NYC nurses strike

[Dr Mantis Toboggan]

Anyone caught up in this? Are the ERs closed etc?

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[valianteffort]

yes

 

[emergentmd]

Good for them. If they hold together, they will get what they want. They should ask for the moon. There is no way they will get enough nurses to cover these hospitals unless they get a bunch of hired guns at double the salary.

 

[miacomet]

Good for them. If they hold together, they will get what they want. They should ask for the moon. There is no way they will get enough nurses to cover these hospitals unless they get a bunch of hired guns at double the salary.

And increase staffing. Sounds like nurses at Montefiore had up to 20 patients. Insane. And no one will ever hold administrators to account.

Best of luck to the nurses.

 

[emperor tamarin]

Other hospitals getting slammered now.
Painful.
The sad part is that as usual the people who will be hurt by this are patients.
But I do hope the RNs hold strong. Wish we MDs would do the same.

 

[emergentmd]

Did they really close the ER down, if so I assume they kept the hospital open. What are the ER docs doing?

 

[alpinism]

Reportedly currently have contracts for 300/hr for travel nurses.

 

[AlmostAnMD]

Reportedly currently have contracts for 300/hr for travel nurses.

Glad we aren't the only ones willing to shoot ourselves in the foot

If they actually had national solidarity and no one took those contracts I'd feel embarrassment beyond reproach.

 

[NYEMMED]

Did/can they close the ERs? What about all the patients? What’s the long term liability to each of the nurses? IE their striking causes a patient not to receive care and dies, are they all now liable for wrongful death?
I ask this because our admin advised us of these barriers, to stifle any attempts…

 

[ScepticSkeksis]

Did/can they close the ERs? What about all the patients? What’s the long term liability to each of the nurses? IE their striking causes a patient not to receive care and dies, are they all now liable for wrongful death?
I ask this because our admin advised us of these barriers, to stifle any attempts…

Likely no liability for individual nurses. It would be hard to prove that one single nurse striking caused X patient's death. Hospitals may face liability for inability to provide adequate care.

If doctors went on strike, and agreed to only do MSEs, see real emergencies, and not staff freestanding EDs we could actually make a difference as well.

 

[BicepsTriceps]

Did/can they close the ERs? What about all the patients? What’s the long term liability to each of the nurses? IE their striking causes a patient not to receive care and dies, are they all now liable for wrongful death?
I ask this because our admin advised us of these barriers, to stifle any attempts…

They didn't abandon patients. They gave adequate notice that they won't be showing up to work starting a certain date unless their demands are met.

It's similar to giving your resignation notice.

The hospital should be liable on the other hand.

All these corporate ghouls just care about short term profit, zero long term thinking.
If they can literally put you in shackles and have you see patients 24/7 nonstop they would not hesitate to do so.
They don't adapt and adjust their beds situation to accomodate the current staff shortage. They want the remaining staff to stretch and see beyond their capacity. More staff burn out and resign and you have now more shortage. Rinse and repeat until the hospital collapse.

Where are the admins then? On to the next hospital to increase profit for couple of months to a year before destroying it again.

Speaking from first hand experience. My hospital increased bed capacity during COVID to meet demands. Staff showed up and grinded through it. Pandemic kinda ended and we rarely see COVID now but admins figured out we can just continue the current beds capacity and make more money. Month by month physicians and many nurses left one by one. The big corporate now freaking out and wondering why is this location collapsing? They will send their guys to look into it.

Their guys will have the insight of an alcoholic into their 5th withdrawal within one summer and won't see or be able to fix any thing.

I already gave my notice and counting my days out of that situation 🙂

 

[thegenius]

Did/can they close the ERs? What about all the patients? What’s the long term liability to each of the nurses? IE their striking causes a patient not to receive care and dies, are they all now liable for wrongful death?
I ask this because our admin advised us of these barriers, to stifle any attempts…

It's a scare tactic. There might be some legal problems if they immediately all went on strike. The liability part. At Kaiser here nurses and pharmacists, etc. they give admin a 1-2 weeks notice of a strike before they strike. I imagine one reason is to give the hospital time to staff the critical areas in the hospital.

