Nurses at 15 Twin Cities and Duluth-area hospitals will vote Nov. 30 whether to strike for a second time this year in their contract standoff over pay, security and staffing.

Negotiations after a three-day strike this fall produced progress, but not enough to appease nurses whose wages are falling behind inflation and who are being asked because of staffing shortages to care for too many patients at once, said Mary Turner, president of the Minnesota Nurses Association.

"We're in crisis. How many times can I say this?" said Turner, an intensive care nurse at North Memorial Health in Robbinsdale. "Do you think we want to be on the sidewalk in January or whatever? Did you see the snow out there?"

While MNA nurses conducted one protest in downtown Minneapolis two weeks ago, the union had tamped down public actions between the last strike and the election. But after several post-strike negotiating sessions, nurses said they were left frustrated.

Nurse John Welsh said it isn't good that he has moved from 18th to fifth in seniority on his floor at Allina Health's Mercy Hospital campus in Fridley. Veteran nurses have left bedside care in frustration and haven't been replaced, leaving him to make difficult choices with excessive patient assignments, he said.

"Do I first care for the 85-year-old woman with pneumonia lying in her urine for more than an hour, or do I first respond to that bed alarm for the 90-year-old man with dementia who is unsteady on his feet?" he asked. "Two nights ago, one of my patients took a deadly turn overnight. And I'm left wondering, if we had the right resources, the right care, could we have recognized that deterioration sooner?"

Negotiations involve about 15,000 nurses working at Allina's Abbott Northwestern, Mercy and United hospitals; Children's Minnesota; Methodist Hospital; North Memorial; and Fairview's Southdale and St. John's hospitals along with the west bank campus of the University of Minnesota Medical Center. Two Essentia hospitals in Duluth and Superior, Wis., also are involved along with St. Luke's.

Hospital leaders acknowledged the staffing pressures and shortages, but balked at MNA proposals to increase nurse wages. The gap has narrowed over time, but nurses are seeking 24% raises over three years while hospitals are offering around 12% to 13%.

A joint statement from several of the Twin Cities hospitals expressed hope for a deal that would avert another work stoppage and allow nurses "to work in an environment where they feel valued and supported."

"We know the current situation inside hospitals throughout the country is very challenging," the hospital statement said, "and a union work stoppage could have disastrous consequences for our patients and the communities we serve."

Union leaders hoped the announcement of a second strike vote would spur productive talks. Turner said the union is open to mediated talks if both sides remain face-to-face at bargaining tables and mediators don't just shuttle proposals back and forth. Hospital leaders for months have been pressing the MNA to allow mediation.

Turner said negotiations produced a tentative agreement around nurse safety at North Memorial, but that nurses continue to bring fresh reports of recent assaults to talks to remind hospital leaders of the urgency.

Nurse Chelsea Schafter said Fairview negotiators at least agreed to look into panic alarms that would allow security to quickly locate nurses under assault — a rising problem in recent years. But no specific agreements have been made.

MNA leaders said fresh claims have been filed with federal authorities over unfair labor practices by the negotiating hospitals. Such claims are key ahead of strikes, providing nurses with guarantees their jobs will be preserved after walkouts. Turner said the unfair practices ranged from all-staff emails to casual conversations by managers to persuade individual nurses to give up their contract demands.

If the strike vote is favorable, the union would need to set a date and length of time and give hospitals a 10-day notice. The soonest a strike could commence would be Dec. 10.

Allina nurses went on two strikes in a contract holdout in 2016 over health benefits. The second strike ended that year when mediated negotiations at then-Gov. Mark Dayton's residence produced a compromise.