NYC nurses, hospital leaders continue to clash in ongoing strikes

The nurses of New York City are a-strikin’.

In what has been touted as the largest nurse strike in the city’s history, 15,000 nurses from Mount Sinai, Montefiore, and NewYork-Presbyterian hospitals started striking on Jan. 12. The issues at the top of the docket include addressing expected cuts in health benefits, better workplace violence protections, and safer staffing.

Almost immediately, the strike was shrouded in drama.

Three Mount Sinai labor and delivery nurses were fired the day before the strike began. The unit had been experiencing “aggressive” union busting, including a prior incident in which nurses were disciplined after going to a union meeting, a Jan. 13 New York State Nurses Association release claims.

According to the hospital’s statement, these nurses were terminated for “interfering with patient safety by deliberately sabotaging [its] emergency preparedness drills,” including allegedly hiding critical supplies for newborns from temporary staff and then lying about their involvement, despite security footage of the incident.

Union President Nancy Hagans also alleged in a Jan. 14 statement that Montefiore attempted to “slander” and “disrespect” its nurses through “outrageous PR campaigns.”

Montefiore didn’t respond to a request for comment about the allegations or any campaigns it may be running.

As of the time of reporting, the strike and negotiations are ongoing. Picket lines have drawn support from notable political figures like Vermont Senator Bernie Sanders and NYC Mayor Zohran Mamdani.

“Unfortunately, greedy hospital executives have decided to put profits above safe patient care and force nurses out on strike when we would rather be at the bedsides of our patients,” Hagans said in a Jan. 12 statement. “It is deeply offensive that they would rather use their billions to fight against their own nurses than settle a fair contract.”

Addressing ongoing issues

These complaints from nurses—both in New York and across the country—aren’t exactly new. In fact, two years ago, Montefiore and Mount Sinai nurses held strikes for similar reasons. After three days, 7,000+ nurses returned to work once they came to a resolution about staffing issues, pay discrepancies, and working conditions.

“What it shows is that there’s chronic issues here that keep recurring, and the parties seem to be at a state where they’re not able to resolve them,” John August, program director at the Cornell University School of Industrial and Labor Relations (ILR), told Healthcare Brew.

The National Center for Health Workforce Analysis projects the US will see an 88% drop in nursing staff by 2038, a shortage of more than 141,000 nurses. Between 2020 and 2021 alone, the total number of nurses dropped by more than 100,000.

Not only does this contribute to burnout among staffers but research has also shown that when nurses are stretched to their limits, it can negatively impact patient safety.

Business as usual?

New York has been through a grueling flu and cold season, with nearly 2,500 hospitalizations in Manhattan alone reported by the state’s Health Department so far.

But according to spokespeople at all three hospitals, they’re carrying on business as usual: NewYork-Presbyterian spokesperson Angela Karafazli said in a statement the hospital has utilized temporary travel nurses to help—a cost that’s estimated to exceed $100 million.

“NYSNA’s demands remain unrealistic,” Karafazli said, citing the hospital’s proposal for a 25% wage increase over three years. Since December 2022, NewYork-Presbyterian has hired more than 400 new nurses and is implementing new training and tools to help keep staff safe, according to the statement.

“It would be unreasonable to agree to NYSNA’s current proposals while the healthcare landscape has never been more challenging and uncertain, given drastic federal cuts to Medicaid and ACA marketplaces, and rising overall costs,” she added.

Mount Sinai CEO Brendan Carr said in a Jan. 19 notice to staff that the hospital was working with agency nurses and that outpatient practices and labor and delivery were at “full capacity.”

Spokesperson Ilana Nikravesh shared in an emailed statement that 20% of nurses reported to work the first day of the strike and Mount Sinai has committed “significant funds” to bringing in agency nurses. She added that the proposal from the union, according to the hospital’s calculations, would cost $1.6 billion over three years.

A lose-lose situation

Beyond the federal cuts, hospitals also face reduced reimbursement rates for this year due to pending Medicaid and Affordable Care Act cuts.

According to August, much of a hospital’s wealth comes from assets like property and academic centers, but otherwise, its margins—especially post-Covid—continue to be thin. For instance, hospitals in Medicaid expansion states could see their operating margins cut 11.7%–13.3% on average while safety-net hospitals could have margins cut 25.9%–29.6% on average, according to the Commonwealth Fund.

Since January 2021, Cornell’s labor relations school has recorded more than 200 labor actions in its tracker as hospital admin and providers face ongoing pressures—a “parallel transformation,” as August phrased it.

“Unions [in states like California and New York] have deep penetration. I think they’ve played a huge role in being able to mitigate some of the recruitment and retention difficulties,” he said. “At the same time, I think that more effort should be put in by all parties to see to it that the voice of both frontline managers and frontline healthcare workers are working to solve problems.”