Nurses Union Threatens Strikes at 12 NYC Hospitals as RUMC Staff Cite Rising Violence

As labor tensions simmer, New York’s nurses set the stage for a potential disruption to critical healthcare—raising stakes not just for administrators, but for millions of patients who rely on overstretched hospitals.

A 97% vote in favor of going on strike is a signal of simmering discontent that even the hardiest of New York City’s hospital bosses can ill afford to ignore. On December 4th, the New York State Nurses Association (NYSNA) announced that nurses at a dozen city hospitals had overwhelmingly authorized a walkout should contract talks fail to yield agreement before the year’s end. The implications portend disruption not merely for hospital boardrooms, but for emergency wards, pediatric floors, and—perhaps most gravely—the patients who fill them.

The institutions in question run the gamut from sprawling medical centers in Manhattan to Richmond University Medical Center (RUMC), which serves much of Staten Island. According to Lisa Yeno, a nurse of 25 years and member of the NYSNA negotiating committee at RUMC, security and staffing have become flash points for rank-and-file members. Accounts of violence—nurses punched, hair pulled, staff assaulted—have been punctuating regular reporting from local hospitals, a grim trend that Yeno argues now warrants metal detectors, more guards and panic buttons on wards. “We’ve seen an increase in workplace violence, especially in places like the emergency room and pediatric units,” she says.

The union’s grievances, though familiar, are no less acute for their repetition. Staff shortages, the ever-present bogeyman of American healthcare, have grown more pronounced, with nurses warning they are regularly assigned patient loads that verge on unsafe. At RUMC and elsewhere, recurring disputes also focus on reductions to healthcare benefits, a galling irony in an industry meant to champion wellbeing.

For New Yorkers, the prospect of a prolonged nurses’ strike bodes ill. Past labor actions at city hospitals have triggered patchwork coverage: agencies scramble to source temporary staff at premium rates, and patients sometimes find elective procedures postponed or non-urgent care delayed. In a metropolis where over 50,000 nurses underpin the public health infrastructure, even a brief disruption can ripple outward, straining clinics, urgent care centers, and first responders alike.

Should negotiations fail and walkouts ensue, both the quality and quantity of care risk deterioration. While administrators insist that contingency plans—which often include contracting with expensive staffing firms—are ready, history’s verdict is less sanguine: morale tanks, costs balloon, and patient satisfaction tends to plummet. The city’s Department of Health has voiced concern about the downstream effects on vulnerable groups, such as elderly patients and young children in need of regular treatment.

There is, as ever in labor disputes, a fiscal undertow. New York’s hospital systems—public and private alike—entered 2024 with their finances already stretched by pandemic-era costs and Medicaid deficits. Higher wage and benefit demands, if agreed, may yield short-term stability but risk compounding long-term pressures: New York had a state-wide hospital operating margin of just 1.7% in 2023, a puny figure compared with the national norm, and barely enough to cover rising inflation, much less strident wage claims.

Beyond the hospital walls, the strike vote lands in the midst of a broader reckoning over work in the city. Union power, long on the wane, has seen faint signs of resurgence—from actors to hotel workers, from teachers to delivery drivers. Yet progress has been erratic, as labor laws and public tolerance for strikes often accord less patience to sectors, like healthcare, where the stakes are literally life or death.

Nor is New York alone: across the country, the healthcare workforce is restive. In California, nearly 75,000 Kaiser Permanente employees walked off the job in October, the largest healthcare strike in American history. In each instance, violence, burnout, and “moral injury”—the toll of not being able to provide adequate care—now compete with traditional pay and benefit issues for primacy in contract fights.

The city’s hospitals argue that workplace security remains a top priority, with RUMC stating it maintains highly trained security staff, collaborates closely with the NYPD, and utilizes security detectors at all critical entry points. Such measures, however, have not mollified the union’s negotiators, who counter that hospital promises have failed to stem a rise in reported assaults. On the benefit front, hospital leaders point to budget restrictions and rising provider costs that give them little room to maneuver—hence the impasse.

Why healthcare labor discord in New York portends broader trouble

The calculus facing city leaders—and, by extension, Albany—is hardly reassuring. A drawn-out strike may deliver nurses improved conditions but at the cost of ballooning operational expenses and possible service degradation. Conversely, an overly hard line from management risks a further exodus of nurses to other regions or professions. For patients, the best-case scenario is a speedy resolution; the worst, a winter flu season coinciding with industrial action, when the city’s healthcare system can least afford it.

Nationally, New York’s experience will resonate in policy circles as a cautionary tale. The American healthcare system’s low tolerance for redundancy—lean staffing, just-in-time scheduling, relentless subsidy cuts—has delivered efficiency but at the price of fragility. When essential workers feel unsafe or overworked, small bottlenecks risk spiraling into full-blown crises.

Some might be tempted to dismiss the union’s threats as the familiar theater of contract season. Yet the scale of the margin—97% of the rank and file voting to strike—suggests something rather more volatile than mere bluster. That New York’s best hospitals are now debating whether to bolster security as much as to raise pay hints at a culture shift: nurses, long lauded as pandemic heroes, are now flexing their clout to demand palpable change on their terms.

In the final reckoning, the threats of strikes and staffing exigencies cast a harsh light on the city’s brittle healthcare ecosystem. We reckon that both sides should pause their brinkmanship and acknowledge an unpleasant truth: if the terms of work for nurses are allowed to deteriorate, New York’s vaunted reputation for medical care will be squandered, one missed shift at a time. The time for fixes—tentative or otherwise—is now. ■