The healthcare system is in crisis. The New York nurses’ strike is just the latest sign

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Naniaka Camara grew up near Montefiore Hospital in the Bronx in New York and remembers going there for her own medical care. She has been a nurse in Montefiore for three years, still lives just minutes from the hospital and often knows the neighborhood patients she cares for.

She loves her job, she said, but has been on strike since early Monday morning out of frustration at not giving patients the care they deserve.

It’s just the latest in a series of industrial action across the country by nurses’ unions and other healthcare workers who say they had to strike to provide quality healthcare to patients.

“Sometimes I feel like what I did was pointless, I apologize for things that have nothing to do with me,” Camara said of the picket line outside her neighborhood hospital. She said she is often late in delivering medicines or other services patients need due to staff shortages, which can stretch her shifts to 12 or 14 hours. She goes to bed as soon as she gets home.

Naniaka Camara, who has been a nurse for the past 3 years, is on the picket line outside Montefiore, her neighborhood hospital where she works.

“I don’t like to think about the previous shift because I don’t want to come back for the next one,” she said.

The strike by 7,100 nurses began Monday at Montefiore’s three hospitals, which provide about half of the Bronx’s hospital beds, and 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 20 major strikes tracked by the Labor Department in the first 11 months of 2022, seven, or 35%, involved healthcare. Five of these, or 25%, were nurse strikes.

A big problem with everyone? staffing.

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The surge in health care strikes is coming anyway nationally, only 3% of union members work in the private sector in healthcare.

“It’s extraordinary that so many [registered nurses] are on strike,” said Bob Muehlenkamp, ​​a retired union organizer for Local 1199 who has spent much of his career organizing and negotiating on behalf of nurses. The problem isn’t wages, he said. The nurses are on strike because they want to do their job the way they think it should be done.

“There’s a trauma that every single RN goes through when they decide to walk away from patients,” Muehlenkamp said. “It’s against every instinct they have.”

Only about 10% of nurses are unionized and able to go on strike. But for many of them, quitting doesn’t mean going on strike, it means quitting the job they love and stepping up the lack.

According to the Department of Labor, there are 3.1 million nursing jobs nationwide, of which about 60% or 1.9 million are in hospitals.

“One 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 an estimated 67,000 nurses, or one in 20, working in Hospitals who work for temporary employment agencies. “That was historically high.”

The striking hospitals use traveling nurses to replace the strikers, but this is an expensive alternative – these nurses are typically paid far more than the staff they replace. Traveling nurses fill in hospitals across the country because hospitals cannot fill all positions with their own staff.

Hospitals have a financial incentive to get by with as few nurses as possible, health care professionals say.

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“Work is the main expense in healthcare, so how do you make money? They’re depressing your labor costs,” said Janette Dill, a professor of health policy and management at the University of Minnesota. “Your nursing staff is your largest workforce.”

The affected New York hospitals insist they are doing whatever they can to fill their own staffing shortages.

Mount Sinai says it has hired and now has more than 4,000 new nurses in the last three years Today, 503 more nurses are working than four years ago, beating the hiring pledge made in the last round of union negotiations in 2019.

And it has offered the union a so-called “robust” staff enforcement plan to improve nurse-patient ratios, it said, but when it offered to create 50 additional foster jobs, the union said it would use the money for those extra jobs to pay raises for existing staff.

The union denies this and says improved staffing, not pay, is their top priority in these talks.

“We are in a staffing crisis post this pandemic,” Fran Cartwright, chief nursing officer at Mount Sinai, said in an interview with CNN on Monday. “This is especially true for our academic medical centers and it will take time for the bank to strengthen.”

Nurse shortages and working conditions have fueled a wave of strikes and union organizing efforts, said Sal Rosselli, president of the National Union of Healthcare Workers. While staff shortages existed before the pandemic, the pandemic was the turning point for many nurses.

“They have learned during the pandemic that their employer is not concerned about their safety or the safety of their patients,” he said.

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ECRI, an independent health research firm, ranks the industry’s understaffing as the top risk for US patients. It doesn’t expect that to change any time soon.

“Unfortunately, there is no short-term solution to this problem,” said Dr. Marcus Schabacker, CEO of ECRI.

Aside from the aging of the US population, part of the current surge in hospitalizations is due to “demand that has been pent-up during the pandemic, with patients returning to hospitals for elective procedures.”

Added to this is the increasing “need to treat patients with post-Covid complications. All of this puts additional pressure on a system that has long been understaffed.”

The nursing shortage will worsen, he said. “A few years ago we estimated that there would be a shortage of 1 million nurses nationwide by 2025,” said Schabacker. For those who have left the field during the pandemic, that could be an undercount.

ECRI data shows that the median age of a registered nurse is 52 years old, with 20% of them being aged 65 and over. The shortage of nursing staff has also led to a shortage of nursing educators. In 2019, ECRI estimated that over 80,000 qualified nursing school applicants were turned away because there were not enough staff to teach them.

“Many nurses take part because they are motivated to help patients,” says Schabacker. “When there are bottlenecks, they tend to step in and do an extra shift, come at the weekend. If someone is tired, overworked or not getting enough sleep, they will make more mistakes.”

A nurses’ strike does not help the patients short term, he said. “It’s a sign of real, understandable desperation.”

– CNN’s Tami Luhby contributed to this report

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