Why nurses are striking and quitting en masse

Why nurses are striking and quitting en masse

Why nurses are striking and quitting en masse


This flu season, Benny Matthew — an emergency room nurse at Montefiore Medical Center in the Bronx — has often been responsible for 15 to 20 patients at a time.

At 3 p.m. most days, the emergency room is often exploding with patients, Matthew said. Hospital stretchers stand inches apart. When there are no more beds, patients squeeze into tight chairs. When the chairs are exhausted, patients must stand. Wait times to see a doctor can be up to six hours. At the same time, the hospital advertises more than 700 nursing positions.

“We go home feeling like failures,” Matthew said. “There are times when you can’t sleep because you think, ‘Did I do something wrong today?'”

Matthew is one of more than 7,000 unionized nurses who went on strike in New York City last week, protesting staffing levels, which has led to two of the city’s largest nonprofit hospital systems to agree to strengthen staffing ratios in some hospitals. On Thursday, hundreds of healthcare workers across the country protested understaffing at HCA Healthcare, the nation’s largest hospital system. That included an El Paso worker who recently admitted herself to her own emergency room with dehydration and exhaustion after working four straight 12-hour days, her union said.

Those tensions have continued to surface over the past month, as nurses have also protested, gone on strike or threatened strikes in California, Oregon, Michigan and Minnesota.

Understaffing issues have been at the heart of labor disputes in a myriad of industries in recent months, including an averted national rail strike threat, but perhaps nowhere have those tensions been more pronounced than in health care and nursing. Nurses led a quarter of the top 20 work stoppages tracked by the Bureau of Labor Statistics in 2022.

While understaffing has plagued some hospitals and medical centers across the country for years, the pandemic has added new layers of stress, as nurses have had to deal with back-to-back coronavirus outbreaks that have killed and disabled thousands of health workers. The resurgence of influenza and respiratory illnesses in recent months has only aggravated the situation.

With no end in sight, legions of nurses left the field, retired early or changed jobs. Some 100,000 nurses left the industry between 2020 and 2021, according to an estimate from an industry trade journal. Although there were 4.4 million registered nurses with active licenses in 2021, according to the National Council of State Boards of Nursing, only 3 million people were employed as registered nurses, according to the Department of Labor .

Those who remained faced increasingly heavy workloads. They also gained influence in the tight labor market, causing nurses to organize new unions and even quit their jobs to join the ranks of traveling nurses. who parachute in from out of town to fill staffing gaps and tend to be paid more.

“The problem is that we’re understaffed, not just at my facility, but across the country,” said Cathy Kennedy, president of the California Nurses Association, which represents 100,000 nurses in the state. “We’re seeing an upsurge of nurses saying, ‘We’ve had enough. We want to organize ourselves. We really want our hospital to hear what we have to say.

New York-based Montefiore Hospital Corporation did not respond to a request for comment on staffing levels. But the company touted the deal reached by negotiators and the hospital on Wednesday night that ended the strike, with some big concessions for nurses. The agreement includes a 19.1% increase over three years, 170 new nursing positions and emergency room staffing ratios based on the severity of patient needs.

Harlow Sumerford, spokesman for HCA Healthcare, said Thursday’s protest was “an expected tactic as we are set to begin our regular round of bargaining with the union in the coming weeks.” He noted that the hospital system staffs its “teams appropriately and in accordance with state regulations.”

In the years leading up to the pandemic, there were roughly enough new nurses entering the pipeline to replace those who retired, according to a 2022 McKinsey & Co report titled “Assessing the Continuing Impact of COVID -19 on the nursing workforce”. But Covid has changed everything. “Over the past two years, McKinsey found that nurses consistently and increasingly reported that they planned to leave staff at higher rates compared to the past decade,” the report found, a trend that is growing. continued even as covid cases declined.

From coast to coast, growing nursing shortages have triggered a widespread set of problems for nurses and patients, according to conversations with nine nurses. Nurses say there has been a significant drop in patient care, including delays in cancer treatments and critical exams for pregnant women. Medicines are given late or completely missed. The shortage has also impacted the mental and physical health of nurses, as they are forced to skip meals and breaks and have little recovery time between shifts.

