A replacement nurse from Georgia stopped working at Mercy Hospital in Coon Rapids Wednesday, citing concerns about the quality of patient care while the hospital's regular nurses are on strike.

Allina Health replaced its 4,800 regular nurses at Mercy and four other Twin Cities hospitals with 1,400 temporary nurses when a seven-day strike started Sunday morning.

In an interview, Tracy Mitchum said some of the replacement nurses are excellent, but others are inexperienced or placed in units for which they lack training.

"There are some nurses working out of their scope of practice that are completely lost," Mitchum said. She said she decided to stop working at the end of her Tuesday night shift in a post-anesthesia care unit, or PACU, after arguing with a manager. She surprised union nurses when she joined them on the picket line at Mercy Wednesday before flying home.

Mitchum's account contrasts with Allina's description of conditions at Mercy and the other affected hospitals — United in St. Paul, Unity in Fridley, and Abbott Northwestern and the Phillips Eye Institute in Minneapolis. Hospital admissions remain normal for this time of year, and special inspections by state health regulators have found no threats to patient safety, said David Kanihan, an Allina spokesman.

Allina also challenged Mitchum's account directly, saying it was the hospital that severed her employment. "Because of concerns about her raised by leaders and staff, we asked her agency that she have no further assignments in our hospitals," a company statement said. "What she is now saying about patient care inside Mercy Hospital is completely untrue."

Allina's adoption of national best practices has made it somewhat easier for nurses from other states to take over patient care, said Dr. Allison Peterson, vice president of medical affairs at United. "My physician colleagues are consistently reporting that the new nurses are well trained and able to integrate into our system because of those national standards."

State health inspectors visited Mercy and Unity earlier this week, and Abbott and United the past two days. The results of such inspections often don't come out for weeks, but the state would step in if inspectors found any immediate threats to care.

Leaders of the nurses' union, the Minnesota Nurses Association, said Mitchum's concerns about replacement nurses in inappropriate roles had been seconded by nursing assistants and technicians inside the hospital. Allina had previously acknowledged that a handful of replacement nurses showed up for work without completed licensing paperwork, but Mitchum said some nonetheless provided patient care.

Checking the license before allowing a nurse to work is "nurse managing 101," said Matt Keller, a policy and regulatory specialist with the union.

Mitchum said she was dismayed Tuesday night when a child recovering from an appendectomy languished in the post anesthesia care unit for hours. Another nurse also provided inadequate attention to a man with declining oxygen saturation levels, she said.

Regarding Mitchum's allegations of unlicensed nurses providing patient care, the Minnesota Board of Nursing's director replied Wednesday night that it is up to date in processing all applications of nurses seeking temporary permission to work in the state. Mitchum's permit on the board's web site indicates she can practice in Minnesota through Aug. 10.

Mitchum has worked as a travel nurse for the past five years. The Nursys website shows she has licensure in Georgia and six other states with no disciplinary actions.

The strike, triggered by a dispute over health insurance benefits, ends at 7 a.m. Sunday.

Jeremy Olson • 612-673-7744