7,000 nurses on strike- Mount Sinai, NY

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G.A.S Team

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Nursing union rejected a 19% pay increase. Elective cases shut down. Travel nurses brought in for a fortune (as high as $300/hr?) to try to stabilize operations. Patients including NICU transferred to other hospitals. New York Governor tried to bring the 2 parties to arbitration with no luck. Maybe residents are bedside at this point? Not sure.

Thoughts on this and the overall implication to our profession as anesthesiologists?
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G.A.S Team said:
Nursing union rejected a 19% pay increase. Elective cases shut down. Travel nurses brought in for a fortune (as high as $300/hr?) to try to stabilize operations. Patients including NICU transferred to other hospitals. New York Governor tried to bring the 2 parties to arbitration with no luck. Maybe residents are bedside at this point? Not sure.

Thoughts on this and the overall implication to our profession as anesthesiologists?
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Time for resident staff to strike too
 
G.A.S Team said:
Nursing union rejected a 19% pay increase. Elective cases shut down. Travel nurses brought in for a fortune (as high as $300/hr?) to try to stabilize operations. Patients including NICU transferred to other hospitals. New York Governor tried to bring the 2 parties to arbitration with no luck. Maybe residents are bedside at this point? Not sure.

Thoughts on this and the overall implication to our profession as anesthesiologists?
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Blows my mind given how little ny nurses have to do. I wonder if the rest of the country knows they don't have to do difficult IVs, blood draws, NG tubes, remove lines/hold pressure, or transport patients anywhere. And god forbid the CNA is busy, they'd let a patient with a balloon pump and fem cordis sit in their own sh|t for 6 hrs.
 
vector2 said:
Blows my mind given how little ny nurses have to do. I wonder if the rest of the country knows they don't have to do difficult IVs, blood draws, NG tubes, remove lines/hold pressure, or transport patients anywhere. And god forbid the CNA is busy, they'd let a patient with a balloon pump and fem cordis sit in their own sh|t for 6 hrs.
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So how does this compare to a VA nurse
 
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dchz said:
Spent a year fellowship in NY, spent many months at the VA during residency. I would say the two are somewhat on par.

I remembered when they told me a RN will not place an OG tube in NY....
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When I did my rotations at the VA we did all our medical duties and basically did all the nursing stuff as well. We drew blood. We placed IVs. We damn well administered their medications. They sat back at their nurses station. I've never seen such lazy and incompetent nurses in my life. These veterans survived being shot at but they might not survive a VA nurse. The rumors and stereotypes are true.
 
dabears505 said:
How much do these nurses want? A 20 percent increase isn't enough?
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They see travelers stroll in for a couple weeks at a time making 2-3x as much as they do. I honestly don't blame them for demanding more.

I've had this exact conversation with administrators in three hospital systems in three states the last two years. Why don't you give large raises to your staff instead of paying crazy locums and traveler rates, while your loyal local staff get angry and disillusioned and leave, worsening your staffing problem.

All three said words to the effect of Yeah well that's 1099 pay no benefits its not apples and oranges and blah blah blah, different pot of money, locums costs are temporary but pay raises are forever - and the problem has only gotten worse.

"Locums costs are temporary but pay raises are forever" is the bet they made vs the pandemic (and all its cultural and social and work-to-live philosophy effects) and it remains to be seen how much longer they'll be happy to keep doubling down and losing that bet.
 
True though that w2 pay is more valuable than 1099 pay given the benefits. 20% pay increase is very good, but maybe there were other terms that were unfavorable. Im too lazy to read the article.
 
PainInTheAnes said:
What is missed in the conversation on pay raises is that the cost of providing health insurance to employees has gone absolutely bananas in the past 10 years.

People complain “my pay doesn’t rise with inflation.” Well, in many cases it does, but assuming a person wants health insurance, then they’d be spending that extra pay on higher premiums anyway. So maybe a 2-4% nominal increase, but probably a 5-10% per year increase in the cost of insurance and benefits.

This is the hard part in providing full family health coverage to every employee regardless of their marital status, comorbidities, or dependent status. If something like the ACA comes along and health insurance costs go through the roof, an employer is gonna have to pay that cost and an employee will think it’s unfair because they don’t see the part of their pay that is spent on keeping them insured
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Yes and no. A large corporation to add extra employees to the health care plan cost them very little.

Considering most of new employees are pretty healthy. The “health care benefit” is over stated to be honest. The chances a nurse family member on a new policy will cost the hospital much is slim. Very slim.
 
