Nearly 15,000 nurses went on strike Monday at some of New York City’s top hospitals, setting the stage for what could be one of the biggest labor showdowns in the city’s health care industry in decades.
The union representing the nurses says a strike is necessary to force hospitals to ensure minimum staffing ratios so that nurses aren’t overwhelmed with too many patients. They are also demanding higher wages and more security at hospitals to reduce violent episodes and shootings.
The strike is targeting some of the city’s leading medical institutions: NewYork-Presbyterian/Columbia, Montefiore Medical Center and the main campus of Mount Sinai Hospital along with two other major hospitals within the Mount Sinai system.
Gov. Kathy Hochul signed an executive order Friday declaring that “a disaster is imminent” and that the strike was likely to “impact the availability and delivery of care, threatening public health.”
For weeks, hospital executives had been preparing to keep hospitals running and medical care accessible in the event of a strike. They secured contracts with staffing agencies to provide travel nurses and reserved hotel rooms for them, according to officials at the Greater New York Hospital Association, a trade group.
Some hospitals canceled scheduled surgeries and accelerated discharges during the weekend to reduce patient counts because of the prospect of a strike. The affected hospitals arranged to transfer infants out of their neonatal intensive care units to units elsewhere, according to Elisabeth R. Wynn, an executive vice president at the hospital association.
The state Department of Health on Saturday instructed hospitals not affected by the strike to be prepared to accept patients from the affected medical centers. The letter makes it clear that hospitals where nurses are on strike are free to transfer patients, even against the patients’ will.
About 7,000 nurses at Mount Sinai, in Manhattan, and Montefiore, in the Bronx, went on strike three years ago. That time, the biggest issue for the nurses was chronic understaffing of units, which nurses said left them with too many patients to care for safely. The strike ended after three days when the hospitals agreed to hire more nurses and to set minimum staffing ratios with a strict enforcement mechanism. In the years since, the nurses’ union has been able to win payouts for its members when hospitals left units understaffed.
But nurses say that they need to strike now because hospitals are trying to erode some of those protections related to minimum staffing levels.
“Wealthy hospitals are trying to undo the safe staffing standards we won for our patients when we went on strike three years ago,” Nancy Hagans, the president of the nursing union, the New York State Nurses Association, said Saturday.
Three years ago, nurses also won significant raises, boosting minimum pay nearly 20 percent over three years, and propelling starting pay well above $100,000.
At Montefiore, pay for starting nurses is $119,423, and the average base salary for nurses — many of whom have years of experience — is about $165,000, according to figures provided by the hospital.
The last strike unfolded when the coronavirus pandemic still felt recent. Many New Yorkers remembered banging pots and pans and cheering from their windows at 7 p.m. each day in gratitude for nurses and other health care workers.
There was a widespread sense that some hospitals had done too little to prepare for the pandemic, leaving some nurses to fashion protective gear out of garbage bags in the deadly first wave in March 2020. And hospitals were buoyed by federal pandemic bailout money.
But the dynamics this time could turn out to be different. Hospitals are expecting lean years ahead, as many New Yorkers lose health insurance and billions of dollars in federal care health funding to the state start to dry up, the result of the domestic policy law President Trump signed in July.
“The health care system is under siege financially,” Kenneth E. Raske, the president of the Greater New York Hospital Association, said. “The demands of the union are so outrageous that there is no way they can concede to what the union is asking for.”
Lucia Lee, a spokeswoman for Mount Sinai, said that nurses at the hospital make on average $162,000 — and that the union’s salary demands would increase that to $275,000 over three years.
Officials with the New York State Nurses Association, however, said that Mount Sinai and the other hospitals were offering only about $4,500 more a year in benefits.
Nursing union officials, meanwhile, point to the multimillion-dollar salaries of hospital executives. The head of NewYork-Presbyterian, Dr. Steven Corwin, for instance, received more than $26 million in compensation in 2024, some of which related to retirement funds and bonuses deferred from years before, according to a public filing. A spokeswoman for the hospital declined to comment on Dr. Corwin’s salary.
“While NewYork-Presbyterian, Montefiore and Mount Sinai — three of New York City’s wealthiest private hospitals — are claiming they can’t afford to settle a fair union contract that keeps nurses and patients safe, they likely have plenty of cash on hand to use to fight their own workers,” Ms. Hagans, the union president, said.
Nurses cite workplace safety concerns as another reason they are striking.
“We deserve not to get hurt on the job,” Beth Loudin, a nurse at NewYork-Presbyterian/Columbia, said.
Hospitals across New York have been the site of shootings or threatened shootings in recent years, and some nurses have been troubled by the lack of metal detectors and other measures to screen weapons at some hospital entrances.
On Thursday at NewYork-Presbyterian Brooklyn Methodist Hospital, a man cut himself with a makeshift knife and barricaded himself in a blood-spattered room with a patient and a security guard. He was killed after the police said he had rushed them with the weapon.
At Mount Sinai, meanwhile, some nurses felt that the hospital had failed to adequately inform employees when a gunman threatened to shoot up the facility in November. The incident happened around the shift change, when nurses were coming in and out. But some nurses said they were unaware of the danger unfolding.
“We have told them that we need weapons detection systems at each entrance,” Dania Munoz, a Mount Sinai nurse practitioner, who is on the union’s negotiating committee, said.
Mount Sinai’s chief executive officer, Brendan G. Carr, has previously written to Mount Sinai employees that new security measures were in the works, including “expanding both our enhanced visitor management and weapons detection programs.”
Dr. Carr said that during the November incident, the emergency department was placed on lockdown, and everyone was told to shelter in place. “Once we knew it was safe, the all clear signal was given and work resumed,” he wrote.
The strike began at 6 a.m. Monday, when night shift nurses in their teal blue scrubs left Mount Sinai Hospital, at the cusp of East Harlem and the Upper East Side. Other nurses soon joined the growing crowd outside the hospital, cheering and carrying signs. One read, “Burnout is not a staffing plan.” Cars honked in support along Madison Avenue.
At another hospital about a mile and a half away that is part of the same health system, Mount Sinai Morningside, nurses also walked off at 6 a.m., after updating their managers.
“We made sure our patients were OK, and we walked out together,” said Ally Viloria, a third-generation nurse at Mount Sinai Morningside, formerly St. Luke’s Hospital.
“It was pretty emotional,” Ms. Viloria, 26, said. “I think it’s pretty silly that nurses have to fight for safe staffing. Who takes care of us, when we’re the ones who take care of other people?”
Ms. Lee, the Mount Sinai spokeswoman, said the hospital was prepared.
”We are ready with 1,400 qualified and specialized nurses — and prepared to continue to provide safe patient care for as long as this strike lasts,” she said.
Outside NewYork-Presbyterian/Columbia hospital, a large crowd of nurses gathered midmorning as politicians stopped by to voice their support and address reporters, including Mayor Zohran Mamdani, who said that the value of nurses is not “negotiable.”
“New York City will do everything in our power to ensure the sick and injured can receive high quality care, while refusing to abandon those who have time and again refused to abandon us,” Mr. Mamdani said.
Samantha Latson contributed reporting.
Joseph Goldstein covers health care in New York for The Times, following years of criminal justice and police reporting.
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