Nearly 2,400 nurses from other states have flooded the Minnesota nursing board with license applications in the last month, 10 times the normal volume, as Twin Cities hospitals line up replacements for a possible strike June 10.

The 14 hospitals have said they're preparing to stay open if a walkout occurs, and staffing agencies are offering as much as $2,200 a day to recruit temporary replacement nurses.

Already, some elective procedures are being postponed, and some doctors are starting to field questions from patients about what to expect if a strike occurs.

Late Wednesday, the two sides reported little progress in their first face-to-face talks in three weeks. Members of the Minnesota Nurses Association have threatened a one-day strike next week if they don't reach an agreement on salaries, benefits and staffing issues.

"We're pretty pessimistic,'' said Maureen Schriner, spokeswoman for the hospitals. However, the two sides are scheduled to meet again Friday.

Since April, applications from nurses have been surging at the Minnesota Board of Nursing, said Shirley Brekken, the executive director. Typically, fewer than 200 out-of-state nurses apply for Minnesota licenses in any given month, but the number shot up to 2,370 in May, she said-- more than in the previous 10 months combined. If they're licensed elsewhere, she said, nurses can get temporary permits to work in Minnesota in as little as a day.

Brekken said some nurses have been calling to check on their applications, saying they need to be ready next week.

So far, the hospitals have not disclosed how many replacement nurses they would need. Although the union represents some 12,000 nurses at 14 hospitals, "we don't need 12,000 replacements," Schriner said. She noted that many nurses work part time, and the hospitals have other options, including postponing elective procedures if necessary.

"Right now, the contingency plans are still rolling into place," she said.

Already, Abbott Northwestern in Minneapolis has postponed all elective surgeries that had been scheduled for June 10. But emergency or urgent cases will not be affected, said spokeswoman Gloria O'Connell.

The hospital also postponed some nonemergency heart surgeries this week, said Dr. Kevin Graham, a cardiologist at Abbott. The reason: Many procedures require several days of inpatient recovery, and if there are complications, someone having surgery today could still be hospitalized June 10. "With cardiology and stuff, you don't know when things are going to turn sour," Graham said.

In terms of impact, Graham added, "this is not a one-day strike, this is a 10-day strike."

With the scheduled walkout a week away, some patients are starting to raise concerns, said Dr. Juan Angelats, an obstetrician-gynecologist at Diamond Women's Center in Edina. "I think women that are due this month are going to be somewhat nervous about it," he said. "It's unknown territory." He said he has told patients, "If it's one day, I don't know if it's going to make a huge impact."

At the same time, he said, he's uncertain about working with replacement nurses. "We don't know the backgrounds of these nurses,'' he said. "Maybe they're the best nurses in the world, maybe they're not.''

Others, though, say they expect business as usual. "We're not even worried, because there will be replacements," said Rita Curtis, office manager at Advanced Specialty Care for Women in St. Paul.

As talks continue, many nurses say they are ready to walk out if necessary.

"I think people are really sort of pumped up," Alexandra Wright-Cross, a psychiatric nurse at North Memorial Medical Center in Robbinsdale, said after a union meeting Wednesday.

The main issue, she says, is that nurses are stretched to the limit and don't have enough say in staffing levels.

"I've never seen the morale be so low, the staff be so stressed out," she said.

The nurses union is seeking fixed staffing ratios, while the hospitals say they need more flexibility to move nurses where they're needed. The two sides are also at odds on wages and the hospitals' proposal to cut pension and other benefits.

Still, many hope a strike can be averted.

"Usually, these things happen at the last second ... when finally concessions are made," said Angelats, the obstetrician. "We work with the nurses day in and day out. We want a good agreement for them, because they're an essential part of the process."

Staff writer Chen May Yee contributed to this report. Maura Lerner • 612-673-7384