Guillemot said:
True though that w2 pay is more valuable than 1099 pay given the benefits. 20% pay increase is very good, but maybe there were other terms that were unfavorable. Im too lazy to read the article.
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No no no. If the nurse is married to another husband or wife who already has benefits. Than that nurse doesn’t need the benefits.
 
pgg said:
"Locums costs are temporary but pay raises are forever" is the bet they made vs the pandemic (and all its cultural and social and work-to-live philosophy effects) and it remains to be seen how much longer they'll be happy to keep doubling down and losing that bet.
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It’s gonna be this way for a while though. It’s not like these hospitals just need to hold out just a few more months for the pandemic to end then all will revert to business as usual. It’s been 3 years. This is business as usual now, and will be for the foreseeable future. This is the new normal for young/new nurses with minimal obligations and loans to pay off. It’s a no-brained for someone in that position. Hell even seasoned nurses with serious time invested are jumping ship. Just the other day I heard one of our cardiac OR nurses who has been here for 20+ years is leaving to do travel because she “can’t afford not to in the current market”.

A year or 2 from now admins will still be sitting on their hands talking about 1099 vs W2 and different pots and “weathering the storm” while every nurse in the hospital makes $200/hr and not a single one has been there longer than 6 months.
 
agammaglobulin said:
NYT article.

www.nytimes.com

Nurses Go on Strike at 2 New York City Hospitals (Published 2023)

More than 7,000 nurses at Mount Sinai Medical Center and Montefiore Medical Center are seeking better wages and working conditions.
www.nytimes.com www.nytimes.com
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It sounds like some hospitals NY Presbyterian are paying more and they want pay to match. There are also differences in pay between the various Mount Sinai campuses. They are asking for admin to offer competitive signing bonuses to be able to hire more permanent staff. They seem to mainly be asking for enforceable staffing ratios at this point. There is NY state law establishing safe staffing ratios, but they have not been enforced.

Nah, we’ll put up a few “heroes work here” signs and call it good.
 
GravelRider said:
It sounds like some hospitals NY Presbyterian are paying more and they want pay to match. There are also differences in pay between the various Mount Sinai campuses. They are asking for admin to offer competitive signing bonuses to be able to hire more permanent staff. They seem to mainly be asking for enforceable staffing ratios at this point. There is NY state law establishing safe staffing ratios, but they have not been enforced.

Nah, we’ll put up a few “heroes work here” signs and call it good.
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and so what it there are no more nurses to be had? you post all the ratios you want the issue is few people want to go into healthcare for the fear or mental trauma of pandemics etc... and fear of poor staffing ... its a self perpetuating cycle. Now if you raise salaries 20% every year we should all go to nursing school then as they will be higher then ours
 
lotsapain said:
and so what it there are no more nurses to be had? you post all the ratios you want the issue is few people want to go into healthcare for the fear or mental trauma of pandemics etc... and fear of poor staffing ... its a self perpetuating cycle. Now if you raise salaries 20% every year we should all go to nursing school then as they will be higher then ours
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Yeah but....
"Health care is a human right."
Get used to it.
 
aneftp said:
Yes and no. A large corporation to add extra employees to the health care plan cost them very little.

Considering most of new employees are pretty healthy. The “health care benefit” is over stated to be honest. The chances a nurse family member on a new policy will cost the hospital much is slim. Very slim.
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My employer pays like $600 q 2 weeks for health insurance. They pay more for people who make less. That isn’t a big % of a physican’s pay, but a pretty hefty addition to a nurse’s pay.
 
epidural man said:
Hahahaha!

I know that I would gladly take a 50% pay cut if only my leaders would put up a “Heroes” sign. That would make all the difference.
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I hate those signs. They are patronizing and insulting, in my opinion. Even moreso when they are grammatically incorrect with regards to spelling and throwing in unnecessary possessive apostrophes, which I saw way too often.
 
NITRAS said:
My employer pays like $600 q 2 weeks for health insurance. They pay more for people who make less. That isn’t a big % of a physican’s pay, but a pretty hefty addition to a nurse’s pay.
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It’s an arbitrary number what major corporations pay for health insurance. Many are self insured as well. They just need to put a number there for cobra purposes when an employee leaves.
 
Truth here is somewhere in the middle. Unions are just doing what they were intended to do - protect their membership. Hospital admin is just doing what it was intended to - self preserve and make money of the backs of the nurses and physicians doing the work. I'm more inclined however to error on the side of the nurses in this debate though. Because it's clear that hospitals can run indefinitely with high rate locums staffing (even if you account for the cost of benefits locums are still tremendously more expensive than full time staff). If they can do that, and it's clear that they can, then they should treat their staff more fairly.
 