 

[Dred Pirate]

One of my nurse friends posted a job up there to fill the shifts for $300 an hour "Must start tonight or tomorrow".
When someone called her out for promoting being a scab she said this was "to help the staff strike without worrying about their patients" - unless the union is paying it (which makes no sense) - this is being a scab unless I am missing something- but we all have our price.

 

[emergentmd]

If I were the union, and they are paying 300/hr right now, I would put my rate at 200/hr. The hospital in no way can keep the rate at 300/hr for very long unless the gov bails them out.

 

[RustedFox]

They didn't abandon patients. They gave adequate notice that they won't be showing up to work starting a certain date unless their demands are met.

It's similar to giving your resignation notice.

The hospital should be liable on the other hand.

All these corporate ghouls just care about short term profit, zero long term thinking.
If they can literally put you in shackles and have you see patients 24/7 nonstop they would not hesitate to do so.
They don't adapt and adjust their beds situation to accomodate the current staff shortage. They want the remaining staff to stretch and see beyond their capacity. More staff burn out and resign and you have now more shortage. Rinse and repeat until the hospital collapse.

Where are the admins then? On to the next hospital to increase profit for couple of months to a year before destroying it again.

Speaking from first hand experience. My hospital increased bed capacity during COVID to meet demands. Staff showed up and grinded through it. Pandemic kinda ended and we rarely see COVID now but admins figured out we can just continue the current beds capacity and make more money. Month by month physicians and many nurses left one by one. The big corporate now freaking out and wondering why is this location collapsing? They will send their guys to look into it.

Their guys will have the insight of an alcoholic into their 5th withdrawal within one summer and won't see or be able to fix any thing.

I already gave my notice and counting my days out of that situation 🙂

Brilliantly written.

 

[CoolDoc1729]

Other hospitals getting slammered now.
Painful.
The sad part is that as usual the people who will be hurt by this are patients.
But I do hope the RNs hold strong. Wish we MDs would do the same.

I just hate as you say that 95% of the pain will be taken by the patients while the admins relax comfortably in their beds. I can’t imagine how terrible it would be say to wait 4 months to get your really painful hip replaced, then on the day of surgery it is canceled because someone else is being greedy. This hits close to home, I had a family member die in a hospital during a nursing strike and maybe they would have anyway? I was not a doctor then and I don’t know all the details. But it makes me sick that maybe it could have been avoided if things were different. I sympathize for the however many patients 7000 nurses are responsible for.

It’s just a game for the union leaders and the hospital administrators. The whole thing has to stop being a profit motive. I’m not a communist by any means but I think in the healthcare setting the only way this even sort of works is to have a set pay rate/cap for nurses so there isn’t incentive to hop from place to place and destroy everyone’s institutional knowledge for a few bucks. There still aren’t enough nurses but at least some will stay in place long enough to know where things are.

I would strongly support capping nurse administrator and NP rates at a lower rate than bedside nurses because bedside nurses are more valuable. Maybe that would retain some nurses in actual useful bedside nursing. I would support capping rate for CEO at say 5x the bedside nurse rate. Unions and strikes are not the answer to healthcare IMO because there’s no way to implement them without harming innocent people. I would not be able to sleep for a month if I went on strike and someone died on my floor during a time I was supposed to be there, I would feel personally responsible (though I agree they have no legal liability in this setting, and I hear all of you that they gave plenty of notice to administration ). Even if doctors were allowed to unionize and strike I would never do it - the only way it is effective is if no one picks up the work, and it’s not fair to the patients for no one to pick up the work.

 

[miacomet]

I would love to hear from anyone on the ground at Mount Sinai or Montefiore....

