NYC nurses strike

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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
New York hospitals are insane. A few are great (Special Surgery, for example).
Nurses do fewer tasks in NYC because the hospitals have always relied on residents (not sure why the Boston hospitals are different, but they are) since there is an overabundance of residents all over NYC, which led to hospitals staffing nurses really thin. NYC nursing in the private hospitals is starting to be much better, and now they need....more nurses.

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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.
See all those NPs running IV clinics? Med spas? They were once nurses. Techs, they are everywhere. Hospitals dont want to pay. And yes they are waiting for better pay and staffing. The strike will improve pay and force better staffing and that will lead to more nurses wanting to work. There are a ton of nurses they just decided to go to online school and play noctor. It is easy to blame the nurses but the hospitals are there to serve the people. The nurse can work in a clinic or do whatever they want. It is the hospitals role to make the work environemnt safe and appealing to hire people.
 
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The CEO of Ascension made $13.5 MILLION in 2019.

F' them.
The. He left and runs their private equity fund and makes $11m now. What a planet. Non profits run amok.
 
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All of the non profits are a scam. All it literally means is they attach a mission/donate some $$$ to a charitable entity and get the tax benefits to pay their management large fees. Non profits should not have billions stashed away.
 
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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.

At Columbia where I trained we would often put in IVs, drag people down to CT, help the CT tech prioritize who needs to go first. Not a good system
 
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I would love to read their contracts. I wonder how they could ensure staffing ratios by hiring enough staff.. I understand they already have 750 nurse vacancies at these hospitals
 
I would love to read their contracts. I wonder how they could ensure staffing ratios by hiring enough staff.. I understand they already have 750 nurse vacancies at these hospitals

By taking all the hundreds of clipboard nurse administrators and throwing them back into the wards? Just kidding. They are probably worse than useless clinically
 
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I would love to read their contracts. I wonder how they could ensure staffing ratios by hiring enough staff.. I understand they already have 750 nurse vacancies at these hospitals
It's the same everywhere – our ED has something like 40 nurse FTE approved but unable to hire. Same story everywhere – effectively always poaching from some other aspect of the health system that also is short nursing FTE.

Though we don't have as much of the "med spa" down here.
 
I would love to read their contracts. I wonder how they could ensure staffing ratios by hiring enough staff.. I understand they already have 750 nurse vacancies at these hospitals
If (and this is a big if) the new contract is better than competitors across town they will poach nurses from them? I mean around here nurses change jobs more often than any other profession I know,
 
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If (and this is a big if) the new contract is better than competitors across town they will poach nurses from them? I mean around here nurses change jobs more often than any other profession I know,

What do they have to bid against each other really besides salary? My understanding is nurses in NYC easily start at $50 an hour, which for NYC living is not a whole lot
 
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What do they have to bid against each other really besides salary? My understanding is nurses in NYC easily start at $50 an hour, which for NYC living is not a whole lot
again- without knowing the NYC market I don't know - but here it is salary, benefits (retirement, health insurance, working conditions, etc)
Nurses also seem to jump ship for a slight raise without thinking of the long term consequences more than most people as well.
 
I would love to read their contracts. I wonder how they could ensure staffing ratios by hiring enough staff.. I understand they already have 750 nurse vacancies at these hospitals

The article I read said there is a financial penalty attached for any staffing violation. Basically the hospital gets fined every time they failed to properly staff the inpt beds.

This basically means decrease in hospital bed capacity and massive boarding in the ER. That's my guess. Glad I'm not working in NY.
 
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The article I read said there is a financial penalty attached for any staffing violation. Basically the hospital gets fined every time they failed to properly staff the inpt beds.

This basically means decrease in hospital bed capacity and massive boarding in the ER. That's my guess. Glad I'm not working in NY.
Yep but with more $$$ maybe easier to hire?

It’s amazing how the hospital can suddenly find 20% more to pay nurses. All docs should learn from the power of a collective. We suck so bad at it. Summa was the main example that inflicted real pain. They lost but everyone else in em won. It showed how much pain can be inflicted.

I am tired of the belief that crappy care is better than no care. The crap hole (not all) critical access hospitals staffed with only noctors or non em people need to shut down. Become what they are. An urgent care.
 
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The article I read said there is a financial penalty attached for any staffing violation. Basically the hospital gets fined every time they failed to properly staff the inpt beds.

This basically means decrease in hospital bed capacity and massive boarding in the ER. That's my guess. Glad I'm not working in NY.

How significant the fine? Or is it like when massive corporations make billions doing shady illegal **** and get fined 100k?

