Six weeks after the term of the New York State Nurses Association contract with a group of city hospitals ended, the two sides have yet to reach a deal, mostly because of their disagreement about defined nurse-to-patient ratios.
The contract dispute is with the New York City Hospital Alliance, a bargaining group that includes Montefiore, Mount Sinai and New York-Presbyterian. Nurses will hold informational pickets at 13 hospitals Wednesday, including those that are part of the aforementioned systems as well as Brooklyn Hospital Center, BronxCare Health System and Wyckoff Heights Medical Center in Brooklyn.
To support the need for the ratios, the union released protest of assignment summaries that catalogue nearly 2,500 complaints from nurses at Montefiore, Mount Sinai and New York-Presbyterian filed last year.
The reports describe "inadequacies in staffing and a caseload that is overwhelmingly high in both volume and acuity." The union wrote that these conditions "challenge the dedicated registered nurses who work tirelessly to protect and advocate for the patients, families and communities they serve."
In one example, a report describes a neonatal intensive-care unit with 44 babies and only three registered nurses on duty in addition to two orientee nurses. The proposed nurse-to-patient ratio in intensive-care units is 2 to 1 in the Safe Staffing for Quality Care Act, a bill backed by NYSNA that failed to pass the state Legislature.
A spokesman for the hospital alliance said the 2,500 protests of assignment represent about 0.1% of all scheduled shifts last year.
The hospitals are currently abiding by the terms of a contract agreed to in 2015, which expired Dec. 31. The staffing ratios and lack of consensus on the size of wage increases are holding up a deal, according to a source with knowledge of the talks. In past negotiations, the union's informational pickets were followed by mediation. If its members decided to vote to strike, they would need to give their employers 10 days' notice.
The hospital group spokesman noted that today's pickets are not a strike, and operations are continuing at facilities as normal.
"We continue to bargain in good faith to reach agreement with nurses on an economic package that would increase salaries and preserve and fully fund health and pension benefits," the spokesman said.
At the same time, Gov. Andrew Cuomo's executive budget proposes the state Department of Health should study the effect of health professional staffing, not just for registered nurses, and how different approaches affect quality and cost of care.
Setting staffing minimums "is safer to patients, safer for direct-care workers and in the end more cost-effective than short-sighted management efforts to cut corners and pinch pennies by skimping on patient care," Jill Furillo, NYSNA's executive director, wrote in budget testimony submitted to the Legislature. A union spokesman did not make Furillo available for comment Tuesday afternoon.
The hospital alliance spokesman disagreed that mandatory staffing ratios would improve care.
"The reality is that the union's rigid, mandated staffing ratios would lower the quality of patient care," he said. "We support a patient-first approach to staffing that is built on tailored, flexible staffing plans—designed by experienced nurses—that have proven to best meet the individual and ever-changing needs of patients."
"N.Y. nurses to picket as negotiations with hospitals drag on" originally appeared in Crain's New York Business.