Pedro, age 2, has lived in a hospital almost half his life. He needs a new heart. Some days, he used to play peekaboo with the nurses. He covered his face, and the nurses who cared for him for months rushed over and acted surprised, to his delight.
No one rushes over anymore when Pedro pretends to hide. The nurses he knows are on strike, walking a picket line outside the hospital in New York City. And the new nurses — brought in by the hospital during the walkout — are temporary hires who don’t know Pedro.
He is one of several children who live in a pediatric cardiology unit on the sixth floor of the children’s hospital at NewYork-Presbyterian/Columbia. When nearly 15,000 nurses went on strike Jan. 12 at several of the city’s largest hospitals, Pedro’s nurses were among them.
The walkout has sent a jolt through New York’s health care system. Elective surgeries were canceled. Some patients were transferred to hospitals unaffected by the strike. And a few thousand travel nurses were hired on weeklong contracts to do the jobs of the striking health care workers. The hospitals have insisted that they are running smoothly and that patient care has not suffered.
But the strike has profoundly affected the long-term patients who live in hospitals and the nurses who care for them, sometimes for months and years on end. It has proved especially bewildering for the patients on Pedro’s floor — known as “6 Tower” — where children with cardiac and neurological problems are treated. For their families, the past two weeks have been full of anxiety, as the nurses they have grown to trust with every aspect of their child’s care are suddenly replaced by temporary workers.
“When he saw these new persons” — the replacement nurses — “he was crying,” Pedro’s mother, Ana Valoy, recalled. She was upset, too.
“I used to go home and feel secure he was with people who were really prepared to take care of him,” she said during the second week of the strike. “Now, I don’t know which nurse is going to come at the night shift, if this nurse is prepared or not to handle this type of situation.”
Pedro’s mother says she knows of two other children younger than 5 who live in the hospital as long-term patients.
The parents worry about the skills of the new nurses, some of whom appeared unaccustomed to working with children with heart failure, according to Ms. Valoy. She said that she and the others were spending more time at the hospital than usual, to make sure their children received the proper care.
Overall, Ms. Valoy said that the disruption to her son’s care has been less than she feared originally, which she credits partly to doctors who are putting in more time checking in on Pedro and monitoring his day-to-day care. Officials at NewYork-Presbyterian/Columbia declined to comment specifically about the care Pedro and other patients on his floor are receiving.
But a spokeswoman for the hospital, Angela Karafazli, said that while the nurses’ “strike is designed to create disruption,” the hospital continued to provide high-quality care.
“Thanks to the careful preplanning and continued dedication of our teams, including hiring qualified temporary travel nurses for as long as needed, our operational capacity is strong,” she said.
During the city’s last nursing strike, in 2023, an infant with a heart condition died in a neonatal intensive care unit of another hospital, Mount Sinai. A lawsuit brought last year by the infant’s mother asserts that striking Mount Sinai nurses were “inadequately replaced with unexperienced and unqualified nurses” — a claim that the hospital denies.
In the weeks leading up to this strike, nurses said that they were assigned to train the travel nurses who would replace them and that some of those nurses expressed concern that they would be put in specialized roles for which they lacked experience.
Ms. Valoy has reason to be anxious. Pedro has a condition called dilated cardiomyopathy, which makes it harder for the heart to pump blood. His heart is failing, and he needs a transplant. For now, he has an external pump that performs the job of his heart. Called a VAD — ventricular assist device — it emerges from Pedro’s chest, with large, blood-filled tubes dangling down his legs.
After the device was implanted last year, requiring open-heart surgery, Pedro was terrified of his new appendage. Looking down at it, he tried to stay still but grew frightened when anybody tried to move him, his mother said. With the help of nurses and therapists, he was soon back to his normal, playful self.
The device requires careful monitoring to prevent blood clots. Ms. Valoy was alarmed to discover that some of the new nurses caring for Pedro seemed unfamiliar with it. Early in the strike, Ms. Valoy watched as a VAD specialist trained two replacement nurses on how the device worked — basic knowledge that the nurses on strike possessed.
Another time, Ms. Valoy said, the travel nurses did not put enough milk in her son’s feeding tube overnight, which Ms. Valoy refilled. “Before, those things didn’t happen,” she said. It wasn’t a big deal, she said, but it made her nervous. “Imagine if that happened with medicine?”
She resolved to spend as much time as she could at the hospital during the strike, which was poised to enter its third week on Monday as the nurses and officials from NewYork-Presbyterian and two other hospital systems, Mount Sinai and Montefiore, remained locked in negotiations. The nurses say they are striking to improve nurse-to-patient ratios and other working conditions, as well as to earn higher pay.
“I’m there, I’m watching,” Ms. Valoy said.
Some families with children at the hospital are able to sleep over, the parents taking turns. But Ms. Valoy, a single mother, has a 4-year-old daughter at home. The two of them sleep over at the hospital on weekends, but on weekdays, Ms. Valoy usually leaves by 4 or 5 p.m.
After that, Pedro is with the nurses. Before the strike, they would play his favorite songs from “Frozen” and “KPop Demon Hunters” and dance with him. They would bring him to get ice from the ice dispenser, which he loved to do. They would put him to bed.
One of those nurses, Arunodhaya Jebamani, known as A.J., said that when Pedro’s mother went home for the day, “I would play that role of taking care of him, doing what mom would do.”
She misses him. On the picket line, she spoke tenderly of how Pedro would wake up grouchy, but soon was smiling after a little coaxing.
On a recent evening outside the hospital, as Ms. Valoy and her daughter emerged from visiting Pedro, they stopped to watch the nurses on the picket line, a few of whom were dancing. Pedro’s sister, Ariana, spotted Ms. Jebamani and jumped into her arms.
Ms. Jebamani listened as Ms. Valoy shared her worries.
The insertion sites where the VAD enters Pedro’s torso need to be cleaned every two days, a process that can take 15 minutes or more. One of the openings is inflamed. Even though Pedro is on painkillers, the process of cleaning and scrubbing the opening hurts him, leaving Ms. Valoy crying along with her son, doing her best to comfort him.
Ms. Valoy worried that the new nurses weren’t as adept at cleaning the sites or calming Pedro.
As the days went by, her concerns eased slightly. During the strike, the doctors checked in with Pedro far more than usual. And they and the charge nurse have been cleaning the insertion site and changing his dressings, which rarely happened before the strike when nurses on the floor handled the task.
In the meantime, Pedro’s world has shrunk. His mother, who knows how to monitor the VAD, used to be able to push her son and his device in a stroller, often coming down to the lobby, the closest her son has been to going outside in many months.
But she doesn’t get to roam as far with Pedro anymore. With fewer nurses able to respond to emergencies involving the VAD, she has been told not to take Pedro off the floor. Pedro misses these trips to the lobby. When they pass by the elevator, he points at it.
In her son’s room, Ms. Valoy has put up signs expressing support for the nurses. Pedro often stands at the window watching the crowd of health care workers below.
On the picket line, Ms. Jebamani finds herself looking up at the sixth floor of the children’s hospital, searching for the faces of her patients and their parents in the window. She has FaceTimed with a few.
“I wish desperately that this strike would end in a fair contract,” she said.
From the sidewalk, a little away from the picket line, Pedro’s face is sometimes visible against the dark glass.
“I just wish I could give him a hug,” she said.
Joseph Goldstein covers health care in New York for The Times, following years of criminal justice and police reporting.
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