NYC Hospitals Start Moving Sick Babies, Diverting Ambulances as Nurse Strike Looms

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https://www.nbcnewyork.com/news/local/nyc-hospitals-start-moving-sick-babies-diverting-ambulances-as-nurse-strike-looms/4030088/

 

 

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By Melissa Russo • Published January 5, 2023 • Updated on January 6, 2023 at 3:49 am

 

Time is running out, with just four days left until a possible New York City nurses' strike at multiple major local hospitals — and one of the city's largest hospital systems is starting to take drastic measures.

But in a possible glimmer of hope, two more hospitals reached deals with the union Wednesday night, potentially putting pressure on the others to settle.

Until then, Mount Sinai Health System is beginning to divert "a majority" of ambulances from four of its facilities, and is transferring babies from its neonatal intensive care units to other hospital systems, according to a memo from hospital leadership to staff, a copy of which was obtained by News 4.

The memo from the leaders of Mount Sinai Hospital, Mount Sinai Morningside and Mount Sinai West makes clear that most issues in the ongoing negotiations have been resolved - but not all, and the clock is ticking.

"To do what is best for our patients, we have no choice but to proceed with our strike planning," the memo says, outlining a series of steps:

• Diverting ambulances from Mount Sinai Hospital, Mount Sinai West, Mount Sinai Morningside and Mount Sinai Beth Israel
• Cancelling elective surgeries, and scheduling only emergency surgeries at the main and Morningside facilities
• Transferring some patients. "In addition, this - sadly - means transferring NICU babies outside the Mount Sinai Health System to ensure they get the care they so desperately need."
• Discharging "as many patients as appropriate" and shifting services - inpatient care at the main and West facilities, and emergency and child psychiatry at the Morningside campus

 

 

Strike Jan 2

NY-Presbyterian Reaches Tentative Deal to Avoid Nurses Strike: Sources

Strike Dec 30, 2022

NYC Hospitals on Notice: Nurses Set to Strike Second Week of January

A Mount Sinai source told News 4 that there were more than 50 NICU babies on site, slightly below the maximum capacity of 64.

The source who works in the hospital went on to say that the parents of those babies did not appear to have been notified yet that their babies would have to be moved to another facility -- although no babies have been moved as of Thursday evening.

Additionally, according to several hospital insiders and union representatives, nurses in the Mount Sinai neonatal intensive care unit are furious they were not informed about plans to transfer their frail newborn patients to other hospitals. They said that they found out after it was reported by News 4.

Several sources also said that Mount Sinai was being dishonest about transferring the NICU babies, and that it was an attempt by the hospital to make nurses look bad.

A Mount Sinai spokesperson responded, saying that the plan is to move patients on Friday if no deal is in place.

Nurses have said that there has been some progress at some bargaining tables where hospitals are negotiating with their respective staffs, but not enough progress to avoid a strike — yet.

"The New York State Nurses Association will rescind a strike notice when we reach a tentative agreement at Mount Sinai that respects nurses and our patients. Not before," said New York State Nurses Association president Nancy Hagans.

"Nurses feel abandoned and disrespected by their bosses," Hagans said. "We held the hands of dying patients, set up last FaceTime calls so dying patients could say goodbye to their loved ones."

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2:47

NYC Nurses Strike: What Impacts Would Potential Strike Have on You?

The New York State Nurses Association says its nurses are not backing down in a fight for better wages, staffing and benefits. Rana Novini reports.

Five private hospitals (Montefiore, Mount Sinai Hospital, Mount Sinai Morningside and West, BronxCare and Flushing Hospital Medical Center) are on notice for a potential strike starting the morning of Jan. 9 — a move that would send already busy hospitals into full-on crisis mode, and potentially have a devastating impact on care.

The union said Thursday morning that deals were struck Wednesday night at Maimonides Hospital and Richmond University Medical Center, leaving the other five still pending.

