The nurses issued the formal 10-day strike notice, which is required by federal labor law, as hospital management continues to refuse to agree to negotiate solutions for desperately needed improvements to ensure that patients do not continue to be at risk. Numerous studies over the last decade have shown a direct and immediate link between excess patient assignments for nurses and the serious complications, medical errors, and readmissions caused by a lack of access to timely nursing care. The one-day strike will begin at 6 a.m. on Thursday, April 11 and will end on Friday, April 12 at 6:00 a.m."Our members have had enough," said Ryan. "We have attempted to negotiate for months with management. We have presented written reports; we have told them we are worried that there are imminent risks of negative patient outcomes. They have refused to respond except to say that this is a financial decision. We feel that we have a duty to our patients, our practice and to each other to take action. We also consider it to be our duty to the future of this hospital that we love. I have been a nurse here for 45 years. I received my RN training here, and had my children here. This is our hospital and we want it to succeed. But when you find yourself to be in a hole, the first step is to stop digging. We are at the point where we have to say 'stop.'" Since the closing of the medical-surgical unit, ED nurses report being put in the position of providing types of care for which they are not equipped for patients who have been "admitted" to the hospital as ICU, Medical Surgical or Telemetry patients, but who, in reality, are physically being housed in the ED. They also report that they are caring for admitted patients without bolstering the number of staff in the ED. When not boarded in the emergency department, patients are being sent to other areas of the hospital, such as the intensive care unit, which means that there are now fewer beds available for more critically ill patients. MNA/NNU nurses have been complaining urgently to Steward management for four weeks that patients are not receiving the level of nursing care they should expect and deserve, and that they are greatly concerned about imminent potentially negative outcomes.