With the heated exchanges leading up to today's likely walkout by 12,000 Minnesota nurses, several air-clearing points need to be made:

The majority of Minnesota nurses are dedicated, professional caregivers who work extraordinarily hard. Those nurses don't deserve the "greedy" label used by some critics. In advocating for pay raises and benefits, their union is doing what a union does during contract talks.

At the same time, Minnesota nurses do not have a monopoly on patient safety concerns. The reality is that state hospitals consistently get high marks nationally for quality. The message sent by the union this week -- that nurses are the thin white line guarding patient safety -- unfairly dismisses the teamwork with physicians and other staff that makes Minnesota a health care standout. It also ignores the substantial investments made by Minnesota taxpayers and private health care organizations to track outcomes, make these measurements available to the public and focus shrinking resources on areas most in need of improvement.

On Wednesday, Minnesota Nurses Association spokesman John Nemo said there was "zero chance" of averting a one-day strike expected to begin at 7 a.m. today at 14 Twin Cities hospitals. Although the two sides remain far apart on wages and benefits, staffing is where both have really dug in. The impasse is one that hospitals have brought upon themselves. For too long in Minnesota and elsewhere, there's been a deal-with-it attitude as yet another patient has been wheeled into an already crowded unit.

Nurses absolutely shouldn't be stretched too thin; a growing body of data backs up their critical role in patient outcomes. But the question we have for Minnesota nurses is: Do they understand that they're going to the mat for an unproven staffing solution?

The Minnesota Nurses Association is unyielding in its contractual demands for fixed nurse-to-patient staffing ratios (for example, no more than two patients per nurse in labor and delivery). California is the only state to have legislated such ratios. And there's disagreement within nursing and the hospital industry about whether the 2004 measure has helped patients.

An analysis done earlier this year by the University of Pennsylvania's Linda Aiken found a lower death rate in California hospital patients than in two other states without fixed staffing requirements. One of Aiken's coauthors from the University of California, San Francisco cautions that the study doesn't prove that the ratios caused lower mortality, only that there was a correlation. The UCSF researcher, Joanne Spetz, also led a study by the nonpartisan California HealthCare Foundation, which found that "most of the quality measures analyzed for this study do not appear to have been directly affected by the increase in RN staffing." California hospitals also claim that other patient-safety improvements implemented during Aiken's study may have influenced her findings.

Nursing labor organizations are divided. The American Nurses Association (ANA), a longer-established labor organization that the Minnesota union broke away from, does not support fixed staffing ratios. Instead, it seeks more flexible strategies that reflect the unique needs of a hospital unit and are easier to modify as conditions change. Other states -- Texas, Oregon, Washington, Illinois and Ohio -- that have imposed statewide nurse staffing measures followed this path. The Minnesota union dismisses the ANA approach, saying it's an merely an "intellectual approach" to staffing.

The Minnesota strike comes at a time of a historic transformation and harsh realities in health care. No one is certain how federal reforms will play out. Health care's business model -- passing along unreimbursed care costs to private insurers -- is no longer workable. Nurses are putting their contract on the line for a rigid, controversial staffing formula in a health care era requiring maximum flexibility and new thinking. Are they absolutely certain that this one strategy is worthy of their sacrifice and support?