 

[Dred Pirate]

anyone have a summary of what exactly they are asking for? Are their demands reasonable? I am guessing and sincerely hope they are - but curious as to what sorts of ratios they are asking for compared to what they are averaging now? and how much $$ compared to what they are now getting.

 

[Kryptocoin]

T

......Even if doctors were allowed to unionize and strike I would never do it - the only way it is effective is if no one picks up the work, and it’s not fair to the patients for no one to pick up the work.

Are you a med student or resident?

NYC nurses striking is not the end of the world. There are many other hospitals in NYC for patients to go. 10-20:1 staffing ratio is even more deadly than nurses going on strike.

Bad medical care is not better than no care.

 

[emergentmd]

Even if doctors were allowed to unionize and strike I would never do it - the only way it is effective is if no one picks up the work, and it’s not fair to the patients for no one to pick up the work.

Assuming you are an MD, if you were getting paid $30/hr and doing the work of 3-5 nurses, then I doubt you would feel the same.

 

[allantois]

Someone did the math and they are paying something like $30 million a day to strike nurses; meanwhile they only promised a $60 million increase to staff or so over next 3 years..

*apparently I also read somewhere that they have strike insurance for these situations

 

[allantois]

I just hate as you say that 95% of the pain will be taken by the patients while the admins relax comfortably in their beds. I can’t imagine how terrible it would be say to wait 4 months to get your really painful hip replaced, then on the day of surgery it is canceled because someone else is being greedy. This hits close to home, I had a family member die in a hospital during a nursing strike and maybe they would have anyway? I was not a doctor then and I don’t know all the details. But it makes me sick that maybe it could have been avoided if things were different. I sympathize for the however many patients 7000 nurses are responsible for.

It’s just a game for the union leaders and the hospital administrators. The whole thing has to stop being a profit motive. I’m not a communist by any means but I think in the healthcare setting the only way this even sort of works is to have a set pay rate/cap for nurses so there isn’t incentive to hop from place to place and destroy everyone’s institutional knowledge for a few bucks. There still aren’t enough nurses but at least some will stay in place long enough to know where things are.

I would strongly support capping nurse administrator and NP rates at a lower rate than bedside nurses because bedside nurses are more valuable. Maybe that would retain some nurses in actual useful bedside nursing. I would support capping rate for CEO at say 5x the bedside nurse rate. Unions and strikes are not the answer to healthcare IMO because there’s no way to implement them without harming innocent people. I would not be able to sleep for a month if I went on strike and someone died on my floor during a time I was supposed to be there, I would feel personally responsible (though I agree they have no legal liability in this setting, and I hear all of you that they gave plenty of notice to administration ). Even if doctors were allowed to unionize and strike I would never do it - the only way it is effective is if no one picks up the work, and it’s not fair to the patients for no one to pick up the work.

NPs often make same or less than RNs. In fact this is why many NPs work as RNs. I mean there's a reason they are all fleeing the bedside.

You also have an interesting take on doctors striking. I mean we do this in outpatient practice all the time - we don't take crappy paying insurances in the hopes that they will eventually raise rates if they can't get anyone in their network.

 

[miacomet]

anyone have a summary of what exactly they are asking for? Are their demands reasonable? I am guessing and sincerely hope they are - but curious as to what sorts of ratios they are asking for compared to what they are averaging now? and how much $$ compared to what they are now getting.

You must not have worked in an NYC hospital. While the rest of the country is working hard to catch up in the race to the bottom, NYC hospitals are legendarily understaffed with nurses, California it is not, and the salaries are terrible for the cost of living. Their demands are reasonable. The hospitals are trying to prove a point, and probably, like the railroads they are hamstrung by their pensions, and someone will force them to arbitrate. Unlike the railroads, these nurses can leave and find easier, higher-paying gigs anywhere.

 

[CoolDoc1729]

T


Are you a med student or resident?

