LOS ANGELES (CNS) -- Thousands of unionized Kaiser Permanente registered nurses and other health professionals began a five-day strike Tuesday in California and Hawaii amid ongoing contract negotiations -- but Kaiser officials said affected facilities remain open with some adjustments.

Workers represented by the United Nurses Associations of California/Union of Health Care Professionals began picketing at 7 a.m. at locations across the region.

Participating workers include registered nurses, pharmacists, nurse anesthetists, nurse practitioners, midwives, physician assistants, rehab therapists, speech language pathologists, dietitians and other specialty health-care professionals, according to the union.

"We do not take the decision to strike lightly. A strike is always a last resort, r

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