They save more money understaffing and paying the fine?
 
How significant the fine? Or is it like when massive corporations make billions doing shady illegal **** and get fined 100k?

They save more money understaffing and paying the fine?
They’ve got to put the money in the swear jar. At the end of the year the day shift and night shift nurses get 4 large pizzas per shift and the admins get the rest of the money.
 
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People will come out of this praising these nurses because "they are nurses" and "they are the only ones who care about patients" despite the horrible patient care and neglect that has occurred over the past few days due to the disagreement between the hospital and nursing staff. It's not like patients stop getting sick during this time. Some of the poignant stories from the boots on the ground show just how much of a **** show this was. Patient morbidity and mortality almost certainly went up during this time, although the hospital will try to cover this up. A strike of this magnitude is a pretty damn destructive way of getting to what these nurses wanted. It's like using the nuclear option. They could have done "work-to-rule" if they wanted to renegotiate their salary and work conditions.
 
People will come out of this praising these nurses because "they are nurses" and "they are the only ones who care about patients" despite the horrible patient care and neglect that has occurred over the past few days due to the disagreement between the hospital and nursing staff. It's not like patients stop getting sick during this time. Some of the poignant stories from the boots on the ground show just how much of a **** show this was. Patient morbidity and mortality almost certainly went up during this time, although the hospital will try to cover this up. A strike of this magnitude is a pretty damn destructive way of getting to what these nurses wanted. It's like using the nuclear option. They could have done "work-to-rule" if they wanted to renegotiate their salary and work conditions.

You have examples?
 
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Nursing in NYC is very different than nursing in the rest of the country.
In NYC nurses do not do: IVs, medication dosing (all comes from pharmacy), foleys, toileting/ambulating assistance, Foleys, etc etc etc. basically everything is done by a resident, the nurses literally only give medications (and most of the time they hand it to the resident to give)
Nurses across the country deserve raises for all they do and deal with, but NYC may not be a great nursing role model.
 
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Nursing in NYC is very different than nursing in the rest of the country.
In NYC nurses do not do: IVs, medication dosing (all comes from pharmacy), foleys, toileting/ambulating assistance, Foleys, etc etc etc. basically everything is done by a resident, the nurses literally only give medications (and most of the time they hand it to the resident to give)
Nurses across the country deserve raises for all they do and deal with, but NYC may not be a great nursing role model.
Have had multiple family members as patients at CPMC, to my surprise nurses gave meds and started IVs, helped with ambulation. Urology nurse certainly did foleys, can't speak to regular floor nurses.

It's shocking residents are giving out meds, I can't believe that's allowed.
 
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People will come out of this praising these nurses because "they are nurses" and "they are the only ones who care about patients" despite the horrible patient care and neglect that has occurred over the past few days due to the disagreement between the hospital and nursing staff. It's not like patients stop getting sick during this time. Some of the poignant stories from the boots on the ground show just how much of a **** show this was. Patient morbidity and mortality almost certainly went up during this time, although the hospital will try to cover this up. A strike of this magnitude is a pretty damn destructive way of getting to what these nurses wanted. It's like using the nuclear option. They could have done "work-to-rule" if they wanted to renegotiate their salary and work conditions.
I would love to see an actual peer reviewed study comparing the mortality during the strike to before the strike and after the strike (with the new contract)
 
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Have had multiple family members as patients at CPMC, to my surprise nurses gave meds and started IVs, helped with ambulation. Urology nurse certainly did foleys, can't speak to regular floor nurses.

It's shocking residents are giving out meds, I can't believe that's allowed.
Unless things have changed recently, I don't believe that's true. I have several friends who trained in NYC or Brooklyn and I know that putting in IVs, pushing patients to CT and back and tons of other menial non-doctor work was all commonplace. I don't recall any of them ever saying that the nurse would go get meds from the Pixys and then hand them to the resident to administer. Honestly, it doesn't make sense from an effort point of view. It's easier to find the patient than it is to find the resident most of the time and then you don't need to worry about getting in trouble (hah!) for losing the meds you pulled.
 
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I dont quite understand the "how dare nurses strike stuff". What if you as an ED doc went into work and they kept loading you with 10 patients per hour. When you would say, man this is insane. I am done working and that hospital then doesnt have an EM doc and they have to staff with an MLP. IS the answer man how could that doc quit, i mean the outcomes are so much worse now than before because they have someone who isnt well trained there. Outcomes are gonna be way worse.

is that the fault of the EM doc or the hospital? Similar here. Simply, hospitals and insurers are destroying healthcare, treating patients poorly etc. Thats the fault of hospitals and insurers and not the docs or nurses.
 