NYC nurses striking is not the end of the world. There are many other hospitals in NYC for patients to go. 10-20:1 staffing ratio is even more deadly than nurses going on strike.

Bad medical care is not better than no care.

I am a 10 year attending. I agree it is not the end of the world, but I feel bad for the patients who are already in the hospitals where the strike occur.

 

[emergentmd]

I agree it is not the end of the world, but I feel bad for the patients who are already in the hospitals where the strike occur.

I think everyone agrees that pt care comes first but if they staffing half of what is needed, then dragging a dead corpse for a few more yrs not gonna help

 

[CoolDoc1729]

Assuming you are an MD, if you were getting paid $30/hr and doing the work of 3-5 nurses, then I doubt you would feel the same.

I agree. If it were up to me all nurses would get $100/h. Of course it would be nice if my husband got paid more than $17 as an experienced paramedic too. I think $30-50 would be fair for that.
I think they need to nationalize health care in terms of ratios and pay for nurses and other ancillary staff. The free market isn’t working here. I agree nurses shouldn’t have more than 4-5 patients. My hospital has them at 4. The system is still going to struggle for the next 20 years as the boomers stop working, get sick and die and there keep being less healthcare workers as the working segment of the population gets smaller. But instead of these frequent pointless and costly local standoffs Congress needs to step in and do their job for once.

 

[Kryptocoin]

I agree. If it were up to me all nurses would get $100/h. Of course it would be nice if my husband got paid more than $17 as an experienced paramedic too. I think $30-50 would be fair for that.
I think they need to nationalize health care in terms of ratios and pay for nurses and other ancillary staff. The free market isn’t working here. I agree nurses shouldn’t have more than 4-5 patients. My hospital has them at 4. The system is still going to struggle for the next 20 years as the boomers stop working, get sick and die and there keep being less healthcare workers as the working segment of the population gets smaller. But instead of these frequent pointless and costly local standoffs Congress needs to step in and do their job for once.

Unfortunately the only thing that gets Congress or politicians to act is a crisis or death. It took the death of Libby Zion for New York to institute 80-hr week for residents. Which later came became the national standard.

 

[Dred Pirate]

You must not have worked in an NYC hospital. While the rest of the country is working hard to catch up in the race to the bottom, NYC hospitals are legendarily understaffed with nurses, California it is not, and the salaries are terrible for the cost of living. Their demands are reasonable. The hospitals are trying to prove a point, and probably, like the railroads they are hamstrung by their pensions, and someone will force them to arbitrate. Unlike the railroads, these nurses can leave and find easier, higher-paying gigs anywhere.

nope- never worked anywhere close to NYC - hence why I was asking - if the patient ratios I have heard about are true - that is straight up criminal

 

[xaelia]

The sad part is that as usual the people who will be hurt by this are patients.

Not as a whole – increasing staffing is a benefit to patient safety. Short-term harms, yes, but long-term gains.

 

[EctopicFetus]

Yes it sucks bad for the patients. However, it is easy to blame the docs and nurses but the administrators make the money and create the work situation. They bare blame. They bare it all. Anyone who works in a busy Ed right now sees it. We take the dysfunction as if there was no solution. I simply say this as a mental exercise If you were the ceo of a hospital or ran your own fsed and were on shift would it look like this? Simply if I was the king we would have no holds in the Ed until every floor upstairs had at least 1-2 Ed holds upstairs waiting for beds. We would go all hands on deck if the Ed wait was an hour. I would have a runner(s) to bring non critical patients to us and Ct. Techs to draw labs, Eva to c,ean rooms. My place has little to none of this. I would see patients in the hallway. Etc etc.

we accept total dysfunction as if it is normal. In no planet is the ok. Simply if your ceo would want to be treated in the hallway then it’s fine but usually they want the good treatment. What’s right for them should be right for all. I left a shift once cause I was disgusted as a nurse was helping some 90 year old lady take a dump in the hallway on her bed. I was disgusted we would treat people like this. Good for these nurses. Screw the admins of these places. Close the hospitals down if you can’t run them right. Shut them the F down.

