The president of the union representing nurses at Nova Scotia's largest health authority says they are ready to defy back-to-work legislation as officials warned transplant surgeries for Atlantic Canada would be suspended in the event of a strike.

Joan Jessome, the president of the Nova Scotia Government and General Employees Union, said the nurses will go on strike if Stephen McNeil's Liberal government brings in back-to-work legislation.

"If legislation was to come in tomorrow, there would be a strike tomorrow," she told reporters at a news conference on Monday.

"We have a moral responsibility on this one. This isn't just a bargaining issue. This is a life and death issue. I have heard these nurses and I am not going to be silenced."

On Sunday, mediated talks between the union — which represents about 2,300 registered nurses — and the Capital District Health Authority reached an impasse after three days of negotiations.

Jessome said she hopes a negotiated solution can be reached by April 3 — when the nurses are in a legal strike position — but added she is losing confidence that the government will compromise on the union's request to hire more nurses.

Joan Jessome

Joan Jessome says Capital Health nurses will go on strike if Stephen McNeil's Liberal government brings in back-to-work legislation. (CBC)

The union has said it wants nurse-to-patient ratios, something it says would improve patient safety.

"The issue of patient safety, I think, is something that's resonating with the public and the nurses are saying to the employer and to government that we need to address this," said Jessome.

"We will be very flexible on how the ratios could be introduced and implemented."

No movement on ratios, says health authority

The Capital District Health Authority, meanwhile, has said there is no evidence that shows mandated registered nurse-to-patient ratios guarantee improved patient safety. It claims meeting the nurses' demands would require hiring 800 more registered nurses at a cost of more than $60 million per year.

"We had some, what we thought were some fairly positive moves that we were able to make on other issues other than the ratios. I think the ratio issue continues to be the sticking point," said Chris Power, the president and CEO of the Capital District Health Authority.

"At this stage, it doesn't appear that either of us are moving on our position."

The nurses primarily work at four places in the Halifax area: the QEII Health Sciences Centre, Nova Scotia Hospital, the East Coast Forensic Hospital and Public Health Services.

On Monday, Capital District Health Authority officials said services such as transplant surgeries and addictions treatments will be cancelled in the event of a strike by its registered nurses.

Workers with Local 97 have agreed to maintain full staffing levels for certain services, including the QEII emergency department, dialysis unit, Nova Scotia Cancer Centre, veterans services and intensive care units, according to the health authority.

"At QEII, we do about 120 surgeries, for example, every day. It would be some portion of that we could not do," said Dr. David Kirkpatrick, chief of the Department of Surgery at Capital Health.

Transplant surgeries to be suspended

Although a potential strike is 10 days away, officials will start cancelling some surgeries ahead of time to ensure the beds that will no longer be staffed will be empty by strike day.

According to the Capital District Health Authority, only emergency surgeries will be done if the nurses walk out. 

The impact of that may be felt well outside Nova Scotia since all transplant surgeries for the Atlantic region are performed in Halifax. Capital Health said it will be forced to stop performing transplants altogether if the strike happens, meaning organs available during a strike will go elsewhere or go unused.

Jessome disputed that claim.

"Capital Health is saying a lot of things that aren't accurate today and organ transplants will not stop," she said.

"They know full well, they've been down this road with emergency services before. They know how it's applied."

Those who rely on methadone treatment through the Nova Scotia Hospital may also be affected, as the health authority is planning to shut down that program in the event of a strike.

There are 113 people who rely on Capital Health's opioid treatment program. John Gillis, spokesperson for Capital Health, said 30 of those clients are the in the first phase of treatment who come to the clinic daily for assessment and to receive their medication.

Health officials estimate 30 per cent of addicts in the first phase of treatment will relapse as a result of the closure.

With files from The Canadian Press