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I dont quite understand the "how dare nurses strike stuff". What if you as an ED doc went into work and they kept loading you with 10 patients per hour. When you would say, man this is insane. I am done working and that hospital then doesnt have an EM doc and they have to staff with an MLP. IS the answer man how could that doc quit, i mean the outcomes are so much worse now than before because they have someone who isnt well trained there. Outcomes are gonna be way worse.

is that the fault of the EM doc or the hospital? Similar here. Simply, hospitals and insurers are destroying healthcare, treating patients poorly etc. Thats the fault of hospitals and insurers and not the docs or nurses.

Because there is a safe and reasonable way to strike in healthcare: show up to work and take care of the patients, but not do any of the documentation that the hospitals use to bill (both doctors and nurses can do this)

And then there is a selfish and dangerous way to strike: not show up to work and force intubated NICU and PICU kids to be transferred, surgeries to be cancelled, etc

Which "puts patients first"?. Hint: not the way the nurses at Sinai and Monte did it.
 
Because there is a safe and reasonable way to strike in healthcare: show up to work and take care of the patients, but not do any of the documentation that the hospitals use to bill (both doctors and nurses can do this)

And then there is a selfish and dangerous way to strike: not show up to work and force intubated NICU and PICU kids to be transferred, surgeries to be cancelled, etc

Which "puts patients first"?. Hint: not the way the nurses at Sinai and Monte did it.
But striking is a legal right for nurses in New York, while not documenting would put them at huge legal/licensure risk. Come on.
 
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But striking is a legal right for nurses in New York, while not documenting would put them at huge legal/licensure risk. Come on.

This attitude is what lets nurses keep this moral superiority thing they have going on where they can literally force intubated sick children be transferred, yet still be celebrated as heroes.

Yet physicians are villified lol.
 
This attitude is what lets nurses keep this moral superiority thing they have going on where they can literally force intubated sick children be transferred, yet still be celebrated as heroes.

Yet physicians are villified lol.
Don't hate the player, hate the game.
Maybe you should advocate for a legal right not to document, if you want things to better, instead of castigating people for using the only tools they have.
 
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Don't hate the player, hate the game.
Maybe you should advocate for a legal right not to document, if you want things to better, instead of castigating people for using the only tools they have.

Yeah I dunno you might feel differently if your kids heart transplant surgery was affected so that some nurses can get a 19% compounding raise for 5 yrs.

Man the simping to nurses here is insufferable. Just know that the same would not be repaid to us.
 
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Yeah I dunno you might feel differently if your kids heart transplant surgery was affected so that some nurses can get a 19% compounding raise for 5 yrs.

Man the simping to nurses here is insufferable. Just know that the same would not be repaid to us.
They were offered that before they went on strike. They went on strike because of understaffing and patient care issues. #facts
 
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They were offered that before they went on strike. They went on strike because of understaffing and patient care issues. #facts

Yawnnnnnnn.

Staffing ratios on floor = floor nurses capped = patients boarding in ED = ER physicians, nurses and patients f***ed.

Yano who doesn't board in the ED? The patients who were pre-scheduled for expensive spine and joint surgeries.

It's a feature, not a bug.
 
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Yawnnnnnnn.

Staffing ratios on floor = floor nurses capped = patients boarding in ED = ER physicians, nurses and patients f***ed.

Yano who doesn't board in the ED? The patients who were pre-scheduled for expensive spine and joint surgeries.

It's a feature, not a bug.
So, what's your solution?
 
Yep. It sucks for patients but so does a terribly run hospital who is busy hiring another DEI leader and a semi *****ic Noctor to follow meaningless metrics after the total ***** left for the cno position.

Yeah, I’m not blaming the nurses. The hospitals had ample time to respond. It’s not like they announced the strike and it was on in 24 hours. Hospital could have mitigated things. In the end they need the labor, the labor stuck together and the Freddy crappy run hospitals blinked.

Again, I don’t blame the nurses.
 
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Yes, nursing ratios on floors can lead to caps and increased ED boarding.

Despite this fact, I can still support nurses who want reasonable pay and working environments, and see they both personally benefit and ALSO have a true point about safety/quality of care.

Things can be nuanced.

In MA, ICU RNs are (basically) capped at 2:1 by law, other areas of the hospital have no legal caps (though various union shops and organizations may have internal rules).

