Registered nurse Cindy Olson has been doing her work for 32 years now, in frantic emergency rooms, in the controlled chaos of the intensive care unit, in tense waiting rooms with family members catatonic with worry, in cancer wards filled with both hope and acceptance.

On Wednesday, Olson was at her job in the intensive care unit at St. John's Hospital in Maplewood. She was planning to attend an afternoon rally focused on the ongoing negotiations between 12,000 Minnesota nurses and the hospitals that employ them.

Olson has been at the table for those contentious negotiations. She knows that if the two sides fail to agree, she may become part of the largest nurses' strike in the United States.

"I had two very sick patients," said Olson. "I had to shuffle one patient to another hospital because of her neurological condition. I was right in the middle of making arrangements and my other patient became unresponsive."

With tough negotiations underway and a potential strike looming after a contract vote next week, Olson was already getting a taste of the excruciating decision she and thousands of other nurses will have to make in the coming days.

Nurses are trained to keep an emotional distance from their patients, but Olson and others know that they often get close to them, especially in places like the ICU, where a nurse might spend 12 hours a day with one or two patients. They meet patients' families and friends; they overhear the love stories and the horror stories.

"I love my patients," said Olson. "I like being their advocate in the health care system, and I like dealing with their families and getting them to get involved with me in the care. The more challenge, the better. I love the chaos; my life revolves around chaos."

The hospitals say patients shouldn't worry if there's a strike, that they will be able to handle the care with replacement nurses. But how do nurses who have dedicated their lives to the practice deal with walking away?

Olson paused briefly. "It's very difficult to think about," she said. "To leave them in the hands of someone I don't know ... is horrible."

But then Olson thought back to the previous night, when a frightened family came looking for a loved one. They had not been informed that the patient's condition had worsened, causing the hospital to move her to intensive care. Everyone was too busy to alert the family, Olson said.

She also recalled visiting with nurses on the floor recently and listening to concerns. "It was one of the biggest weekends anyone can remember," she said. "They were getting so many admissions that they would be assigned someone at 7 a.m., but didn't even get in to see them until 10. The nurses said it was terrible."

Olson said she understands finances are tight for hospitals, "but I have a lot of financial stress too, and I have to focus our income where it's important, on my family. Hospitals have to focus it on care."

Laurie Bahr has been a nurse for 16 years because "you are seeing people when they are at their most vulnerable, and if you can help them get through that, it's an incredible feeling."

Bahr said she tries not to become too attached to patients.

"But there are days when you take it home with you," she said. "And there are memories of certain patients you carry with you for years."

The possibility of a strike "is an inner struggle," said Bahr. "You go back and start thinking about doing the right thing because just thinking about being away from your patients is enough to break your heart. It's a difficult decision that I couldn't make for anyone else, but I might have to make for myself.

"If I do," said Bahr, "I know I want to make sure I know it will be worth it."

jtevlin@startribune.com • 612-673-1702