Our health system recently gave our nurses a 20% raise because we were way behind competing health systems. Now new grad nurses with no experience start at $60/hr. I think in northern Ca, they start at 80-90/hr. Does anybody know what they pay at Mt Sinai? Looks like one of the areas of contention is understaffing but that can be solved by offering enough money. How much is average rent in NYC?
 
nimbus said:
Our health system recently gave our nurses a 20% raise because we were way behind competing health systems. Now new grad nurses with no experience start at $60/hr. I think in northern Ca, they start at 80-90/hr. Does anybody know what they pay at Mt Sinai? Looks like one of the areas of contention is understaffing but that can be solved by offering enough money. How much is average rent in NYC?
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My old job used to pay us $83/hr for in house weekend call. I heard they just bumped it to $92/hr.

Those nurses are doing well to advocate for their worth.
 
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nimbus said:
Our health system recently gave our nurses a 20% raise because we were way behind competing health systems. Now new grad nurses with no experience start at $60/hr. I think in northern Ca, they start at 80-90/hr. Does anybody know what they pay at Mt Sinai? Looks like one of the areas of contention is understaffing but that can be solved by offering enough money. How much is average rent in NYC?
Click to expand...

You're gonna have a hard time keeping people at 60. Places here that offer 60 are hemorrhaging staff. Kaiser is at 100/h. But I hear they are hemorrhaging money so...
 
GassYous said:
You're gonna have a hard time keeping people at 60. Places here that offer 60 are hemorrhaging staff. Kaiser is at 100/h. But I hear they are hemorrhaging money so...
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How much does Kaiser pay their pediatricians…?
 
GassYous said:
You're gonna have a hard time keeping people at 60. Places here that offer 60 are hemorrhaging staff. Kaiser is at 100/h. But I hear they are hemorrhaging money so...
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We lost MANY nurses, anesthesia techs, and scrub techs to Kaiser and the university in the past 5 yrs.
 
G.A.S Team said:
Nursing union rejected a 19% pay increase. Elective cases shut down. Travel nurses brought in for a fortune (as high as $300/hr?) to try to stabilize operations. Patients including NICU transferred to other hospitals. New York Governor tried to bring the 2 parties to arbitration with no luck. Maybe residents are bedside at this point? Not sure.

Thoughts on this and the overall implication to our profession as anesthesiologists?
Click to expand...


Funny/sad that as physicians we routinely expect and take our CMS pay cuts annually...
 
and thats the "problem". they want a raise and enforced staffing ratios. the problem is that it would require WAY more nurses than supply. then a huge wage war will start to hire nurses and their wages will spiral upwards until less rich hospitals are forced to closed down. its unfortunate our patient population is sick as hell.

it is hard to control ratios in the ED in nyc. the ED can be jam packed. if you mandate 1:3 nurse to patient, what happen when the ED is busier than usual and the nurses are maxed out at their 1:3 ratio? transfer patient out to another hospital? what if its less busy and you have many nurses sitting around?

in a way this happens with CRNAs here. they can only be in 1 OR, and many of them locum/per diem at high rates and jump from hospital to hospital depending on who offers best rates. thats how they managed to get higher paid than physicians here/hour
 
HemeOncHopeful19 said:
How much does Kaiser pay their pediatricians…?
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probably less than these nurses

anbuitachi said:
they'll be cutting pay to physicians to pay for this 20% raise and staffing ratio mandates probably. where else would the $ come from
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100% guaranteed that it doesn't come from the c-suite's compensation

i'm pretty certain they will give themselves a big fat bonus at the end of this for navigating the hospital out of this self induced predicament.
 
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anbuitachi said:
and thats the "problem". they want a raise and enforced staffing ratios. the problem is that it would require WAY more nurses than supply. then a huge wage war will start to hire nurses and their wages will spiral upwards until less rich hospitals are forced to closed down. its unfortunate our patient population is sick as hell.

it is hard to control ratios in the ED in nyc. the ED can be jam packed. if you mandate 1:3 nurse to patient, what happen when the ED is busier than usual and the nurses are maxed out at their 1:3 ratio? transfer patient out to another hospital? what if its less busy and you have many nurses sitting around?

in a way this happens with CRNAs here. they can only be in 1 OR, and many of them locum/per diem at high rates and jump from hospital to hospital depending on who offers best rates. thats how they managed to get higher paid than physicians here/hour
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We demand enforced ratios, right? Would you take a job where you could be supervising 3 rooms or 10 rooms on any given day? What happens if your employer said it’s been so busy that you sometimes have to flex to 1:6 or even 1:10 supervision ratios? Would you say “sure thing boss, anything for the company” or would you demand some cap on supervision ratios and ask for a raise?

