Hundreds of nurses and others who serve patients at Delaware County Memorial Hospital remained off the job Monday on the second day of a strike prompted by a breakdown in talks over staffing issues.

Passing cars blared horns Monday as large groups of pickets representing over 370 strike workers braved temperatures in the 20s outside the facility in Upper Darby, with an assist from coffee and doughnuts supplied by union supporters.

Negotiations between the Pennsylvania Association of Staff Nurses and Allied Professionals (PASNAP) and Prospect Medical Holdings, which owns the hospital, have been stalled.

The sticking point has been staffing. "We have been working pretty much consistently without adequate staffing since Prospect has taken over," said Mary Ludwig, 64, a nurse at Delaware County Memorial since 1991.

"We lost nurses that have gone on to other jobs and they have not been replaced," said Ludwig, a member of the bargaining committee.

"We're always working understaffed. We try to do the best we can, but when you don't have adequate staffing it just puts more pressure on you," said Ludwig. "We don't get lunches, we don't get our breaks, we're just constantly working."

Adding one more nurse on a hospital floor could save lives, said Nicole Kligerman, 29, an organizer with PASNAP. "It's a matter of life and death," she said.

While the union had planned on only striking for two days, Sunday and Monday, the staffers will be out of work for an additional three days, the company said, because staffing agencies require a five-day pay period deposit for temporary replacements.

According to a statement from the hospital, the facility is fully operational and staffed during the strike. The company says nurses receive excellent benefits and pay, with an average full-time nurse salary of about  $82,000 a year. It also says staffing levels are on par with the national average.

In its statement, Prospect, which purchased  the Crozer-Keystone Health System, of which Delaware County Memorial is a part, in July 2016, said its officials met with the union more than 20 times to try to negotiate a fair contract.

To Kligerman, Prospect isn't concerned with having enough money, but rather negotiations are a matter of control.

"They really do put profit before patients," said Ludwig.