Thousands of NYC nurses prepare to strike

Update 01/09/23: More than 7,000 nurses in Manhattan and the Bronx began striking Monday morning after failed negotiations with Mount Sinai Hospital and Montefiore Medical Center.

Thousands of New York City nurses will strike as early as Monday if negotiations falter with major health systems over issues around pay, benefits, and patient loads.

About 10,000 nurses across five systems, including Mount Sinai and Montefiore, are looking for raises, benefit preservation, and policies that will address chronic understaffing—an issue that has plagued the healthcare industry for years. Nurses have threatened to strike if a deal for their three-year contracts isn’t reached by Jan. 9.

“When you speak to most nurses, it seems like they just want assurance that the hospital will have safe staffing,” a nurse within the Mount Sinai system (who asked for anonymity as they are not officially permitted to speak with the media) told Healthcare Brew about the practice of setting manageable nurse-to-patient ratios. “Every dangerous shift I work I think, ‘Today is the day. Someone will die [as] a direct result of how short we are on nurses.’”

The negotiations are coming to a head as groups of nurses in different parts of the country (and even in some areas in the UK) go on strike over working conditions, which they say have disintegrated over burnout-induced attrition and an influx of Covid-19, RSV, and flu cases—billed as the “tripledemic.”

Hospitals and health facilities across the US have struggled to fill vacancies that have been exacerbated by the pandemic as well as professionals leaving the medical field. The workforce shortages (and the costs associated with filling those open positions) have plagued hospital finances.

In New York, nearly all hospitals reported nursing positions they cannot fill, and almost half said they’ve reduced or eliminated services to mitigate the staffing challenges, according to a December 2022 survey conducted last fall on behalf of the Greater New York Hospital Association (GNYHA) and four other New York hospital associations.

Nearly two-thirds of facilities surveyed, meanwhile, reported negative operating margins.

Kenneth Raske, the president and CEO of GNYHA—which represents more than 200 hospitals, health systems, and continuing care facilities in the New York City metro area—said a strike “would be irresponsible and not in the interest of our patients” in the face of the tripledemic.

“The hospital community values and supports our nurses,” he said in a statement. “Fair and reasonable bargains have already been struck by many institutions, and many others are prepared to follow their lead.”

Still, facilities are making preparations for an impending strike.

Hospitals have begun canceling elective procedures and “decanting” (or moving patients) in anticipation of a strike, despite continuing “good faith negotiations,” Raske said, noting that some are prepared to spend “tens of millions” on travel nurses.

Mount Sinai Health System has started diverting ambulances from four of its facilities and transferring babies from its neonatal intensive care unit to other systems, according to an internal memo. The service cuts will result in a loss of revenue for the system.

“The impact is great,” Mount Sinai spokesperson Lucia Lee said in an email to Healthcare Brew. “We are focused on our patients/families and Mount Sinai community to prepare in the absence of a contract agreement.”

New York passed a “safe staffing” law in 2021 requiring hospitals to create committees that would oversee the development and implementation of annual staffing plans to outline specific nurse-to-patient guidelines or ratios. At the time, the New York State Nurses Association and other health care unions that had long pushed for the legislation said it would address the “chronic understaffing at New York hospitals and nursing homes.”

Per the law, those staffing plans were set to take effect on Jan. 1, but not every facility reached consensus on them, City and State New York and New York Focus reported.

“At least during the height of the pandemic, [management] did not expect us to operate as normal,” the Mount Sinai nurse said. “Now we work with a skeleton staff and are expected to act like everything is normal. But it’s not. The house is on fire and somehow the landlord is refusing to call the fire department.”