage and history here.''þþLabor strife is as familiar in these Appalachian hills as poverty and poor health. Blevin's own Harlan County, home to several century-old coal-mining communities, has a history of violent labor fights. Attempts to organize miners in the 1930s drew national attention to ''Bloody Harlan.''þþThe hospital system that became ARH was established by the United Mine Workers' union in 1956 to help the underserved coal mining camps. Many of the nurses on the picket lines are the children and grandchildren of miners.þþ''In most rural areas, the hospitals tend to be the largest employer in the area,'' said Kenneth Troske, director of the Center for Business and Economic Research at the University of Kentucky. ''Unfortunately, that gives the hospital more power than in other places, especially in the labor market.þþ''They keep wages down, as they should to minimize costs. From a worker's standpoint in a rural area, that's a problem. It's a fact of life, it's not right or wrong.''þþSo far, about 125 positions vacated by striking nurses have been filled and nearly 175 nurses have crossed the picket line. ARH is relying on nursing supervisors, temporary nurses, licensed practical nurses and nurses' aides to fill the gaps.þþThe contract rejected by the nurses would have increased insurance premiums for families, eliminated a policy of paying nurses 40 hours of pay for 36 hours of work and reduced holiday pay from double-time to time- and-a-half.þþThe pay range for ARH nurses is $47,000 to $65,000 -- far above the $39,000 median household income in Kentucky. In Appalachia, more than a quarter of the population lives below the federal poverty level. Few other jobs, beyond coal mining, offer better wages or compensation, Troske said.þþBut the striking nurses say the dispute isn't about salaries. They say staffing levels were spread too thin and mandatory overtime had become the norm.þþHaynes denied the claims, saying federal and state regulators have never cited ARH for poor care or staffing ratios. Payroll documents offered by ARH show that nurses on average worked 2.5 hours mandatory overtime a week.þþ''Do I think we have a problem sometimes? Yes. Are we perfect? Absolutely not,'' Haynes said. ''Is it management's intent to work short and not provide care to our patients? No.''þþ
Source: NY Times
