If you're looking for the front lines in the battle between labor and management in the nurses' contract dispute and lockout, the sidewalks in front of Valley Hospital Medical Center and Desert Springs Hospital are good places to start.

The picket slogans are catchy. "Patients before Profits" and "Protect Patients Improve Staffing" are bound to reverberate with passers-by -- even if they do send chills down the spines of the hospitals' patients.

The image of dedicated caregivers being locked out by corporate overlords is irresistible. If you don't have a special spot in your heart for nurses, I suspect you don't have a heart at all.

With television cameras rolling and print reporters asking questions of veteran nurses represented by the Service Employees International Union Local 1107, the lockout scene has already made national news.

When The New York Times publishes a story on the lockout of hundreds of nurses from two highly profitable hospitals smack in the middle of the holiday season, there's no question which side is winning in the court of public opinion. Expect images of Mr. Potter and the Grinch any day.

If the hospital barons at Universal Health Services, parent company of Valley and Desert Springs, were concerned about their public image -- and, at this point, I don't believe they are -- they might have tried to appear sympathetic to the nurses' stated concerns about staffing levels and patient safety. They might have embraced the offer by an impressive array of local and state political officials to set up a meeting with hopes of generating a 30-day "cooling off" period.

No less a lineup than Gov.-elect Jim Gibbons, Assembly Speaker-elect Barbara Buckley, Clark County Commission Chairman Rory Reid and Las Vegas Mayor Oscar Goodman called on both sides to reason together -- or at least back off the brinkmanship.

After declining to attend the meeting, Valley Health officials deigned to sit down Tuesday afternoon "out of respect" for the elected officials.

Chances are good that the elected leaders weren't feeling all that well- respected. Hospital higher-ups made it clear they didn't expect anything positive to come from the session and were going through the motions. The results were better than expected, with both sides returning to the bargaining table, but the issues remain.

Management calls the staffing issue a union-concocted deception. Forget that SEIU offers what it says is irrefutable proof that staffing levels are higher at its other organized hospitals in the valley, including at St. Rose Dominican and the HCA groups.

Why go out of the way to appear so intractable and arrogant?

It's only speculation, but I'll wager parent company Universal Health Services isn't looking at the sidewalk in front of its two unionized hospitals, but at the sidewalks of its two nonunion medical centers and at the construction site of its Centennial Hills Hospital Medical Center. Taking a financial hit by agreeing to hire a few dozen extra nurses -- the union says the hospitals are approximately 200 short -- is nothing compared to the message such a decision would send.

Think about it: If higher staff ratios are appropriate at the unionized hospitals, then why wouldn't they be the right thing for the nonunion facilities -- especially that sparkling new place due to open in 2007?

The Southern Nevada market is extremely profitable for Universal Health Services. According to its SEC Form 10-K, the company in 2005 derived 20 percent of its consolidated net profit from its four area hospitals. That's a cash cow.

The corporation and the union have one thing in common. They're healthiest when they're growing. For the company, it is facility creation and acquisition. For the union, it's membership expansion.

SEIU officials have cleverly focused their story on the plight of the overworked nurses and the correlation between staffing ratios and patient care. It's no secret there's a nursing shortage in Southern Nevada. The union also has provided illustrations of employer harassment of nurses and has taken its message to the airwaves.

The question now is whether the union can "persuade" the corporation to raise its ratios without itself appearing more interested in increasing its clout than protecting patients.

The front lines are on the sidewalks, but before this hospital war is through, you can expect the shots to echo throughout the valley.

John L. Smith's column appears Sunday, Tuesday, Wednesday and Friday. E-mail him at Smith@reviewjournal.com or call 383-0295.