There is some truth to their rhetoric that this is a patient safety issue, but the reality is when these nurses have high ratios, it’s a damn sh*tty job and probably no amount of money would make it worth it.
 
GravelRider said:
We demand enforced ratios, right? Would you take a job where you could be supervising 3 rooms or 10 rooms on any given day? What happens if your employer said it’s been so busy that you sometimes have to flex to 1:6 or even 1:10 supervision ratios? Would you say “sure thing boss, anything for the company” or would you demand some cap on supervision ratios and ask for a raise?

There is some truth to their rhetoric that this is a patient safety issue, but the reality is when these nurses have high ratios, it’s a damn sh*tty job and probably no amount of money would make it worth it.
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That’s why we need to look at healthcare as a public service like fire, police, military. Those are essential but not money-making ventures. When they’re not running up burning buildings, firefighters sit around the firehouse, work out and make and eat chili. They’re staffed to crisis levels. The military is staffed for wartime, not peace. They are all “money losing” ventures but serve a public good. Likewise hospitals, especially in places like NYC, need to be staffed to peak/crisis levels which means people who work there will be sitting around much of the time. When I take trauma call, I sleep most nights between midnight to 6 but I’m paid to be there just in case.
 
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If this strike means bleeding the C-suite dry, by all means, strike as long as you want! I fully support any healthcare worker striking for better pay or contracts because we all get screwed in many ways by the fat cats while they laugh all the way to the bank off our sweat. We all know hospitals are sitting on a lot of money, and how they are able to afford the per diem/locums no problem but cry a river that they can't adequately pay for their own staff because no money. Our hospital system refuses to pay for staff what is appropriate rate for the market claiming money blah blah, but somehow found hundreds of millions of dollars to install Epic, build new hospital floors, expand the main campus hospital with new ORs and cancer center, while paying through the nose for locums. They give staff hero placards and sweatshirts, pennies on the dollar to make them feel "appreciated" and forget about the raises. Let them bleed
 
2Fast2Des said:
If this strike means bleeding the C-suite dry, by all means, strike as long as you want! I fully support any healthcare worker striking for better pay or contracts because we all get screwed in many ways by the fat cats while they laugh all the way to the bank off our sweat. We all know hospitals are sitting on a lot of money, and how they are able to afford the per diem/locums no problem but cry a river that they can't adequately pay for their own staff because no money. Our hospital system refuses to pay for staff what is appropriate rate for the market claiming money blah blah, but somehow found hundreds of millions of dollars to install Epic, build new hospital floors, expand the main campus hospital with new ORs and cancer center, while paying through the nose for locums. They give staff hero placards and sweatshirts, pennies on the dollar to make them feel "appreciated" and forget about the raises. Let them bleed
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Screenshot_20230111-130838_Samsung Internet.jpg


"HEROES WORK HERE"

But no you aren't getting a raise

Sincerely,

Every hospital administrator ever
 
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2Fast2Des said:
If this strike means bleeding the C-suite dry, by all means, strike as long as you want! I fully support any healthcare worker striking for better pay or contracts because we all get screwed in many ways by the fat cats while they laugh all the way to the bank off our sweat. We all know hospitals are sitting on a lot of money, and how they are able to afford the per diem/locums no problem but cry a river that they can't adequately pay for their own staff because no money. Our hospital system refuses to pay for staff what is but somehow found hundreds of millions of dollars to install Epic, build new hospital floors, expand the main campus hospital with new ORs and cancer center,
Click to expand...


The sales pitch that Epic makes is that it will pay for itself by capturing more charges. Cancer centers are usually pitched as money makers too.
 
