Unhappy with proposals from Providence Health during a Dec. 30 bargaining session, nurses working for Swedish Medical Centers could still decide to go on strike.

Swedish, and it’s parent company Providence, have been in negotiations with nurses’ unions since last April. Nurses cited concerns about under-staffing, hundreds of unfilled positions and wages too low to live near the hospitals or clinics where they work.

There are more than 900 open positions across the Swedish and Providence campuses, and nurses are concerned about how low staff levels can harm patients, a press release from SEIU Healthcare 1199NW said. The union represents 8,000 nurses and other staff at the medical centers and hospitals.

Low staffing levels can lead to longer wait times, the release said. Additionally, standby pay for on-call workers sits around $4.25 an hour with unpredictable schedules.

A press release issued by Swedish said they proposed a 5.5% pay increase by next July and a $750 per-person sign-on bonus in an attempt to avoid a strike. It said nurses at Swedish on average earn more than $96,000 annually. It said it also offered zero-premium medical plans for full-time caregivers and their family.

However, the union’s press release said front line worker pay hasn’t kept up with the cost of living in the area. It said the company pays nearly 40% of its employees below the salary needed to rent a one-bedroom apartment in the Seattle area. Workers commute an average of 84 minutes per day.

In the press release, Swedish said staffing remained a top concern. Health care providers across the country are being impacted by shortages, it said. The company said it will partner with SEIU to host discussions in January focusing on retaining candidates.

“We remain optimistic that a strike can be avoided through good-faith negotiations by both parties,” the release read.

Nurses and other caregivers voted to authorize a strike in November. They could be joined by the Washington State Nurses Association and UFCW 21 at other Providence hospitals across the state. In total, 13,000 health care workers across the state could call a strike after delivering a 10-day notice.