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NY Nurses Reach Landmark Agreement


After weeks of intense negotiations, the New York State Nurses Association has reached a landmark agreement with three of the state’s largest hospital systems: Mount Sinai, New York-Presbyterian and Montefiore. The agreement includes a four-year contract that calls for minimum staffing ratios, annual pay raises for nurses, and the hiring of over 1,450 new nurses. While union leaders have yet to officially ratify the agreement, the decision could have lasting implications for nurses and hospitals around the country. Learn more about this historic agreement and what it means for the future of healthcare.

How NY Nurses Fought Their Way to Victory

Over 10,000 nurses threatened to strike earlier this month over the ongoing contract negotiations, accusing hospital administrators of spreading misinformation regarding minimum staffing ratios and choosing profits over the well-being of patients. With some nurses responsible for as many as 18 patients at a time, NY nurses started calling for mandatory minimum staffing ratios so they could better care for their patients. Hospital administrators refused to give in, arguing mandatory staffing ratios lead to wasteful spending without benefiting patients. As the negotiations lingered on, the New York State Nurses Association held firm, refusing to back down from their earlier demands. After deciding not to strike, union officials went back to the negotiating table to work out a deal. 

The Details of the Agreement

Less than two weeks later, both parties emerged with a historic agreement, including a four-year contract between the union and all three hospital systems. The agreement calls for the following:

  • Annual pay raises of 3 percent for nurses
  • Filling around 800 vacant nursing jobs
  • A budget increase of $25 million a year to hire additional nurses
  • Minimum nurse-to-patient staffing ratios in each treatment unit

While the terms of these staffing ratios have yet to be decided, different ratios will be implemented in each treatment unit. Some units, including ERs and trauma centers, may have a one-to-one nurse-patient ratio, while others could be as high as eight patients per nurse. Nurse representatives will meet with managers within the next month to set minimum staffing levels for each unit in the hospitals, based on patient demand.

The agreement is the culmination of years of hard work. New York nurses have been calling for mandatory staffing ratios for years, citing numerous benefits for patients. With higher staffing ratios and more nurses on the floor, nurses in every unit will be able to spend more time with their patients. Numerous studies have highlighted the benefits of mandatory staffing ratios. California is the only other state with mandatory staff ratios, with the following ratios in place:

  • 6:1 patient-to-nurse workload in psychiatrics
  • 5:1 patient-to-nurse in medical-surgical units, telemetry, and oncology
  • 4:1 in pediatrics
  • 3:1 in labor and delivery units
  • 2:1 in intensive care units

According to Health Services Research, patient outcomes improve when staffing levels meet those established in California, including reduced mortality rates, shorter hospital stays, and general improvement in the quality care. Mandatory staffing levels also help hospitals save money by reducing nurse turnover. When hospitals exceed these ratios, nursing turnover increases and patient satisfaction decreases, both of which inflate the cost of care and impede hospital funding.

The Lasting Implications of the Agreement

Mandatory staffing ratios have been controversial ever since California implemented the law back in 2003. Numerous nursing unions and organizations have been arguing for mandatory staffing ratios in recent years, with contested contract negotiations taking place all over the country. More hospitals may adopt these policies in the years ahead if they prove to be a success in New York. The agreement also gives nurses more authority in the workplace. Nursing representatives will work with managers to determine adequate staffing levels, setting a trend for more nursing autonomy at other hospitals around the country.

For years, nursing organizations have been pushing NY legislatures to implement mandatory staffing levels and the New York State Nurses Association has succeeded where state legislators have failed, thanks to the power of collective negotiation. Hopefully, more hospitals and states will enact these polices down the line, so patients can get the care they deserve.



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