Organized strikes, and even the threat of strikes, have been successful in pushing some hospitals to agree to address some staffing issues. This winter, nurses won guarantees of investment in new hires, a bigger role in shaping nurse-patient ratios and strong wage gains that could help retention.

In Kalamazoo, Michigan, 300 nurses – part of the Michigan Nurses Association – won a 20% raise in the first year of their contract, after threatening to strike at Ascension Borgess Hospital on the workforce in December. Night nurse Lori Batzloff said the pay rise should help retain nurses. But she worries about her hospital’s ability to cope with another covid outbreak.

Last September in Minnesota, 15,000 nurses went on strike for three days over understaffing issues, in the largest-ever strike by private nurses. While the hospitals still refused to give in to their demands, the nurses threatened to strike a second time, for three weeks in December. With days to go until the strike deadline, more than a dozen hospitals have, for the first time, agreed to give nurses a say in staffing, averting the strike.

“I think hospitals looked around and realized they couldn’t stand up, frankly, to a three-week strike by 15,000 members in Minnesota,” said union vice president Chris Rubesch. Minnesota nurses. “It would be crippling.”

A Twin Cities Hospital Group spokesperson said in a press release when the agreement was reached that the new agreement shows that hospitals and workers can work together to “develop a staffing language that meets unique needs.” hospitals, nurses and patients.

For other healthcare workers who typically earn less than nurses – such as healthcare technicians, dieticians and orderlies – the effects of understaffing are just as severe.

“There’s no morale left,” said Gregorio Oropeza, an admissions representative who checks in patients at Cedars-Sinai Hospital in Marina del Rey, Calif. Oropeza has co-workers who had to leave work after suffering severe covid symptoms. “Everyone is there because they need a salary. They’re terrified of getting sick, but it’s a job and they have to support a household.

Oropeza and 400 of his colleagues began a five-day strike with SEIU-United Healthcare Workers West in December over understaffing and wage issues, but union contract negotiations continue to stall.

Marni Usheroff, spokesperson for Cedars-Sinai Marina del Rey, said the hospital recognizes that its employees are its “most important asset” and that during contract negotiations the hospital has shown its “commitment to maintaining staffing levels that provide significant support for our healthcare workers.”

During the coronavirus pandemic, nurses have organized and won union elections, even as unionization rates in the United States have declined.

“I remember in the middle of the pandemic I predicted that once the dust settled there might be an explosion of new organizations and strikes to reach safe staffing levels,” said Sal Rosselli, president of the National Union of Health Care Workers, which represents 15,000 health care workers in California. “And that’s what’s happening now.”

While some nurses are getting organized, many have left the field altogether or are considering leaving the industry. A 2022 survey by recruitment agency ShiftMed found that two-thirds of nurses say they are likely to leave the profession in the next two years.

Some nurses left their full-time jobs to take on highly lucrative contract work, traveling to other parts of the country and filling in temporarily at understaffed hospitals. The option has become popular among young nurses, especially those looking to pay off their student loans. Demand for travel nurses is roughly double what it was at the start of the pandemic, although it has tempered since the peak of the outbreak, according to April Hansen, executive at Aya Healthcare, the nation’s largest travel nursing agency.

Nurses unions say hospitals are to blame for nursing shortage issues, noting that healthcare companies have deliberately chosen not to spend resources on hiring additional nurses. Many hospitals have profited from the pandemic, receiving millions in covid-related aid, rewarding investors with generous stock buybacks and paying executives seven-figure salaries. In the Bronx, Montefiore CEO Philip Ozuah took home $7.4 million in 2020.

“I think hospital administrators are hypocrites,” said Zulma Gutierrez, 42, an intensive care unit nurse in Montefiore who went on strike this week. “They go home making millions and we go home with guilt.”

But a growing and aging population, combined with continued waves of covid, means the demand for nurses will continue to soar in the years to come. By 2025, the United States is expected to be short of 200,000 to 450,000 nurses, according to the McKinsey report.

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