Why New York City’s nurses walked out and how strike could hit patient care

New York nurses strike over safety

Before dawn broke over New York City, nurses pulled on winter coats instead of scrubs and gathered outside hospital gates they have walked through for years. Some came straight from night shifts, others clutching placards between cups of coffee, all carrying the same fear — that the system they hold together is no longer holding them. Nearly 15,000 nurses have now walked out of hospitals across the city, not only over pay, but over what they say is a daily struggle to keep patients safe while feeling increasingly unprotected themselves. What began as stalled contract talks has turned into one of the largest nurses’ strikes in the city’s history, raising urgent questions about staffing, safety and the future of care in New York’s hospitals.

The strike, led by the New York State Nurses Association (NYSNA), began on Monday after contracts expired on December 31. Nurses are protesting at five privately run hospitals: Mount Sinai Hospital, Mount Sinai Morningside and Mount Sinai West in Manhattan; NewYork-Presbyterian in Manhattan; and Montefiore Einstein in the Bronx. The walkout has prompted widespread concern about staffing, patient safety and hospital finances.

Anticipating disruption, New York Governor Kathy Hochul declared a state of emergency ahead of the strike, allowing hospitals to take emergency measures to maintain operations. CBS News described the action as one of the most significant nurses’ strikes New York City has ever seen.

Why nurses are striking

At the centre of the dispute are long-standing union demands over pay, staffing levels, workplace safety, health-care coverage and pensions. Nurses argue that hospital management has prioritised profits over patient care, particularly as hospitals attempt to scale back staffing guarantees and benefits during a period of intense strain on the health system.

According to the Guardian, NYSNA has pointed out that chief executive pay at Montefiore, Mount Sinai and NewYork-Presbyterian is nearly 12,000 times higher than the earnings of an average nurse.

Nancy Hagans, president of NYSNA and a nurse with more than three decades of experience at Maimonides Medical Centre in Brooklyn, accused hospital administrators of undermining patient safety. “Hospitals are pushing to scale back safe staffing ratios. They are refusing to guarantee healthcare benefit coverage for nurses, and declining to address workplace safety issues.”

She also criticised proposals to reduce benefits during a surge in influenza cases. “These hospitals are pushing to cut health benefits for nurses who put their own health on the line to care for New Yorkers during this historic flu surge,” Hagans said.

“Nurses do not want to strike, but our bosses have forced us out on strike,” she added, according to the Times.

Responding to claims by hospital management that the union was demanding pay rises of up to 40 per cent, Hagans disputed the figure. “Our average salary is about 125-130,000. We are also asking for fair wages. Wages, we would negotiate, but patient care, we will not cut corners. According to media reports, management claims we are asking for 40 per cent, which is false, as the CEO of NYP earned $23 million last year (roughly Rs 190.9 crore). His two-day salary is more than what nurses make in a year,” she told NPR.

Workplace violence has also emerged as a major issue. Hagans referenced a recent incident at a Brooklyn hospital that ended in a fatal police shooting. “We are also asking for workplace violence protection because, as you know, it has been a rampage. And last week - Thursday - there was an active shooter at New York Methodist, which belongs to NYP in Brooklyn, New York.”

Many nurses say they feel they have little choice but to strike. Cecilia Barreto, a registered nurse picketing outside Mount Sinai, told CBS News, “I have been here two years. I know that there are nurses who have battled cancer and depend on their health care. So we need to make sure that the health care we receive stays intact because their lives depend on it.”

Hospitals push back

Hospital administrators have rejected the union’s demands, describing them as financially unsustainable. Montefiore Hospital has previously labelled some proposals “irresponsible”, while a joint statement from the affected hospitals described the strike as “reckless” and accused nurses of abandoning patients.

“NYSNA leadership has chosen to abandon patients in their time of need, but Montefiore Medical Centre, Mount Sinai, and NewYork-Presbyterian will not. Their decision to walk out on our patients can only be described as reckless,” hospital officials said, according to CBS News.

Mount Sinai has said it is prepared for a prolonged walkout. “We have taken every step to best support our patients and employees in the event of NYSNA forcing our nurses to walk away,” the hospital said.

A Mount Sinai spokesperson told The New York Times that nurses at the facility earn an average of $162,000 a year (approximately Rs 1.46 crore) and that meeting the union’s demands would increase pay to $275,000 (approximately Rs 2.48 crore) over three years.

Kenneth E Raske, president of the Greater New York Hospital Association, warned that the broader system is under financial strain. “The health care system is under siege financially. The demands of the union are so outrageous that there is no way they can concede to what the union is asking for,” he said.

Not all hospitals are affected. Several facilities, including all Northwell Health hospitals in Nassau County, have reached agreements with NYSNA.

Impact on patients and political response

Despite the strike, hospitals remain open. Travel nurses have been brought in to cover staffing gaps, and Montefiore has said its emergency rooms will continue operating without delays or cancelled appointments. NYSNA has also urged patients to continue seeking care.

Governor Hochul signed executive orders on January 9 to maintain staffing levels during the strike.

New York City Mayor Zohran Mamdani joined nurses on the picket line outside NewYork-Presbyterian in Washington Heights. “In every one of our city’s darkest periods, nurses showed up to work. Their value is not negotiable, and their worth is not up for debate,” he said.

“They show up, and all they are asking for in return is dignity, respect and the fair pay and treatment that they deserve. They should settle for nothing less,” Mamdani added.

In a post on X, he wrote, “No New Yorker should have to fear losing access to health care — and no nurse should be asked to accept less pay, fewer benefits or less dignity for doing lifesaving work. Our nurses kept this city alive through its hardest moments. Their value is not negotiable.”

“They must bargain in good faith, and they must arrive at a deal that is satisfactory to all, that allows the nurses who work in this city to live in this city,” he added.

New York Attorney General Letitia James echoed that message, saying, “Health care workers are being stretched to their limits, and as workplace violence in hospitals is on the rise, nurses are asking simply for the basics.”