Each of the hospitals negotiates individually with their own nurses, so depending on how talks go, there could be no strikes at all, a single strike or as many as five strikes.

"It could be an enormous public health calamity," Ken Raske of the Greater New York Hospital Association previously told NBC New York. He has described the mood as among hospital managers as "extremely apprehensive."

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3:25

Potential NYC Nurses Strike Just Days Away — Here's What We Know About Situation

Seven private hospitals are on notice for a potential strike Monday morning. Melissa Russo reports.

The nurses union said there has been at least one sign of progress: All of the hospitals on the list have agreed to not cut health benefits. The union had said on Wednesday that Flushing Hospital had not made such an agreement, but a hospital spokesperson on Thursday said that they have "always maintained the healthcare benefits of our employees during active negotiations," calling it "unequivocally false" that they were considering cutting them.

"There has been some offers and progress but we are not there yet," said Hagans.

As of Wednesday, all eyes are on New York-Presbyterian Hospital and the nurses there. There was a tentative deal reached over the weekend that, if accepted, would give nurses 18 percent raises over the next three years, with added incentives to retain experienced nurses. There was also a promise to address chronic understaffing, which was the union's biggest complaint.

But there is a large caveat: NY-Presbyterian is widely considered to be the richest hospital in the city, and not all hospitals are in the same financial situation. While all the hospitals have said they are negotiating in good faith, some said they can't afford to pay as much — a big sticking point considering some hospital executives are paid in the millions.

Smaller so-called "safety net" hospitals are more reliant on lower reimbursement rates for the care they provide, like through Medicare or Medicaid. Some of the others on the list say they are hemorrhaging money, but nurses at those hospitals aren't buying the argument.

According to a source familiar with Mount Sinai's past talks, the hospital had previously offered nurses a deal that included 14 percent raises over four years — a deal that nurses rejected, and that was noticeably lower than the offer extended by NY-Presbyterian.

"If Montefiore can afford to pay its executives so much, they can't hardly cry broke when it comes to negotiate a contract with frontline nurses," said Hagans.

While it remains to be seen whether the nurses at NY-Presbyterian will accept the offer, Montefiore Hospital said Wednesday that nurse representatives at their hospital had rejected a deal that mirrored the one NY-Presbyterian offered. A spokesperson for the hospital said that nurses were offered "an 18 percent wage increase over three years, fully funded healthcare for life, and a significant increase in registered nurses in the emergency departments, among other benefits."

That development may spell trouble for other hospitals given the financial landscape. According to the Montefiore spokesperson, NY-Presbyterian posted $200 million in profits in 2022 while Montefiore posted $200 million in losses. That sort of deal was considered potentially unattainable for other hospitals on the list, but now nurses at NY-Presbyterian may think twice about ratifying the deal they tentatively agreed to (voting began Tuesday night and concludes Saturday).

Gov. Kathy Hochul's office has said previously that they are "monitoring the situation." Sources said that both Hochul and NYC Mayor Eric Adams are getting regular daily updates on the talks. While the hospitals involved are all private, meaning neither Hochul nor Adams have any formal role, some have wondered whether they would step in to apply pressure or try to broker a deal.

Aides to Gov. Hochul confirmed that she has been very engaged for many days, not directly at the bargaining table but speaking to both sides regularly and pushing both sides to get to yes. The state has also started to review the hospitals' strike contingency plans.

"We have been working with all parties to help reach a fair resolution to keep New Yorkers and health care workers safe," said Hochul spokesperson Avi Small.

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3:33

Nurses at One NYC Hospital Reach Tentative Deal Amid Strike Threat

New York-Presbyterian has a tentative agreement with nurses to avoid a strike, but there are 7 other hospitals who are not in the same situation. NBC New York's Melissa Russo reports.

NBC New York has learned that the other hospitals that have not reached agreements with their nursing staffs are starting to shell out tens of millions of dollars in nonrefundable down payments to have traveling temporary nurses on reserve — a huge expense they must shoulder, even if no strike takes place.