 

[emergentmd]

There is no way they will get enough nurses to cover these hospitals unless they get a bunch of hired guns at double the salary

Wow, I guess I was wrong. They are paying 7-10x probably for nurses that have no idea how the system works. 3 hired nurses would be equal to an experienced nurse so they literally are paying 900/hr to cover for one nurse. I would love to be a fly on the wall.

 

[allantois]

TikTok - Make Your Day

 

[CoolDoc1729]

Not as a whole – increasing staffing is a benefit to patient safety. Short-term harms, yes, but long-term gains.

I agree we need increased staffing, too, but where is it going to come from? Are there a lot of unemployed nurses techs paramedics etc just waiting for staffing and pay to be more reasonable? Again it would help for the federal government to step in and heavily subsidize people to go to nursing school and have a set high federal wage for nurses so we can take care of the increasing number of sick old people. No strike will cause there to be more nurses and everywhere is already short staffed.

They could pay a lot of nurses with the CEOs bonus, yes I agree. They could afford to pay the nurses more than they do, and they should. 20:1 ratio is abhorrent and unreasonable and I understand why these nurses are striking. But unless something happens on a National level to improve the supply of nursing staff, the situation will continue to worsen and there will continue to be local strikes and travel contracts spinning out of control robbing Peter to pay Paul and the patients lose on that. At some point most of us will be patients and I hope things improve by then.

 

[allantois]

There's tons of nurses who have quit healthcare, moved on to the NP role, moved on to non-clinical roles or non-healthcare roles. There's absolutely no shortage of nurses. How many scam insurance companies have sucked healthcare staff into their dirty business of rationing care? Bring back the LPNs if needed. Pass the tort reform. We are talking about a career that requires 3-4 years of training, not 11

 

[thegenius]

Assuming you are an MD, if you were getting paid $30/hr and doing the work of 3-5 nurses, then I doubt you would feel the same.

I would strike in a heartbeat if 1) we were allowed to and 2) the situation was right and just.

Societal change never comes easy. There is always a cost and people die for change. Our health care system is an abomination. I have Aetna platinum PPO and the premium is paid entirely by my wife's employer. This is allegedly a top of the line insurance plan. They still deny all of the psych care that we have paid for our son's shrink. They do that because they can and that's how they make money. By denying legitimate care to patients. It's such an awful system

 

[thegenius]

Unfortunately the only thing that gets Congress or politicians to act is a crisis or death. It took the death of Libby Zion for New York to institute 80-hr week for residents. Which later came became the national standard.

Problem is people are dying each year due to crappy care. Not missing their knee replacements, but literally dying by the thousands. We need a Senator or someone high profile to die as a result of this stuff who can fund a 10M legal bill to fight UNH, Aetna, Humana, Cigna, Kaiser, and all of the other bad actors

 

[emergentmd]

Man I would love to be a fly on the wall in the ER, floor, ICU. If they really are paying 300/hr, then admin is desperate. 20:1 in the ER pay better be $300/hr. This isn't worth $100 an hr.

 

[Apollyon]

Of course it would be nice if my husband got paid more than $17 as an experienced paramedic too. I think $30-50 would be fair for that.

Dude! (I know, just a term) I was paid $15/hr 21 years ago, when I worked on the bus as paramedic after grad med school and before starting internship. $17 is bad.

 

[Kryptocoin]

Problem is people are dying each year due to crappy care. Not missing their knee replacements, but literally dying by the thousands. We need a Senator or someone high profile to die as a result of this stuff who can fund a 10M legal bill to fight UNH, Aetna, Humana, Cigna, Kaiser, and all of the other bad actors

Unfortunately, not the 'right' kind of people are dying. When the family members of senators and governors are dying in the hallways, then we'll see some change. We saw how much publicity Jake Tapper's daughter got for missed appy. Imagine the heat and publicity if she died??

