Nearly 15,000 nurses at three of New York City’s largest hospitals could walk off the job early Monday in what union officials said would be the largest nurses strike in city history, if no contract agreement is reached before the weekend deadline. The New York State Nurses Association said talks had produced little progress as of Sunday morning, with staffing levels, guardrails on the use of artificial intelligence, and workplace security among unresolved disputes at Mount Sinai, Montefiore Medical Center, and NewYork-Presbyterian/Columbia University Irving Medical Center.
The threatened walkout comes during a severe flu season and three years after the same union mounted a three-day strike at two of the same hospitals — a precedent whose gains nurses say the affected medical centers have since partially reversed.
Staffing, AI, and safety at the center of the dispute
Staffing levels remain the central flashpoint in the current negotiations, as they were in 2023. Nurses say the hospitals are refusing to commit to — or are actively backsliding on — provisions for manageable, safe workloads. The union is also pushing for restrictions on how hospitals deploy artificial intelligence and for additional workplace security measures.
Security concerns took on added urgency after a gunman entered Mount Sinai in November and a man with a sharp object barricaded himself in a Brooklyn hospital room this past week; both men were killed by police.
Scores of nurses rallied in Manhattan on Friday. “My hospital tries to cut corners on staffing every day, and then they try to fight historic gains we made three years ago,” said Sophie Boland, a pediatric intensive care nurse in the NewYork-Presbyterian hospital system.
The hospitals involved say they have made meaningful staffing improvements since 2023 and described the union’s combined demands as far too expensive. In a joint statement issued Thursday, the hospitals called the strike threat “reckless” and vowed “to do whatever is necessary to minimize disruptions.”
Nancy Hagans, president of the New York State Nurses Association, said patients should not delay care during any potential strike. A vast majority of the union’s members voted last month to authorize one.
Hospitals prepare for a possible walkout
Mount Sinai has hired more than 1,000 temporary nurses and conducted preparatory drills. A strike would potentially affect its 1,100-bed flagship Manhattan hospital and two affiliates — Mount Sinai Morningside and Mount Sinai West, each with about 500 beds.
NewYork-Presbyterian said it had also arranged for temporary nurses but warned that some patients might be moved to new rooms or advised to transfer to another facility if a strike occurs. Montefiore posted a message to patients assuring that appointments would be kept.
New York Gov. Kathy Hochul urged both sides Friday “to stay at the table and get a deal done,” expressing concern about the effect a strike could have on patient care.
A 2023 agreement and its disputed legacy
The same union staged a three-day strike at Mount Sinai and Montefiore in January 2023, when nurses emphasized their sacrifices during the COVID-19 pandemic and the national nurse staffing crisis that followed. The walkout prompted the hospitals to postpone non-emergency surgeries, divert ambulances, and transfer patients including intensive-care infants.
The 2023 strike ended with an agreement on raises totaling 19% over three years and staffing improvements, including the possibility of additional pay when nurses were required to work short-handed.
Union nurses say the hospitals are now retreating from those commitments. Michelle Gonzalez, a Montefiore intensive care nurse, said Friday that nurses still scramble to treat patients boarding in emergency room hallways three years after Montefiore agreed to make “all reasonable efforts” to reduce that practice.
Montefiore has said it has made some progress, telling elected officials in a letter in October that there had been a 35% reduction in the time from emergency admission to placement in a clinical unit bed. The hospitals also say they have greatly reduced nursing job vacancy rates since 2023, and that Mount Sinai and NewYork-Presbyterian/Columbia Irving University Medical Center have added hundreds of nursing positions.
Several smaller hospitals, including multiple Northwell Health facilities on Long Island, averted potential walkouts in recent days by reaching agreements or making what the union regarded as adequate progress toward one.