The GNYHA said doing so works against the interest of the nurses in the union because it forces hospitals to spend money that could go to the nurses — but it also increases the leverage of nurses once the strike notice is issued. One nurse involved in negotiations estimated the cost of trade nurses is around $10,000 a week per travel nurse. The New York State Nurses Association estimated that the mere threat of a strike has already cost as much as $32 million to temp agencies, a cost they said could surge to more than $90 million if the travel nurses have to fill in for five or six days.

"Our ERs are backed up, the tripledemic is raging," said Raske. "Even if one hospital would have a strike, it could ripple through the entire system."

The New York State Nurses Association has as many as 10,000 members threatening to conduct strikes at five hospitals where contracts expired on Dec. 31.

The union says members are upset about staffing ratios at the local hospitals, contract proposals that they feel dramatically worsen their healthcare benefits (while paying big bonuses to executives), and Mayor Adams' recent move to forcibly hospitalize psychiatric patients. All of those elements have left workers overworked and burnt out.

"We're not able to clean the patient on time, not able to give medicine on time, no breaks," said Allen. "Burnout was real, so we leave the profession and go to work at a travel agency that's going to pay us more."

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4:06

Some NYC Nurses Reach Tentative Deal Amid Strike Threat

With as many as 12,000 nurses threatening to walk off the job on January 9th, the Greater New York Hospital Association is forced to prepare. Melissa Russo reports.

In a statement Monday, a spokesperson for Mount Sinai said that their bargaining teams "continue to make good-faith efforts to pursue a contract with NYSNA that is fair to our community and responsible with respect to the long-term financial health of our organization. Mount Sinai nurses deserve the best possible working environment, wages, and benefits, and we're tirelessly pursing these to all our employees' advantage."

The statement added that the hospital system is "prepared for staffing changes, and we will do our best to ensure our patients' care is not disrupted and will do everything possible to minimize inconvenience to patients."

The average salary for nurses in New York is $93,000, and $98,000 in NYC, nurses union and the GNYHA confirmed. However, there is a big disparity between nurse pay in private vs public hospitals, where salaries are almost $20,000 less.

Source says there is a lot of frustration among doctors and NICU nurses that the hospital is now announcing plans to relocate their NICU babies, because they say there have been nurse shortages in this unit that make it impossible to maintain target nurse to baby ratios.  "They didn't care about the staffing problems in the NICU until there was a threat of a strike."

All of this comes as the city deals with what is being called a tridemic - simultaneous and serious spikes in infections with COVID, the flu and the respiratory condition RSV.

The city has already issued an advisory (but not a mandate) suggesting that people go back to wearing masks indoors.

 

 

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https://www.cnn.com/2023/01/09/business/nyc-nurses-strike/index.html

 

 

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7,000 nurses at two New York City hospitals on strike as contract negotiations fail

By Chris Isidore, Vanessa Yurkevich and Tami Luhby, CNN

Updated 1:13 PM EST, Mon January 9, 2023

 

New York CNN  — 

More than 7,000 nurses at two major New York City hospitals walked off the job Monday, arguing immense staffing shortages are causing widespread burnout and hindering their ability to properly care for their patients.

The nurses say they are working long hours in unsafe conditions without enough pay – a refrain echoed by several other nurses strikes across the country over the past year. The union representing the nurses said an offer of 19% pay hikes isn’t enough to solve staffing shortages.

This is the latest in a series of strikes in the health care industry in recent years. Those union members who were on the front lines during the three-year battle with the Covid pandemic say the system is no longer able to function with the widespread shortages that arose during those years.

Although tentative deals had been reached in recent days covering nurses at several hospitals, including two new agreements late Sunday evening, talks with Mount Sinai hospital on the Upper East Side in Manhattan and at three locations of the Montefiore Medical Center in the Bronx failed overnight.

