WORCESTER, Mass. (AP) — Management at a Massachusetts hospital where nurses have been on strike for nearly four months made a new offer over the weekend in an effort to end the work stoppage, but the nurses' union appeared skeptical.

Nurses at St. Vincent Hospital in Worcester went on strike March 8 demanding better staffing ratios, which they said is necessary to ensure patient safety.

The offer made Sunday includes better resource nurse staffing, pay raises, health insurance premium improvements for some nurses, and security enhancements, St. Vincent said.

St. Vincent is owned by Dallas-based Tenet Healthcare.

“It provides for resource nurses, regardless of patient census, on day and evening shift for all med/surg units, as well as incremental resource nurses in other areas of the hospital. It also includes limits on how many patients these resource nurses can take, so they will be available to help other nurses or to assist with unique circumstances that arise," the statement said.

The offer is in line with what nurses are accepting at other hospitals in the state, St. Vincent CEO Carolyn Jackson said in a statement.

The Massachusetts Nurses Association said in a statement the St. Vincent's bargaining unit will review the proposal Monday and prepare a counterproposal to present Tuesday.

“Simply put, this is one step forward and two steps back,” said Marlena Pellegrino, co-chair of the St. Vincent bargaining unit. “It is not a serious proposal that will allow nurses to provide patients with the care and dignity they deserve from our community hospital."

Patients at St. Vincent are being cared for by temporary replacement nurses, but the hospital has also hired new permanent nurses. Some staff nurses have also crossed the picket line.

The strike is now the second longest nurses' strike in state history, according to the Massachusetts Nurses Association.