Victor Epstein

BAYONNE, N.J. (AP) — Health-care workers barred from patient rooms walked the picket lines at Bayonne Medical Center on Tuesday, the second time in as many weeks that labor negotiations have broken off at a northern New Jersey hospital.

Friction between management and workers has been fueled by increased costs in a health-care industry grappling with more uninsured patients, the prospect of reduced insurance payments with health-care reform, and fewer elective surgeries that bring in money.

Nine acute care hospitals have closed in New Jersey since Jan. 1, 2007, compared with 13 closings over the last 15 years.

"We're going to see more conflict as hospitals try to contain costs," said Dave Knowlton, president of the nonprofit New Jersey Health Care Quality Institute. "There's a number of ways this cost pressure can manifest itself, from fights with unions to asking someone's grandmother to leave the hospital sooner after an operation."

The American Hospital Association reports that 90 percent of U.S. hospitals are making cutbacks to weather the economic storm. Nearly half have reduced staff.

Before nurses and other health-care workers belonging to the Union of Health Professionals and Allied Employees were locked out of Bayonne Medical Center on Tuesday, union members at Englewood Hospital and Medical Center were barred from their workplace June 3.

The lockouts affect 750 union members at Bayonne and 650 at Englewood.

No dates have been set to resume negotiations at either hospital, as the medical centers continue to function with the help of replacement workers from U.S. Nursing Corp.

"A lot of hospitals are trying to take advantage of the difficult economy," said Jeanne Otersen, an HPAE spokeswoman. "We're not only seeing lockouts, we're also seeing a number of hospitals that are trying to impose policies that allow them to send nurses home without pay when they don't have enough patients to keep them busy."

Maria Margiotta, a spokeswoman for Englewood Medical Center, said the union's demand for a 12 percent pay increase over the next three years seems to ignore the recession. The hospital is offering 7 percent.

"There's a disconnect between the union leadership and reality," Margiotta said, "They need to understand that we can't agree to a contract we can't afford."

But Otersen said the union never stopped bargaining with Englewood. It was management that stepped away from negotiations.

Geri Dickson of the Collaboration Center for Nursing at Rutgers University said nurses have temporarily lost some of their vaunted bargaining power because of hospital closings and an economic slowdown that's spurred some retirees to return to work and part-timers to seek full-time status.