“After bargaining late into the night at Montefiore and Mount Sinai Hospital yesterday, no tentative agreements were reached. Today, more than 7,000 nurses at two hospitals are on strike for fair contracts that improve patient care,” the New York State Nurses Association said in a Monday statement.

Hundreds of nurses and supporters were out on the picket line in front of Mount Sinai early Monday, filling two city blocks, with the number of pickets continuing to grow throughout the morning. The picket line spilled out onto the street, sometimes blocking traffic. At Montefiore, picketers chanted “Safe staffing saves lives.” Passing drivers at both hospitals were honking their horns in support, bringing cheers from the picket lines.

“We’ve been fighting for working under safer conditions,” Warren Urquhart, a transplant nurse at Mount Sinai, told CNN Monday while on the picket line. “We do the best we can every day. There’s something wrong inside the hospital. That’s why we’re outside the hospital.”

Cars are honking as they drive by, prompting the nurses to cheer and wave their signs.

Doreen Chulon, a nurse in Montefiore’s neurology department who has been at the hospital for 15 years said nurses in her department are forced to work without breaks or time for meals.

“We’re burned out. We’re exhausted the next day,” she said. She said the ratio has gone from one nurse for every four patients to one for every six, which is a safety problem for the department’s patients who are often confused or in altered mental states and at a high risk of falling.

Both hospitals criticized the union for going on strike rather than accept offers they described as similar to those the union accepted over the past 10 days at other hospitals in the city.

“NYSNA leadership walked out of negotiations shortly after 1 a.m. ET, refusing to accept the exact same 19.1% increased wage offer agreed to by eight other hospitals, including two other Mount Sinai Health System campuses, and disregarding the governor’s solution to avoid a strike,” Lucia Lee, a spokesperson for Mount Sinai, said in a statement to CNN.

Montefiore said it was “a sad day for New York City.”

“Despite Montefiore’s offer of a 19.1% compounded wage increase — the same offer agreed to at the wealthiest of our peer institutions — and a commitment to create over 170 new nursing positions … NYSNA’s leadership has decided to walk away from the bedsides of their patients,” the medical center said in a statement.

Overworked and burned out

Although the union has agreed to the same raises at other hospitals, it said its major complaint at Mount Sinai and Montefiore is that nurses were being overworked and facing burnout after three years of working on the frontlines, battling the pandemic. They say the hours and the stress of having too many patients to care for is driving away nurses and creating a worsening crisis in staffing and patient care.

“We need management to come to the table and provide better staffing,” NYSNA President Nancy Hagans said in a press call Sunday afternoon.

The union insists it is striking in an effort to improve patient care.

“Going into the hospital to get the care you need is NOT crossing our strike line. Patients should seek hospital care immediately if they need it,” it said in the statement. “We would rather be the ones providing that care, but our bosses have pushed us to be out here instead.”

According to Hagans, Montefiore has 760 nursing vacancies, adding that “too often one nurse in the emergency department is responsible for 20 patients instead of the standard of three patients.”

Montefiore emergency room nurse Judy Gonzalez spoke Monday of the frustration of not being able to take proper care of her patients because of the staffing shortages. At the Montefiore Moses campus, the number of unfilled positions have more than doubled since before the pandemic, she said.

“I don’t feel like I’m doing a service to my patients,” she said. “I have patients who grab my shirt, and I can’t help them because I have to do something else,” said Gonzalez, who has been at Montefiore for 40 years.

Gonzalez is a member of the union’s negotiating team. She was on the picket line early Monday after she said she was at negotiations until about 3:30 am.

On Sunday evening, New York Gov. Kathy Hochul had urged the management and the union to agree to binding arbitration as a way of avoiding the strike. Although the management of the two hospitals embraced the idea, the union did not.

“We will not give up on our fight to ensure that our patients have enough nurses at the bedside,” the union said in response to Hochul’s arbitration suggestion.

