Rise in healthcare worker strikes expected to continue in 2024

If there’s one word that could summarize healthcare in 2023, it’s “strike.”

From nurses to dialysis workers, a broad spectrum of healthcare workers participated in labor activity last year, with at least 27 strikes taking place at hospitals and health systems across the US, according to Healthcare Dive’s strike tracker.

And experts don’t think the labor activity is slowing down anytime soon.

“Workers are feeling fired up and emboldened, and really stepping into their power,” Renée Saldaña, a spokesperson for Service Employees International Union–United Healthcare Workers West (SEIU-UHW), which represents over 100,000 healthcare workers, told Healthcare Brew. “What we can see is workers really starting to stand up for themselves and for their patients for better working conditions […] I don’t think that’s going to stop.”

A brief recap

The New York State Nurses Association (NYSNA), which represents 42,000+ registered nurses, began 2023 with strikes at major New York City hospitals, including Mount Sinai Hospital and Montefiore Medical Center.

NYSNA President Nancy Hagans told Healthcare Brew that the New York City strike “was incredible not just for its size—approximately 7,000 nurses at two major hospitals—but for what it accomplished and inspired.”

“Nurses won enforceable safe staffing ratios backed by financial penalties […] They also protected their benefits and won increased wages, health and safety protections, and community benefits,” she said in a statement. “Hospitals had not done enough for nurses and our patients post-Covid, so these nurses fought back and said, ‘Enough is enough’ and inspired other healthcare workers to do the same.”

Hospital management execs in nearby Long Island felt those aftershocks. Northwell Health President and CEO Michael Dowling noted at a March 2023 Huntington Hospital town hall event that union activities across the region had affected contract negotiations within the health system.

“The cost of the recent agreements that have been reached as a result of what was done in the city is in the neighborhood of […] $500–$600 million over three years,” he said at the time. “That was not in our budget.”

Meanwhile, nurses at New Jersey’s Robert Wood Johnson University Hospital ended their 130+-day strike in December 2023 after approving a new union contract. More than 1,000 nurses in United SteelWorkers 4-200 had gone on strike in August 2023 after contract talks hit an impasse over issues like staffing ratios and benefits.

US Senator Bernie Sanders, a Vermont independent who leads the Senate Health, Education, Labor, and Pensions Committee and met with union leaders, said the contract win “gives hope to nurses all over America who are overworked, stressed out, and stretched to the breaking point, that if they go on strike and demand safe nurse-to-patient ratios, they too can win.”

October 2023 saw the largest healthcare strike in US history as 75,000 Kaiser Permanente workers walked off the job over staffing levels, workloads, and wages.

Healthcare workers outside the hospital setting went on strike in 2023 as well. More than 500 dialysis clinic workers in California went on an unfair labor practice strike in September 2023, and hundreds of pharmacy workers at CVS and Walgreens walked off the job the following month, according to Shane Jerominski, an organizer of The Pharmacy Guild, a group meant to help unionize retail pharmacy employees.

The strikes seen across the industry have resulted in some substantial wins for healthcare workers.

For example, nurses at New York City’s municipal health system NYC Health + Hospitals won salary and pay parity increases in August 2023. And in December 2023, resident physicians at Stanford Health Care won a 21% compensation increase following 13 months of “contentious negotiations.”

All the victories healthcare unions saw in 2023—big or small—helped in “transforming the culture of medicine,” Dani Golomb, a third-year resident at California Pacific Medical Center in San Francisco who helped organize the hospital’s union, told Healthcare Brew.

Looking to the new year

The new year could usher in another wave of nursing strikes in New York, with NYSNA contracts at about 20 hospitals across the state—including Albany Medical Center, Northwell Staten Island University Hospital, and Utica’s Wynn Hospital—set to expire in 2024.

In the final days of 2023, the union struck tentative nursing deals with Montefiore hospitals in the Hudson Valley, including facilities in Nyack, New Rochelle, and Mount Vernon, before the nurses’ contracts expired on December 31. The agreements, which included minimum staffing ratios and wage increases, averted a January strike that the union authorized on December 19, 2023.

The Union of American Physicians & Dentists in California may also go on strike in February after postponing a walkout originally planned for December 27 through January 1, the Los Angeles Times reported. The union members plan to protest a lack of benefits, which they say makes it difficult to recruit and retain medical staff.

Golomb said she expects to see the labor activity momentum that was created in 2023 to continue into the new year.

“I think we’re gonna start seeing some pretty big changes,” she said. “I think people are witnessing the power of the labor movement, and as people witness it, they say, ‘I could do this, too.’”