The second strike this summer by more than 4,000 Allina Health nurses started like the first — with a bagpiper serenading the pickets at 7 a.m. Monday at Abbott Northwestern Hospital in Minneapolis, and cheers rising as bleary-eyed nurses finishing overnight shifts emerged from the hospital.

And yet this walkout felt very different to the picketing nurses. The June strike lasted seven days; this one, they say, won’t end until a deal is reached.

“This time we don’t know when we’re going back. This is the great unknown,” said Katie Larson, a nurse on a spinal surgery recovery floor who carried a sign Monday that said “H7000 Has a Backbone.”

Compounding their nervousness about the strike was the knowledge that a deal had been so close after 22 hours of negotiating Friday and early Saturday morning. A spokesman for the Minnesota Nurses Association (MNA) acknowledged he had started preparing a news release early Saturday that an agreement had been reached.

But lingering questions about who pays for the nurses’ health insurance, and who controls their health plans, kept the two sides apart.

And with Allina financially committed to a pool of 1,500 replacement nurses for as long as two weeks, a deal might not be coming anytime soon. No further talks are scheduled.

“We have had a productive negotiation session,” Dr. Penny Wheeler, Allina’s chief executive, said Sunday. “We have actually tried to meet more than halfway on all of their issues, but we’re still held over by health care costs and trying to sustain a plan that is unsustainable.”

Allina has tried to eliminate four union-based health plans, which its leaders view as wasteful because they lack cost controls such as deductibles that encourage wise health care purchases. They want to switch nurses to its corporate health plans.

Union negotiators fought to preserve the union plans, noting that nurses need good coverage given their high risks of on-the-job illnesses and injuries.

Pointing fingers

But in their most recent offer, union negotiators had agreed to phase out the union plans if they were given some authority over the cost and quality of the corporate plans.

The union also wanted contract bonuses of at least $1,000 to compensate for the loss of their union health plans. Allina leaders decided the union was asking for too much control, and offered only $500 in contract bonuses.

Giving the union that authority “would put us right back where we are today, in a place where there is no flexibility” to modify the plans to keep them affordable, said Allina spokesman David Kanihan.

Union officials accused Allina of being disingenuous by demanding that the four union plans be scrapped and then not accepting the union’s offer to do so. MNA Executive Director Rose Roach said the two sides were only $2.4 million apart in their proposals for bonuses, far less than the $20 million Allina spent to stay open during the last strike.

“The amount of money we’re apart they’ve spent just this morning in the cost of the replacement workers,” she said. “How does that make sense?”

Surprise and concern

Picketing nurses were surprised that Allina officials hadn’t jumped at the deal to end the union health plans, which has been a goal for the health system since talks started in February.

“We were clearly willing to make a huge sacrifice,” said Bridget Fairlie, a nurse picketing at Abbott. She plans to defer a car payment and drop her 401(k) contribution for a month to make up for the loss of income.

Making ends meet was a concern for nurses given the uncertainty. Some have already applied for temporary nursing jobs elsewhere. Many expect the strike to follow historical patterns: The 2001 Fairview nurses strike lasted 21 days and the 1984 Twin Cities nursing strike lasted 38 days.

Brita Skalbeck, 23, said she’d probably work in her mother’s interior design business.

Nurse Jackie Erickson was worried, given the costs of raising her twin 7-year-olds, but said she needed to strike for their health benefits.

“They’re always in the emergency room,” she said.

Joe Robeck, 73, an Abbott patient, had a hospital caregiver wheel him outside to the sidewalk where he could smoke Marlboros and encourage the nurses.

As a veteran of California construction strikes, he implored the nurses to get louder.

“Come on! A little hollering! Union! Union!” he yelled at the passing nurses. “We want our money! We want our insurance, by God!”