The privately owned hospitals were postponing nonemergency surgeries, diverting ambulances to other medical centers, pulling in temporary staffers, and assigning administrators with nursing backgrounds to work in wards in order to cope with the walkout.
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As many as 3,500 nurses at Montefiore Medical Center in the Bronx and about 3,600 at Mount Sinai Hospital in Manhattan were off the job. Hundreds picketed, some singing the chorus from Twisted Sister's 1984 hit "We're Not Gonna Take It," outside Mount Sinai. It was one of many New York hospitals deluged with COVID-19 patients as the virus made the city an epicenter of deaths in spring 2020.
Last-minute talks to prevent the strike broke down overnight and nurses took to the picket lines around 6 a.m. at Mount Sinai's main campus on the Upper East Side and at three Montefiore locations in the Bronx.
The stalemate continued Monday night and the NYSNA said that nurses would be back on the picket line Tuesday at 7 a.m.
Mayor Eric Adams said the city has a situation room standing ready and advised people to only call 911 if they truly need emergency care.
It was a jovial atmosphere all day as the nurses made themselves heard, but no one wants the strike to continue for another day. Nurses at Montefiore said they didn't want to strike, they wanted to get to work with a contract agreement that included the staffing levels they have asked for.
"Our patients deserve so much more than what they're getting and we're not able to provide the adequate care because we have such short staff," said Montefiore nurse Barbara Cavallo.
Nurses share their reactions from the picket line
The strike comes after two other hospitals, Mount Sinai Morningside and Mount Sinai West, reached tentative agreements with the union on Sunday.
An NYSNA statement said, "Today, Mount Sinai West and Mount Sinai Morningside reached a settlement, subject to ratification, with NYSNA union leadership and NYSNA has rescinded its strike notice at those sites. This agreement includes the identical 19.1 percent wage increases in agreements that have already been accepted by six other hospitals, and officially ratified by NewYork-Presbyterian and Maimonides.
On Sunday night, Governor Hochul called for binding arbitration to eliminate the treat of a strike. Adams released a statement Sunday night preparing the city for a potential strike.
The statement said in part,
"Nurses stand on the frontlines of our health care system, and we all were witness to their heroic actions during the peak of the COVID-19 pandemic. We are encouraged that most New York City hospitals have reached tentative agreements to avert a nurses' strike and ask that all of the parties remain at the bargaining table for however long it takes to reach a voluntary agreement. We are simultaneously continuing to closely monitor the effect that a strike would have at the remaining handful of hospitals that have not yet reached a deal. In the event of a strike, our system will be prepared to meet the challenges."
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NYSNA President Nancy Hagans says these agreements aren't up to the nurses -- they are up to the bosses.
The biggest issue with the looming strike is the adverse nurse to patient ratio.
"I had a feeling it was coming based on the conditions that I've been dealing with and what we have been dealing with over the last couple of months, if anything it should have been happen sooner," said Mount Sinai nurse Nancy Fried. "Not just my unit, but the whole hospital. It's like you're coming to work and you're understaffed. It's one nurse for nine or more patients possibly up to 11 or 12. And it's impossible. We can't do the job we need to do and it's just not safe."
The state says it will enforce the law when it comes to staffing levels while the strike continues, but that's meant the hospitals can't operate normally.
"We will take care of our patients, we will keep our promise to them, we will keep you safe, we're going to provide you with the best quality care," said Frances Cartwright, Chief Nursing Officer at Mount Sinai. "But unfortunately, that can mean that we needed to refer patients out, transfer patients to other centers that can continue to provide that care."
Montefiore emergency room nurses have complained of having to care for patients in the hallways, while an area with more than 30 beds remains empty, due in part to staff levels. They say they feel like that is a disservice to the patients who could have rooms that are now empty -- if only there were enough nurses.
There is a major shortage of nurses and hiring is already a big challenge for hospitals like Montefiore, but the nurses argue that the hospital is perpetuating that problem and if the nurse-to-patient ratio were improved, it would make recruitment and retention easier because nurses who want work are looking for those ratios in writing in the contracts.
They say this comes up every time a new, three-year contract contract is negotiated. But this time is different, they say they helped the city through some very dark times over the last three years.
"I've been here for 42 years, I think they need to really start understanding that we want to be able to do a good day's work and not have to feel like we're leaving patients unheard," said Montefiore nurse Maureen Barry.
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Nurses said they'll be out on strike for as long as it takes to reach a contract that addresses their concerns.
Montefiore and Mount Sinai are the last of a group of hospitals with contracts with the union that expired simultaneously. The Nurses Association had initially warned that it would strike at all of them at the same time - a potential calamity even in a city with as many hospitals as New York.
But one by one, the other hospitals struck agreements with the union as the deadline approached.
Nurses at NewYork-Presbyterian Hospital ratified a deal Saturday that will give them raises of 7%, 6%, and 5% over the next three years while also increasing staffing levels. That deal, which covers 4,000 nurses, has been seen as a template for the negotiations with other hospital systems.
That came before nurses at two facilities in the Mount Sinai system also tentatively agreed to contracts Sunday. But there was no such pact at the system's flagship hospital on Manhattan's Upper East Side.
(The Associated Press contributed to this report.)
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