This can create an interesting situation where an ICU can have 2 empty beds, 3 RNs and 6 semi-stable ICU patients, while the ED has 5 RN (including one supposedly acting as charge/resource) with 40 patients of whom 4 are ICU holds, 4 are med-surg holds, 4 are psych holds and 28 are on-going ED patients. Clearly depending how you do the math the ED is slammed (2 RN for 4ICU patient, 1 resource, 2 RN for… 36 patients?!… or pretend they are all 8:1 and sharing the ICU patients?)… but it isn’t violating state law while placing another patient into the ICU is…

While this troubles me, I do completely understand why the 2:1 ICU law was passed.
 
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CA nurses have enforced ratios even in ED.
 
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CA nurses have enforced ratios even in ED.
In my states now as well. Nurses have a set cap which is set by the state. It can only be exceeded once the hospital files a reason on a shift by shift basis to the state.

ED: 1:4
ICU: 1:2
Step down 1:4
Med surg 1:7

Etc
 
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In my states now as well. Nurses have a set cap which is set by the state. It can only be exceeded once the hospital files a reason on a shift by shift basis to the state.

ED: 1:4
ICU: 1:2
Step down 1:4
Med surg 1:7

Etc

*Cries in boarding*
 
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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
A major insurer auto-denied claims from our group last year for something like $2M. I don't think they've paid us anything yet.
 
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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.
Um, WTF do they do then?
 
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Yep. It sucks for patients but so does a terribly run hospital who is busy hiring another DEI leader and a semi *****ic Noctor to follow meaningless metrics after the total ***** left for the cno position.

Yeah, I’m not blaming the nurses. The hospitals had ample time to respond. It’s not like they announced the strike and it was on in 24 hours. Hospital could have mitigated things. In the end they need the labor, the labor stuck together and the Freddy crappy run hospitals blinked.

Again, I don’t blame the nurses.

That's all well and good, I just don't wanna hear the complaining from all the NYC docs when they get their pay slashed.

Where do you think the money comes from?
 
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Also are they now going to function as a nurse (draw blood, place IVs, transport patients)?

Sign me up for the job where I make 160k to pass meds to 20 patients and have no liability and no student debt. I'm tots down.
 
In a way higher nursing salaries (especially for travelers) is ultimately going to lead to more nurses being able to save up enough money to leave the profession or afford to work part-time. It is very short-sighted on the part of hospital admin not to increase staff wages over hiring travelers which would down the line exacerbate staff issues. But maybe it's going to take people dying in ED before being seen for politicians to pass meaningful reform such as tort reform so that BS complaints are not sent to the ED in the first place just to shift the medicolegal responsibility to the ED, among other issues
 
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That's all well and good, I just don't wanna hear the complaining from all the NYC docs when they get their pay slashed.

Where do you think the money comes from?

Thats my fear. We have nurses here who have cleared 400k. They were staff, went per diem/locums, work st the same freakin hospital but just do incentive and overtime shifts on top of the shift differential, overtime, weekend pay, etc. These nurses are making more than the hospitalists.

When the powers that be look at the budget, theres no chance of the employed docs getting raises or even cost of living adjustments anytime soon. I just hope my pay isnt slashed in the next few years.
 
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CA nurses have enforced ratios even in ED.
What happens when there are more patients and they exceed the ratio? Like say a critical patient rolls in? What happens? Does the hospital have to call in more nurses? I'm genuinely curious.
 
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So whenever the ER nurses have their max ratios the ER does not accept new patients.

Ambulances will often "hold the wall" and wait for as much as 6-12 hrs transferring patients.

This does not include the critical cases that are taken back and seen in the resus room.
 
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So whenever the ER nurses have their max ratios the ER does not accept new patients.

Ambulances will often "hold the wall" and wait for as much as 6-12 hrs transferring patients.

This does not include the critical cases that are taken back and seen in the resus room.
At least we let the medics give report to the triage nurses and then they leave.
 
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At least we let the medics give report to the triage nurses and then they leave.
As the wife of a paramedic I appreciate that! If he takes his last call to my hospital he gets home on time. If he takes his last call to the hospital across town they make him sit there up to 2 hours over his shift. It’s pretty frustrating at the end of a 24h shift !
 
nurses make way more per diem/locum with way more flexibility. also with the staffing ratio rules, we dont have enough nurses to fill all the spots. its a viscous cycle.
 
From a nursing/physician standpoint, the solution is to just do MSEs. Document that you don't have capacity to care for non-emergent cases. Get vitals, quick 1 minute H&P, and if no emergency, then DC. Probably 20-30% of ED patients could qualify for an MSE and DC.
 
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