Hazard, KY (WVLT) -- They care for patients, change the sheets, empty the bedpans, and send out the bills.
On Sunday at the stroke of midnight they walked out, putting 60 percent of the 4,600 nurses, aides, housekeepers, custodians and clerks for Appalachia Regional Healthcare on strike.
Represented by the United Steelworkers, the strikers are employed in nine hospitals stretching from Middlesboro, Kentucky to Beckley, West Virginia.
The union said it failed to reach agreement on an agreement with ARH on a new contract, and after putting out a strike notice 10 days ago, it was time to act.
"When you make every effort and you see no movement, you reach a point where you wonder why we're still here," said Janice Phipps who is the President of her local USW chapter.
Sen. Daniel Mongiardo, who represents Hazard in the Kentucky General Assembly, thinks the strike resulted from current state of health care.
"It's just a symptom of a failing health care system," Sen. Mongiardo said, "and I'd like to see us look at this as a positive, rather than a negative, to make a major change in what's going on."
ARH President Jerry Haynes said he's extremely disappointed that negotiations broke down and according to the company representatives worked long and hard to present a fair, equitable and competitive contract.
It is unclear how the strike will affect the hospitals ability to provide care.