Last week, 1,300 nurses at Staten Island University Hospital (SIUH) in New York voted by more than 97 percent to authorize a strike. Northwell Health, which owns the hospital, is demanding that the nurses do more work with fewer resources, and also has instituted changes that the nurses say could compromise patient care.
Nine rounds of talks have been held since December 2023. If no new agreement is achieved before the current contract expires on March 31, the nurses plan to walk out.
One of the nurses’ two major demands is safe staffing. The nurses are calling for a ratio of one nurse for every four patients. The current ratio approaches one nurse to every ten patients. This scandalous understaffing not only jeopardizes patient safety, but also imposes untenable workloads on nurses and increases the risk of burnout.
“We’re responsible for 7,000 different things — we’re dietary, we’re environmental, we’re physical therapists,” Shayna Lehrer, an SIUH nurse, told local newspaper the Chief. “They keep saying there’s a nursing shortage. There’s no nursing shortage; they don’t want to hire anybody.”
The nurses’ other demand is higher pay. The average base pay for nurses at SIUH is $11,573 lower per year than the base pay at similar New York City hospitals, the nurses report. The nurses recently demanded a 12 percent increase for 2024 and a 10 percent increase in 2025. In response, the hospital offered insulting 3 percent raises in 2024 and 2025 and a 4 percent raise in 2026. The SIUH administration’s proposed raises for this year and next are below the current rate of inflation, which means that they would in fact be cuts to real wages.
Adriana DeLeon, a registered nurse, has worked at SIUH for two years. “I’m considered one of the most seasoned nurses on [the medical surgical] unit, which means that I’m precepting, I’m being a charge [nurse] when management’s not there,” she told Crain’s New York Business. The added responsibility increases the pressure on new nurses, she said.
Understaffing is also forcing nurses to work in units that are outside of their specialties. Such assignments increase the risk of errors and may compromise patient safety. “They want us to do everything, to be a jack-of-all-trades yet a master of none. We are specialty nurses,” Sheila Ramos, a nurse with 37 years’ experience, told the Chief.
Northwell Health runs 21 hospitals and about 900 outpatient facilities in New York City, on Long Island and in Westchester County. The ostensibly nonprofit network is the largest healthcare provider in the state of New York. With more than 81,000 employees, Northwell is also the state’s biggest private employer.
While it has been telling nurses to do more with less, the network has been investing in its executives and in acquisitions instead of in-patient care. Michael Dowling, president and chief executive of Northwell Health, received nearly $8 million in 2021, according to Crain’s New York Business. Moreover, Northwell plans to invest $19.2 billion in its planned merger with Nuvance Health, which is based in Connecticut and owns seven hospitals.
Staten Island is the only New York City borough without an acute care public hospital. It has fewer resources than the other boroughs. Factors such as pollution from diesel exhaust, a high level of poverty and high prevalence of chronic disease affect Staten Island residents’ health. These factors mean that SIUH nurses often care for patients suffering from complicated medical conditions.
The strike vote reflects the SIUH nurses’ strong determination to fight Northwell for safe staffing and better wages, both of which will enable better patient care. But the nurses will also be forced to confront the New York State Nurses Association (NYSNA) union. The NYSNA’s record amply demonstrates that it will spare no effort to achieve a pro-company agreement quickly and call off the strike.
This is the strategy that NYSNA used in February at Long Island Jewish Valley Stream (which is also operated by Northwell Health) and Peconic Bay Medical Center. Nurses at these facilities voted by 99.5 percent to strike, but NYSNA announced agreements with the hospitals at the last minute and called off the strikes.
In January 2023, NYSNA abruptly ended a strike at Mount Sinai Morningside after three days. The union announced a tentative agreement that it proclaimed a “historic victory” that would guarantee safe staffing. The striking nurses were sent back to work without a ratification vote.
Since the agreement was ratified in January 2023, the Mount Sinai Health System has been fined eight times for persistent understaffing. Three of the fines were levied in just the past three months. Mount Sinai Morningside was fined in June 2023 for understaffing in its emergency department, and again in February 2024 for understaffing in the same department. Mount Sinai Health System, which reports annual revenue of $11.3 billion, finds it cheaper to pay fines than to hire an adequate number of nurses. Far from ensuring safe staffing, the NYSNA-backed contract has institutionalized understaffing and failed to provide adequate compensation to nurses who work on understaffed shifts.
NYSNA is run by a layer of bureaucrats who earn their generous salaries by imposing the healthcare companies’ demands on nurses. Like the other trade unions in every industry, it has also integrated itself into the Democratic Party, which represents the interests of Wall Street. As the Democrats escalate the war against Russia in Ukraine and continue supporting Israel’s genocide in Gaza, they are relying more heavily on the trade union bureaucracy to ensure labor peace and the continued generation of profits for executives and shareholders.
The SIUH nurses have shown their determination to fight, but they will not be able to achieve safe staffing or adequate pay unless they take control of the strike away from NYSNA. They can do this by forming a rank-and-file committee that they themselves control democratically. The nurses must appeal for support to other healthcare workers in Staten Island and beyond. Ultimately, their fight is inseparable from the struggle to abolish the profit system and establish socialism, which will provide high-quality healthcare for all.