After a three-day strike last month, the New York State Nurses Association (NYSNA) reached a tentative deal with Mount Sinai and Montefiore hospitals on Jan. 12. Ninety-eight percent of nurses voted in favor of their union contracts, which include safer nurse-to-patient ratios that ensure there will “always be enough nurses at the bedside to provide safe patient care, not just on paper,” said NYSNA president Nancy Hagans in a press statement.
The right to safe staffing is a historic victory for the NYSNA, the largest union for registered nurses at 42,000 members. Before this, California was the only state to have enforceable staffing ratios and was considered the gold standard for the profession.
“This is a historic victory for New York City nurses and for nurses across the country,” said Hagans in a statement. “NYSNA nurses have done the impossible, saving lives night and day, throughout the COVID-19 pandemic, and now we’ve again shown that nothing is impossible for nurse heroes.”
More than 7,000 Mount Sinai and Montefiore nurses participated in the strike, citing poor working conditions and unsafe staffing ratios that put both nurses and the communities they served at risk.
The latest contracts will also provide nurses with a 19% wage increase over three years. Very little of the $175 billion hospitals received during the COVID-19 pandemic addressed the national nurses shortage that hospital administrators blamed for poor working conditions. NYSNA claimed that hospitals did not do enough to attract and retain nurses, with many leaving bedside roles for positions with more flexible hours and higher pay. Despite this understaffing, Mount Sinai and Montefiore executives made millions during the pandemic, and the union believed that the hospitals were placing profits over people.
“Look at what the top CEOs are making… and yet [management] said they cannot afford to hire nurses to continue to care for patients,” said Hagans. “We basically had to save patients over profits.”
The promise of enforceable staff ratios and better pay comes at a welcome time for overburdened nurses. According to Hagans, “the only way we could continue to care for patients and care for them adequately and properly is by having safe patient-to-nurse ratios.” NYSNA urged that burnt-out staff could not give patients the standard of care they deserved, which would severely impact historically disenfranchised communities. During New York City’s Omicron surge last year, COVID-19 hospitalizations were disproportionately higher in majority-Black neighborhoods, contributing to increased morbidity and mortality. Research shows safer staffing ratios can be a direct solution to this; according to a 2021 study, if New York state had had the same staffing mandate as California, at least 4,370 more lives would have been saved in that year alone.
“Every patient is a VIP, regardless of their immigration status, their ZIP code, or their financial status,” said Hagan. “It was very important for us to continue to deliver safe care to our communities and our patients.”
Implementing safe staffing will also help to retain staff, which was an issue for the city’s hospitals even before the COVID-19 pandemic. Lorena Vivas, a registered nurse at Mount Sinai and a member of NYSNA’s executive committee, said she felt like “gladiators trying not to die in the arena” at the beginning of the pandemic. She described the trauma, exhaustion, and burnout caused by long work hours and understaffing.
“Sometimes I don’t want to take a break because then whoever will cover me will have four patients … so we end up just skipping lunch,” said Vivas. She also mentioned how Mount Sinai’s 500-nurse shortage jeopardized patient care.
“Our [medical-surgical] nurses should really only have a staffing ratio of one-to-five, but they get 12. It’s unsafe and not fair to the patients,” said Vivas.
As a Filipina nurse, Vivas acknowledged that the contract victory was not only a win for nurses, but also a win for the many marginalized communities they represented. According to Vivas, the strike marked the first collective action for many nurses, and many learned the importance of building relationships to organize effectively.
“The demographic is mostly women and mostly people of color,” Vivas said. “When you’re building grassroots relationships, it is really about getting to know them and having the right representation on your team.”
Both Hagans and Vivas noted that the strike victory also boosted nurse morale and empowered them to speak up. While the union is still in talks with hospital administrators on how they will enforce safe staffing, Vivas noticed that nurses were already feeling the positive effects.
“People are more brave, calling out management and getting stuff resolved right away. Whereas before, they [were] scared of a pushback or retaliation. Now, there’s a sense of empowerment,” said Vivas.
Vivas and Hagans also expressed their gratitude for the community’s support during the strike. For them, the action was successful because everyone fought for a unified cause.
“If you put things into perspective, you fight for the public, and the public fights for you,” Vivas said, underscoring how both patients and nurses will benefit from the strike’s effects.
NYSNA’s victory has already made a positive impact on union organizing within the nursing profession in other parts of the country. The day after the tentative deal with Mount Sinai and Montefiore was reached, about 800 nurses at Mount Sinai South Nassau, the last non-union Mount Sinai facility, voted to join NYSNA. Later that same month, on Jan. 26, thousands of National Nurses United (NNU) nurses—of which NYSNA is an affiliate—held actions across 10 states to demand hospitals put patients over profit and end the profession’s staffing crisis amid an ongoing “quad-demic.”
Vivas noted that their successful strike has also encouraged current rank-and-file members to participate more within the union. “[Y]oung people are coming to us and asking how they can serve and be part of the [executive committee]. They said we brought sexy back to the union.”
