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The largest healthcare worker strike in American history began Wednesday.

Seventy-five thousand unionized Kaiser Permanente workers walked off the job in four states. The strike will continue through Friday in California, Colorado, Oregon, and Washington.

The union accuses the hospital coalition of not bargaining in good faith and risking patient care. The workers are asking for a $25 per hour minimum wage and better working conditions to help alleviate a worker shortage.

Kaiser has hired temporary workers to fill in the gap. They’re keeping hospitals, emergency departments, and pharmacies open, but the strike may cause delays with non-urgent care.

It’s the latest in a series of strikes this year. Government data shows that those strikes have cost the U.S. more than 7 million days of work so far.