 

[allantois]

https://i.redd.it/y2ph14xvahba1.jpg

 

[Dred Pirate]

https://i.redd.it/y2ph14xvahba1.jpg

that sounds safe

 

[miacomet]

that sounds safe

Bet they have 0 takers, Mount Sinai has been corrupt and insane since the mid 90s, this is just more of the same.

 

[Dred Pirate]

Bet they have 0 takers, Mount Sinai has been corrupt and insane since the mid 90s, this is just more of the same.

I don't really know much about the NYC area hospitals (wife is from there, but never worked inpatient) - if half of what I have heard is true, how hasn't some regulatory board come crashing down on them? Why would any nurse (or other healthcare provider) work at this place when there are literally dozens of other options in close proximity?

I am tempted to call that number on the post and see what happens- I am willing to bet you can't get through after it was posted publicly,

 

[GassYous]

I don't really know much about the NYC area hospitals (wife is from there, but never worked inpatient) - if half of what I have heard is true, how hasn't some regulatory board come crashing down on them? Why would any nurse (or other healthcare provider) work at this place when there are literally dozens of other options in close proximity?

I am tempted to call that number on the post and see what happens- I am willing to bet you can't get through after it was posted publicly,

Probably because they don't have to do much besides pass meds. When you have phlebotomists do all the bloodwork, residents to transport patients and place ivs, LPNs to take care of the patient, why give up a good thing?

 

[miacomet]

Probably because they don't have to do much besides pass meds. When you have phlebotomists do all the bloodwork, residents to transport patients and place ivs, LPNs to take care of the patient, why give up a good thing?

This is very, and unfortunately, true.

The nurses in NYC have historically lobbied for fewer responsibilities, not better staffing. No foleys in men, no IV placement, nothing except passing meds and checking VS. This was a poor strategy on their part, and hopefully they are realizing that they should advocate for better staffing, not fewer responsibilities.

 

[JacobMcCandles]

https://i.redd.it/y2ph14xvahba1.jpg

Kind of sounds like overnight call days in residency, minus the 4 hour break and add on an additional 12 hours.

 

[Dred Pirate]

Probably because they don't have to do much besides pass meds. When you have phlebotomists do all the bloodwork, residents to transport patients and place ivs, LPNs to take care of the patient, why give up a good thing?

that seem counter intuitive to what the strike is about - on one hand I hear how horribly understaffed they ares, but if the don't have to do as much of the work, you can have a higher ratio - so like - which is it? Is it a crappy job that puts lives at danger, or are they being greedy and just asking to have the same ratios as the rest of the country but with less responsibility on each patient?

 

[miacomet]

that seem counter intuitive to what the strike is about - on one hand I hear how horribly understaffed they ares, but if the don't have to do as much of the work, you can have a higher ratio - so like - which is it? Is it a crappy job that puts lives at danger, or are they being greedy and just asking to have the same ratios as the rest of the country but with less responsibility on each patient?

20 patients is too many
In the private hospitals, nurses do a fair amount, just not as much as in, say, Iowa
But 20 patients is too many, I don't understand how people can't see that.

 

[Dred Pirate]

20 patients is too many
In the private hospitals, nurses do a fair amount, just not as much as in, say, Iowa
But 20 patients is too many, I don't understand how people can't see that.

agree completley 20 is way to many- no argument at all - I am just trying to get a clearer picture. 20 seems so ridiculous that it is just hard to believe a hospital would even begin to think that is appropriate

 

[CajunMedic]

Probably because they don't have to do much besides pass meds. When you have phlebotomists do all the bloodwork, residents to transport patients and place ivs, LPNs to take care of the patient, why give up a good thing?

I was wondering this myself. I had heard from classmates that did their residencies in NYC hospitals about the ridiculous amount of nursing tasks they did on top of being physicians.