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2Fast2Des said:
If this strike means bleeding the C-suite dry, by all means, strike as long as you want! I fully support any healthcare worker striking for better pay or contracts because we all get screwed in many ways by the fat cats while they laugh all the way to the bank off our sweat. We all know hospitals are sitting on a lot of money, and how they are able to afford the per diem/locums no problem but cry a river that they can't adequately pay for their own staff because no money. Our hospital system refuses to pay for staff what is appropriate rate for the market claiming money blah blah, but somehow found hundreds of millions of dollars to install Epic, build new hospital floors, expand the main campus hospital with new ORs and cancer center, while paying through the nose for locums. They give staff hero placards and sweatshirts, pennies on the dollar to make them feel "appreciated" and forget about the raises. Let them bleed
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To your point, I don't think the strike is entirely about money/ratios/etc. I think this is about providers being sick and tired of being dictated to by non-providers who they do not respect and it is reaching a breaking point. Ultimately, I agree that at some point healthcare will have to be regulated like other public services and these "c-suite royalty" (and even clipboard-carrying) positions will have to be eliminated. Until then, the disparity between the front line workers and their overlords will continue to fuel resentment and hostility.
Back in the era of the Rockefellers, Vanderbilts, etc. before widespread media access the wealth disparity wasn't so in-your-face. Now these things are public knowledge and familiarity breeds contempt.
 
gasdoc77 said:
Ultimately, I agree that at some point healthcare will have to be regulated like other public services and these "c-suite royalty" (and even clipboard-carrying) positions will have to be eliminated. Until then, the disparity between the front line workers and their overlords will continue to fuel resentment and hostility.
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Is there any precedent for a massive reduction in C-suite/bureaucracy in any industry in our country?

I do think it would be good for the country/system. Many of these administrators are former bedside nurses and even those who aren’t probably have the intellect/capability to be a bedside nurse if that’s where the jobs were. Not to mention it would probably be resisted by that same nursing profession because it provides an alternative career path to leave the bedside.

I just don’t really see a realistic path in that direction.
 
HemeOncHopeful19 said:
Is there any precedent for a massive reduction in C-suite/bureaucracy in any industry in our country?

I do think it would be good for the country/system. Many of these administrators are former bedside nurses and even those who aren’t probably have the intellect/capability to be a bedside nurse if that’s where the jobs were. Not to mention it would probably be resisted by that same nursing profession because it provides an alternative career path to leave the bedside.

I just don’t really see a realistic path in that direction.
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When bedside clinical work is made so unbearable and intolerable healthcare staff will seek out nonclinical roles in the very leadership positions that created this nonsense.
 
HemeOncHopeful19 said:
Is there any precedent for a massive reduction in C-suite/bureaucracy in any industry in our country?

I do think it would be good for the country/system. Many of these administrators are former bedside nurses and even those who aren’t probably have the intellect/capability to be a bedside nurse if that’s where the jobs were. Not to mention it would probably be resisted by that same nursing profession because it provides an alternative career path to leave the bedside.

I just don’t really see a realistic path in that direction.
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Changes will never be made from inside the system, as there are simply too many incumbent interests to resist anything that may take away their oversized piece of the pie. But when the macroeconomics of the country and world no longer support the system then changes will happen regardless of any opposition.

As they say, you can ignore reality but you can’t ignore the consequences of ignoring reality. And when the can has been kicked this far down the road, there’s really only one outcome which is outright collapse.

The scenario I see playing out and the one that is actively playing out (and will continue to play out) is that hospitals will go under one by one until critical threshold is reached. As a whole healthcare can’t survive when overhead costs skyrocket because revenues are largely fixed. And with the higher interest rates a lot of these organizations can’t just dip into the capital markets at 1-2% rates to bail themselves out. The gov will have to step in and socialize it all.
 
coffeebythelake said:
When bedside clinical work is made so unbearable and intolerable healthcare staff will seek out nonclinical roles in the very leadership positions that created this nonsense.
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Yes that’s what they have now. Blind leading the blind. From NYTimes

“Across the hospital, nursing managers have been pressed into service as floor nurses, even those who have not dealt directly with patients for a long time, she said. Some don’t know how to use all the equipment, so they are leaning heavily on the travel nurses who are there, she said, and the travel nurses are not familiar with all of the equipment, either.
 
HemeOncHopeful19 said:
Is there any precedent for a massive reduction in C-suite/bureaucracy in any industry in our country?

I do think it would be good for the country/system. Many of these administrators are former bedside nurses and even those who aren’t probably have the intellect/capability to be a bedside nurse if that’s where the jobs were. Not to mention it would probably be resisted by that same nursing profession because it provides an alternative career path to leave the bedside.

I just don’t really see a realistic path in that direction.
Click to expand...

I think admin will go down with the ship. I haven’t seen or even heard of massive reduction in administrative numbers. Quite the opposite, it seems very common for systems to create new admin positions every year.
 
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