WORCESTER, Mass. (AP) — Hundreds of nurses at a Massachusetts hospital walked off the job on Monday morning after failing to reach an agreement with management over staffing levels.

Nurses and their supporters gathered outside St. Vincent Hospital in Worcester at dawn holding signs that said “Safe Staffing Now” and “Picketing for our Patients and our Community."

The strike started after negotiations with Dallas-based Tenet Healthcare, which owns the hospital, broke down.

“We are sad to see that Tenet holds so little value for our patients, yet we are resolved to do whatever it takes for as long as it take to protect our patients, as it is safer to strike now than allow Tenet to continue endangering our patients every day on every shift," nurse Marlena Pellegrino, co-chair of the local bargaining unit of the Massachusetts Nurses Association, said in a statement.

The hospital has about 800 nurses.

Management in a statement Sunday said they are disappointed in what they called an irresponsible decision to strike during the pandemic, and have enough temporary nurses to ensure patient safety.

St. Vincent nurses say they are required to care for five patients at a time, a difficult task with COVID-19 precautions and care requirements, while other hospital have a limit of four patients per nurse.