Naniaka Camara grew up near Montefiore Hospital in the Bronx in New York and remembers going there for her medical care. She has been a nurse in Montefiore for three years, she still lives a few minutes from the hospital and she often knows the patients in her neighborhood that she takes care of.
He loves his job, he said, but has been on strike since early Monday morning out of frustration at not giving patients the care they deserve.
It is just the latest in a series of labor actions across the nation by nurses’ unions and other health care workers who say they have had to go on strike to provide patients with quality health care.
“Sometimes I feel like what I did was for nothing, I apologize for things that have nothing to do with me,” Camara said from the picket line in front of his neighborhood hospital. She said she is often behind schedule in providing medications or other services patients need due to understaffing that can stretch her shifts to 12 or 14 hours. She goes to bed as soon as she gets home.
“I don’t like thinking about the previous round because I don’t want to go in for the next one,” he said.
The strike of 7,100 nurses began Monday at the three Montefiore hospitals, which provide about half of the beds in the Bronx, and at Mount Sinai Hospital on Manhattan’s Upper East Side.
Last year, 5,000 nurses went on strike in Minnesota, as did 2,000 mental health professionals in California and Hawaii. Of the top 20 strikes tracked by the Labor Department in the first 11 months of 2022, seven of them, or 35%, were related to health care. Five of these, or 25%, were strikes by nurses.
A big problem in all of them? Personal.
The health care-related strike wave comes despite the fact that only 3% of union members nationwide work in the private health sector.
“It’s extraordinary that number of [registered nurses] they are amazing,” said Bob Muehlenkamp, a retired union organizer at Local 1199, who has spent much of his career organizing and negotiating on behalf of nurses. The problem is not the salary, he said. Nurses are going on strike because they want to do their job the way they believe it should be done.
“There’s a trauma that every single RN goes through in deciding to abandon patients,” Muehlenkamp said. “It’s against every instinct they have.”
Only about 10% of nurses are union members and are allowed to strike. But for many of them, going out doesn’t mean going on strike, it means abandoning the profession they love, exacerbating it the shortage.
There are 3.1 million registered nursing jobs nationwide, according to the Department of Labor, with about 60%, or 1.9 million, in hospitals.
“An indication of how difficult it is to find nurses is the number of traveling nurses,” said Joshua Gottleib, a public policy professor at the University of Chicago, referring to some 67,000 nurses, or one in 20 working in hospitals, who they work for temporary staff services. “This has been historically high.”
The hospitals that get hit are using itinerant nurses as replacements for the strikers, but that’s an expensive alternative: those nurses are typically paid far more than the jobs they’re filling in. Traveling nurses cater to hospitals nationwide as hospitals cannot fill all the jobs of their own staff.
Hospitals have a financial incentive to get by with as few nurses as possible, according to experts who study health care issues.
“Labour is the main expense in health care, so how do you make money? Compress your labor costs,” said Janette Dill, a professor of health policy and management at the University of Minnesota. “Your nursing workforce is your largest workforce.”
The affected New York hospitals insist they are doing everything they can to address their own staffing shortages.
Mount Sinai says it has hired more than 4,000 new nurses in the past three years and now has 503 more nurses working today than four years ago, exceeding the pledge made in 2019 during the latest round of union negotiations.
And he has offered the union what he calls a “robust” staffing enforcement plan to improve the relationship between nurses and patients, he said, but that when it offered to add 50 additional nursing positions, the union said it wanted the money for those additional positions to go towards pay raises for existing staff.
The union denies this, saying staff improvement, not pay, is its top priority in these talks.
“We are in a workforce crisis after this pandemic,” Fran Cartwright, chief of nursing at Mount Sinai, said in an interview with CNN on Monday. “It’s especially true in our academic medical centers and it’s going to take time to strengthen the bench.”
Nurse shortages and working conditions have created a wave of strikes and union organizing efforts, said Sal Rosselli, president of the National Union of Health Workers. While understaffing precedes the pandemic, the pandemic has been the turning point for many nurses.
“During the pandemic they learned that their employer was not concerned about their safety or that of their patients,” she said.
ECRI, an independent healthcare research firm, ranks industry understaffing as the greatest risk to US patients today. He doesn’t expect that to change anytime soon.
“Unfortunately, there is no short-term solution to this problem,” said Dr. Marcus Schabacker, CEO of ECRI.
Beyond the aging US population, part of the current increase in hospital admissions comes from “a pent-up demand during the pandemic, with patients returning to hospitals for elective procedures.”
Furthermore, there is the growing “need to treat patients with post-covid complications. All of this puts further pressure on a system that has been understaffed for a long time.
The nursing shortage will get worse, she said. “A few years ago we estimated that by 2025 there would be a shortage of 1 million nurses nationwide,” Schabacker said. With those who have left the field during the pandemic, that may be an undercount.
ECRI data shows that the average age of a registered nurse is 52, with 20% of them aged 65 or over. The shortage of nurses has also created a shortage of nursing instructors. In 2019 it was estimated by ECRI that over 80,000 qualified applicants were rejected from nursing schools due to lack of staff to teach them.
“Many nurses join because they’re motivated to help patients,” Schabacker said. “When there’s a shortage, they’re prone to step in and work an extra shift, come in on weekends. If someone is tired, overworked, sleep deprived, he will make more mistakes.
A nurse’s strike won’t help the patients of the in the short term, he said. “It’s a sign of real, understandable despair.”
– CNN’s Tami Luhby contributed to this report