But the hospitals attacked the union’s decision to reject the arbitration offer and go on strike instead and called on nurses to reject the strike and stay on the job.

“NYSNA continues its reckless behavior. The Governor’s proposal would have provided a path to avoid a strike,” Mount Sinai said in a statement Monday. “Our first priority is the safety of our patients. We’re prepared to minimize disruption, and we encourage Mount Sinai nurses to continue providing the world-class care they’re known for, in spite of NYSNA’s strike.”

Contingency plans

The two hospitals (across four locations) now on strike make up a significant part of the city’s health care system. Together they account for 16% of all hospital beds in the city. Montefiore accounts for more than half of the beds in the Bronx.

The city has about 75,000 licensed registered nurses working at all manner of jobs, so finding replacements for 7,000 strikers will be a challenge.

The hospitals have been preparing for a strike since the nurses union gave notice of its plans 10 days ago. The affected hospitals plan on paying temporary “traveling” nurses to fill in where possible and some had already begun transferring patients. A Mount Sinai spokesperson said Monday that it has brought in “hundreds” of traveling nurses and some of the hospitals non-nursing staff has been redeployed. There are 3,600 nurses in the union at Mount Sinai.

The overall effect on the New York hospital system appear to be minor so far, according to a city official. Hospitals are said to be busy, but managing, the official said. The fire department is monitoring the system, working with affected hospitals and redirecting ambulances to other nearby hospitals. And the New York State Department of Health has posted “strike review teams” at hospitals affected by the nursing strike to review and enforce minimum staffing levels, according to a state official.

Montefiore released a notice to staff, obtained by CNN, telling nurses how to quit the union and stay on the job if they wanted to continue to care for their patients.

Mount Sinai, which operates two hospitals that reached deals Sunday evening in addition to the one still facing a strike, started transferring infants in the neonatal intensive care unit at the end of this past week. Hospitals facing the possibility of strikes had already taken steps to postpone some elective procedures.

The union says the hospitals will be spending more on hiring temporary nurses at a significantly greater cost. It argues the hospitals should agree to their demands to hire more staff and grant the raises the union is seeking.

“As nurses, our top concern is patient safety,” Hagans said in a statement Friday. “Yet nurses … have been forced to work without enough staff, stretched to our breaking point, sometimes with one nurse in the Emergency Department responsible for 20 patients. That’s not safe for nurses or our patients.”

A contentious negotiation

The hospitals say they are doing what they can to hire more nursing staff.

“Mount Sinai is dismayed by NYSNA’s reckless actions,” Mount Sinai said in a statement Friday. “The union is jeopardizing patients’ care, and it’s forcing valued Mount Sinai nurses to choose between their dedication to patient care and their own livelihoods.”

Nurses at the first hospital to reach a tentative deal, New York-Presbyterian, ratified that agreement in a result announced by the union on Saturday. It was a close call with 57% of nurses voting yes and 43% against. The tentative deals reached over the last few days still need to be ratified by rank-and-file union members before they can take effect.

Strikes have become more common nationwide, as tight labor markets and unhappiness with work conditions have prompted unionized employees to flex their muscles more often at the bargaining table.

There were 385 strikes in 2022, up 42% from 270 in 2021, according to the Cornell University School of Industrial and Labor Relations. The US Labor Department, which tracks only major strikes by 1,000 or more workers, recorded 20 strikes in the first 11 months of 2022, up 33% from the same period in 2021.

Numerous nursing strikes were among the recorded work stoppages, with many unions citing instances of burnout and health problems among members.

Four out of the 20 strikes reported by the Labor Department last year involved nurses unions. The largest was a three-day strike by the 15,000 members of the Minnesota Nurses Association involving 13 hospitals in the state.

— CNN’s Deidre McPhillips, Tina Burnside, Artemis Moshtaghian, Mark Morales and Ramishah Maruf contributed to this report.