Bleary-eyed from 22 hours of contract talks, leaders for Allina Health and its union hospital nurses appeared to be just one big issue away from agreement when they halted negotiations at 6 a.m. on Sept. 3.

Forty-eight hours later the nurses hit the picket lines.

Now, as the strike enters its second week, the question is: Will they still be that close when they return to bargaining after having slept, restrategized and traded bitter accusations for days?

“We would really like to know the answer to that ourselves,” said Rick Fuentes, a spokesman for the Minnesota Nurses Association, which represents 4,800 nurses at five Allina hospitals in the Twin Cities.

No further talks have been scheduled, and when the strike started Allina became obliged to pay most of its 1,500 replacement nurses for two weeks. Neither side has even reached out to restart talks, which have been stalled for weeks in a stubborn disagreement over health insurance costs.

The closest the two sides have come to negotiating was an appearance Friday night on Twin Cities public television by union executive director Rose Roach and Allina chief executive Penny Wheeler.

Wheeler blamed the current “conundrum” on the union’s effort to preserve old-style, low-deductible health insurance plans which, she said, permit runaway spending.

“We’re trying to transform health care. … We cannot do that by clinging to old ways and old plans,” Wheeler said.

Roach countered that nurses’ health spending reflects their high risk of on-the-job illness and injury.

“This constant sort of tone that nurses somehow are irresponsible and they don’t use health care properly … is really pretty insulting,” she said.

So close ...

The rhetoric belies how close the two sides have come after eight months and 18 negotiating sessions.

On Sept. 3, they at least tentatively agreed to further discussions of a plan that would free up charge nurses to provide more support to bedside nurses rather than being responsible for their own patients. Their dueling offers both called for security personnel in emergency departments at all times, a nod to nurses’ concerns about hospital violence. And, importantly, they agreed on a transition that would move nurses from four union health plans to Allina’s three corporate plans, which had been the key sticking point.

The union, however, didn’t want to lose all bargaining authority over the cost and quality of the nurses’ health insurance. So its negotiators requested that a hand-picked actuary be able to review the Allina plans each year to make sure their benefit values don’t decline by 5 percent or more without the union’s consent.

“Why shouldn’t we get to know what we’re buying?” Roach explained.

Allina acknowledged the concern, offering to have its own actuary guarantee that one of its health plans wouldn’t change in benefit value by 5 percent during the three-year nursing contract, but management didn’t want to extend that authority to the union.

“The union fear — that as soon as we get the nurses into the core plans, we’re going to make drastic changes to them — that’s never happened,” said Allina spokesman David Kanihan.

Offer no longer a given

The union’s offer to Allina is pending, but there is nothing binding the two sides to use it as a starting point when talks resume. Kanihan said the health system’s latest offer had been contingent on the union withdrawing its plans to strike.

“We can no longer guarantee that we’ll offer the same proposal when we get back, now that we’re a week into a costly strike,” he said.

Strike costs for the first week were expected to reach the $20 million mark that Allina reported for the nurses’ previous strike, a one-week walkout in June. Costs in future weeks might not be as high, Kanihan said, as some temporary nurses will be staying and won’t need to be flown in and trained.

As the strike’s first week came to a close, Allina reported normal patient volumes at the affected hospitals: Abbott Northwestern and the Phillips Eye Institute in Minneapolis, United in St. Paul, Mercy in Coon Rapids and Unity in Fridley. ER visits on Thursday were slightly less at Mercy and Unity than on a comparison date of Aug. 23 provided by Allina, but the number of patients admitted to Abbott, United and Mercy on Friday was above average.

Also, Kanihan said, more than 400 union nurses had been taken off the health system’s strike list after they indicated they wanted to return to work.

Fuentes countered that enthusiasm on the picket lines remains strong and that Allina’s numbers are questionable; the union only found 70 nurses who had crossed the picket line in the June strike despite Allina’s report of 120 at that time.

At least one nurse who crossed the picket line during both strikes is Crystal Rehbein, a mental health nurse at Abbott, who claimed that the union threatened fines or sanctions against her even though she had legally resigned from the organization. A complaint to the National Labor Relations Board was announced Sunday evening by the National Right to Work Legal Defense Foundation on behalf of Rehbein, who said she returned to work in order to support her husband and two children.

The federal board also is reviewing complaints filed by the union, which contends that Allina has harmed negotiations by failing to provide financial information requested by the union. If upheld by the labor board, the filings would enable the union to declare that nurses are striking on the basis of unfair labor practices, which gives nurses federal protection against being permanently replaced while on strike.