From the UK to New York, nurses are voting to go on strike

Twice in the span of a week, thousands of nurses across the United Kingdom walked out of hospitals.

As many as 100,000 nurses have taken part in the strikes in England, Northern Ireland and Wales, according to the Royal College of Nursing, the union representing nurses. Nurses walked off the job for 12 hours on Dec. 20, and they engaged in a similar strike on Dec. 15. The strikes have been the biggest ever in the history of the National Health Service, the British health system, BBC News reported.

The Royal College of Nursing has raised the prospect of more strikes in January. The union is seeking a 19% raise, The New York Times reports, but nurses are also calling for improved staffing.

• Read more: Nursing profession is ‘beyond burnout’, and needs greater attention

Dissatisfaction is rising across the pond.

Thousands of nurses at New York City hospitals have voted to authorize a strike.

The New York State Nurses Association represents 17,000 nurses at 12 hospitals where contracts are set to expire Dec. 31. The union said Thursday that 14,000 of those nurses had completed their authorization vote, and 99% voted to authorize a strike.

Nurses voted to strike at Mount Sinai Hospital, Mount Sinai Morningside and West, NewYork-Presbyterian, BronxCare, Montefiore, and Richmond University Medical Center. The NewYork-Presbyterian facilities are NewYork-Presbyterian/Columbia University Irving Medical Center; NewYork-Presbyterian/Allen Hospital; and NewYork-Presbyterian/Morgan Stanley Children’s Hospital.

The New York nurses would need to issue a 10-day notice before going on strike, but the union said nurses would walk out unless the hospitals don’t take significant steps toward a better contract. The nurses said they want hospitals to invest more to keep nurses and recruit additional nurses.

Nancy Hagans, president of the New York State Nurses Association and a nurse at Maimonides Medical Center, said the health systems have left nurses no other choice.

“We don’t take striking lightly,” Hagans said. “Striking is always a last resort. But we are prepared to strike if our bosses give us no other option.”

Nurses spoke at a news conference Thursday announcing the vote and recalled the harrowing scenes after the arrival of COVID-19, when New York City was ground zero of the pandemic.

“As a psychiatric nurse, I can tell you that the COVID-19 pandemic has pushed our patients and our nurses to their limit,” said Ari Moma, a psychiatric nurse at Interfaith Medical Center in Brooklyn. “Many of us were traumatized by what we saw and by the conditions we have been working under since the pandemic began. Understaffing makes everything worse.”

Nurses also spoke of the challenges of what’s been billed as a “triple-demic,” with the confluence of patients with respiratory viruses such as RSV, the flu, and COVID-19 packing hospitals. Nurses said they deserve more.

As one nurse said at the Thursday press conference, “We’re not asking for the world, but we’re not going to accept crumbs either.”

Mount Sinai said it has been working to reach a new contract with nurses and is confident that talks can lead to a new pact. The system said it values the contributions of nurses in caring for patients.

“Our goal is to reach an agreement that continues to provide our valued nurses with competitive compensation and benefits and ensures a safe, supportive and working environment that enables them to provide exceptional care to all our patients across the diverse communities we serve,” Mount Sinai said in a statement.

In a statement, NewYork-Presbyterian said, “We respect and value all of our nurses, who play a central role in delivering the exceptional care that NewYork-Presbyterian is known for. We remain hopeful that union leadership shares our dedication to reaching a fair and reasonable contract agreement, and we will continue to bargain in good faith.

“While a strike vote does not necessarily mean a strike will occur, and we remain committed to reaching an agreement. We must always prioritize our patients and their care, and we have made the necessary preparations to ensure that our patients at NYP Columbia University Irving Medical Center, NYP Allen Hospital, and NYP Morgan Stanley Children’s Hospital continue to receive the same high-quality care, without interruption, in keeping with our fundamental obligation to the communities we serve.”

• Read more: To address burnout, ‘Return nurses to being nurses’

‘A warning shot’

Nurses across the United States have increasingly called for their organizations to improve working conditions, staffing, and yes, pay. While nursing strikes here are fairly rare, more threats of strikes are happening.

Rebecca Love, chief clinical officer at IntelyCare, told Chief Healthcare Executive in November that the strikes in the United Kingdom would foreshadow the growing unrest of nurses in America. She didn’t foresee nationwide strikes but said walkouts across some states would be feasible.

“It will be a warning shot to the United States,” Love said. “What is going to happen there, will also happen here.” (See excerpts of our conversation with Rebecca Love at the HLTH Conference. The story continues below.)

The Minnesota Nurses Association led the largest nursing strike in U.S. history in September, when 15,000 nurses engaged in a three-day strike.

The nurses were set to begin a second strike affecting 16 hospitals this month, but the union and health systems reached an agreement on a new contract and the planned walkout was averted. In the three-year deal, the Minnesota nurses received raises of 17%-18% and greater say in staffing.

More than 21,000 nurses and nurse practitioners in northern California threatened to hold a two-day strike in November, but nixed the planned walkout when they reached a deal with 21 Kaiser Permanente facilities. They ratified a contract earlier this month. The four-year pact included raises of 22.5%, the Sacramento Bee reported.

The contract also calls for health and safety provisions, and the creation of diversity and equity committees, National Nurses United said.

Battles loom in 2023

Hospitals are going to be dealing with more union pacts, including contracts with nurses, in 2023, and the negotiations aren’t going to be easy, Kevin Holloran, a senior director with Fitch Ratings, told Chief Healthcare Executive in an interview earlier this month.

“We expect those to be protracted,” Holloran said of the contract talks.

Hospitals have struggled financially in 2022, with more than half of all hospitals expected to finish the year with negative margins. Health system leaders have pointed to higher labor costs and a shortage of bedside nurses. Labor expenses at American hospitals and health systems rose 37% per patient between 2019 and March 2022, according to a report from Kaufman Hall, a healthcare consulting firm.

Industry analysts say health systems should understand that higher wages for nurses and healthcare workers are here to stay. And health systems are going to have to budget appropriately.

“Higher labor costs are the new normal,” Holloran said.

Beyond issues of pay, nurses say they are frustrated by the lack of staffing and their inability to focus on patient care because they’re saddled with other duties.

Nurses also say they are increasingly subject to violence in hospitals, adding to their stress and getting many to think about walking away. Nurses, and many doctors, say they don’t feel as if their organizations take their safety seriously.

Some nurses are walking away from the profession. Two out of three nurses (67%) said they intend to leave their position within three years, according to an August poll by the American Association of Critical-Care Nurses. Among those who are thinking of walking away, 36% of those nurses said they would leave within the next year, the AACN poll found.

Many nurses are losing the love of nursing, according to a report by the American Association of Critical-Care Nurses. Beth Ulrich, a longtime nursing executive and the lead author of that report, told Chief Healthcare Executive in August that nurses’ dissatisfaction runs far deeper than their displeasure with certain aspects of their job.

“When a nurse tells you she’s not satisfied with being a nurse, now we’ve got a problem,” Ulrich says. “And we have to find a way to re-engage those nurses and help them find joy in their profession again. That to me is one of the critical issues because that's such a foundational issue.”