A federal mediator has held three sessions over the past 10 days to try to reach a deal, according to Koelsch.

Mandatory overtime shifts have been the primary sticking point. Koelsch said the hospital needs that authority to ensure there's enough staff in case of emergencies.

But, she said, the hospital has taken steps to reduce the likelihood that nurses will be forced to work overtime. For example, she said, it has offered extra pay for nurses who volunteer to work overtime, and it has offered to buy back unused sick days.

Other issues include coverage for domestic partners and the deductibles that employees have to pay when they receive health care outside Memorial's preferred provider network.

Hospital Administrators say they are disappointed that an agreement hasn't been reached, and they're continuing with a "downsizing plan," which includes reducing the number of patients, in anticipation of the possible strike.

There are about 50 overnight patients at the hospital now, down from about 120 before the 10-day strike notice was issued, Koelsch said.